据估计，高达 84%的成年人在一生中会有下背痛的经验。下背痛最常见的原因爲机械性下背痛（占97%），其中腰部扭伤占大部分70%，其他原因包含退化性椎间盘、椎间盘突出。此外，在针刀治疗理论中，第三腰椎横突综合症是常见的病因之一。目前的治疗方法主要有药物和非药物治疗：药物治疗通常包括Acetaminophen或非类固醇类止痛药（NSAID）；非药物治疗包含物理治疗、局部封闭治疗、及手术治疗等。虽然大多数能即时缓解疼痛等不适症状，但是仍存在药物不良反应、依赖性以及停药後病情反复、手术费用高等问题。本病例是一名74岁女性，右侧腰痛症状已10年，疼痛延伸至右侧臀部，伴随右下肢麻电感，踩地刺痛，两脚掌麻症状。MRI检查显示腰椎滑脱（Grade 1 spondylolisthesis L4/5, L5/S1）及椎间盘突出伴有神经根压迫（L4/5、L5/S1），於112/01/09至本院中医部门诊经Activator Methods Chiropractic Technique（AMCT）诊断治疗、针灸治疗及两次针刀治疗松解第三腰椎横突後，下背痛及下肢电麻感症状于一个月内大幅改善（VAS由7分降至1-2分）。此爲慢性下背痛合并第三腰椎横突综合症，经中医椎体偏位矫正、针灸治疗搭配针刀松解第三腰椎横突，分阶段由骨头、肌肉及筋膜多层次介入之治疗经验。 【关键词】脊椎滑脱 ； 椎间盘突出 ； 第三腰椎综合症 ； 针刀 ； AMCT |
According to estimates, up to 84% of adults will experience lower back pain in their lifetime. The most common cause of lower back pain is mechanical lower back pain (acing for 97%), with lumbar strain acing for the majority at 70%, degenerative disc disease at 10%, disc herniation at 4%, osteoporotic compression fractures at 4%, spinal stenosis at 3%, and spondylolisthesis at 2%. In addition, among the causes of low back pain, the transverse process syndrome of third lumbar vertebra is one of the common causes, acing for 33-50% of low back pain. The current treatment methods mainly include medication and non-medication treatments: medication treatment usually includes acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs); non-medication treatment includes physical therapy, local injection therapy, and surgical treatment. Although most treatments can relieve pain and discomfort symptoms immediately, there are still issues such as adverse drug reactions, dependence, relapse after drug withdrawal, and high surgical costs. This case involves a 74-year-old female with right-sided lower back pain for 10 years, which extended to the buttocks, accompanied by numbness and tingling sensations in the right lower limb and numbness in both feet, as well as stabbing pain when walking. MRI examination showed spondylolisthesis (Grade 1) and disc herniation with nerve root compression. After diagnosis and treatment by Activator Methods Chiropractic Technique (AMCT), acupuncture and acupotomy treatment to release the transverse process of the third lumbar vertebrae, the lower back pain and lower limb numbness and tingling symptoms significantly improved within one month (VAS dropped from 7 to 1-2). This is a case of chronic lower back pain combined with the third lumbar transverse process syndrome, treated with vertebral misalignment correction, acupuncture and acupotomy treatment to release the third lumbar transverse process, with multi-level intervention of bone, muscle and fascia in stages. 【Keywords】spondylolisthesis ； intervertebral disc herniation ； transverse process syndrome of third lumbar vertebra ； acupotomy ； Activator Methods Chiropractic Technique (AMCT) |
281.7针刀松解第三腰椎横突缓解下背痛之病例报告
