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投稿时间：2024-10-25 网络发布日期：2025-07-21
投稿时间：2024-10-25 网络发布日期：2025-07-21
中文摘要: 目的 基于倾向性评分匹配（PSM），探讨腰椎峡部裂正骨手法治疗与峡部修复术治疗的疗效。方法 回顾性分析2019年9月至2023年4月空军特色医学中心收治的130例腰椎峡部裂患者临床资料，将采用正骨手法治疗的70例患者纳入正骨组，峡部修复术治疗的60例患者纳入修复术组。基于PSM对两组患者一般资料进行匹配，得到45对组间协变量均衡的样本，比较两组恢复情况，不同时点间腰椎峡部裂主观症状与体征评分、视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）评分及并发症发生情况。结果 PSM后两组恢复情况均良好，但正骨组治疗费用低于修复术组，修复术组住院时间短于正骨组（P<0.05）。两组出院时腰椎峡部裂主观症状与体征评分均高于治疗前，且正骨组高于修复术组（P<0.05）。治疗后，两组VAS评分、ODI评分较治疗前均降低，且正骨组治疗1个月后VAS评分、ODI评分低于修复术组，治疗3个月后ODI评分高于修复术组（P<0.05）。住院期间，修复术组术后并发症发生率高于正骨组（20.00% vs 4.44%，χ2=5.075，P<0.05）。结论 采用正骨手法、峡部修复术治疗腰椎峡部裂，患者均可获益，其中正骨手法治疗的费用相对较少、短期恢复情况相对较好，峡部修复术治疗周期短、预后相对较好。
Abstract:Objective Based on propensity score matching（PSM）， the therapeutic effects of manual orthopedic manipulation and isthmus repair for lumbar spondylolysis were explored. Methods A retrospective analysis was conducted on the clinical data of 130 patients with lumbar spondylolysis treated at the Air Force Special Medical Center from September 2019 to April 2023. Seventy patients treated with manual orthopedic manipulation were assigned to the orthopedic group，and 60 patients treated with isthmus repair were assigned to the repair group.PSM was used to match the general characteristics of the two groups，resulting in 45 pairs of patients with balanced covariates. The recovery conditions of the two groups were compared ，as well as the subjective symptom and sign scores of lumbar spondylolysis ，Visual Analogue Scale（VAS）scores，Oswestry Disability Index（ODI）scores and the occurrence of complications at different time points.Results After PSM，both groups showed favorable recovery outcomes. However，the treatment cost in the orthopedic group was lower than that in the repair group，while the hospitalization time in the repair group was shorter than that in the orthopedic group（P<0.05）. The subjective symptom and sign scores of lumbar spondylolysis in both groups at discharge were higher than that before treatment， and the scores in the orthopedic group were higher than that in the repair group（P<0.05）. After treatment，both groups showed reduced VAS and ODI scores compared to pre-treatment levels（P<0.05）. The orthopedic group had lower VAS and ODI scores at 1 month post-treatment，but higher ODI scores at 3 months post-treatment compared to the repair group（P<0.05）. During hospitalization ，the repair group had a higher incidence of postoperative complications than the orthopedic group（20.00% vs 4.44%，χ2=5.075，P<0.05）. Conclusion Both manual orthopedic manipulation and isthmus repair are beneficial for patients with lumbar spondylolysis. Manual orthopedic manipulation has a lower costs and a better short-term recovery outcome ，while isthmus repair offers a shorter treatment cycle and better long-term prognosis.
keywords: Lumbar spondylolysis Manual orthopedic manipulation Isthmus repair Propensity score matching Visual Analog Scale Oswestry Disability Index
文章编号： 中图分类号：R687 文献标志码：A
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附件
| Author Name | Affiliation |
| 娄宏达，范宇，冯宇，王子昀，那锏 |
引用文本：
娄宏达，范宇，冯宇，王子昀，那锏.腰椎峡部裂正骨手法与峡部修复术的疗效比较[J].中国临床研究,2025,38(7):1082-1086.
娄宏达，范宇，冯宇，王子昀，那锏.腰椎峡部裂正骨手法与峡部修复术的疗效比较[J].中国临床研究,2025,38(7):1082-1086.