有限元分析在腰椎手法治疗中的生物力学研究进展

中医腰椎手法在腰痛等慢性损伤性腰椎病的疼痛治疗中有明显的临床优势，但其基础研究不足是限制手法进步的重要因素。利用有限元技术能够很好地模拟各类腰椎手法的力学状况，分析其作用机制、验证假说，规范手法操作，定量、定性和优化治疗方案，为手法治疗的基础研究提供有效的研究方法。通过回顾近年腰椎手法治疗的有限元研究，探讨不同腰椎手法对椎间盘、附属结构、脊柱负荷以及椎体力学稳定性的影响，结果发现目前关于腰椎手法的有限元研究有待于对模拟方法进行标准化和精确化，同时可进一步推广有限元的研究思路，更好地指导中医腰椎手法的临床运用。
The spinal manipulation in traditional Chinese medicine (TCM) has a prominent clinical advantage in the treatment of chronic lumbar pain, such as low back pain, but the insufficient basic research on manipulation is a serious obstacle to its development. Using finite element analysis (FEA) can preferably simulate the mechanics under various kinds of spinal manipulation, analyze its action mechanism, test the hypothesis, standardize the operating practices, make quantitative, qualitative and optimal treatment plans, so as to provide an effective method for the basic research on manipulation therapy. This paper reviews the FEA studies of spinal manipulation in recent years, discusses the influence of different spinal manipulation on intervertebral disc, lumbar accessory structures, spinal loads and mechanical stability of the vertebral body. The results show that current FEA studies on spinal manipulation need to make the simulation method standardized and precise. Meanwhile, the research ideas of finite element method should be developed to guide the clinical application of spinal manipulation.