腰椎滑脫之整脊合併針灸治療病例報告

Treatment Combined with Spinal Manipulation and Acupuncture on Low Back Pain and Spondylolisthesis : A Case Report

本病例記錄一名六十六歲男性患者因下背痛相關症狀，接受一般復健治療改善有限故轉由中醫治療的病案。下背痛是顯著影響生活品質的疾病之一，每年與此相關診斷在健保花費的統計中名列前茅。常見的下背痛主要原因有：急性腰肌拉傷、椎間盤突出、椎間孔狹窄，以及腰椎滑脫……等。其中腰椎滑脫因涉及脊椎結構改變所以相對嚴重，此症在現代醫學的積極處置常只有手術固定一途，替代性或非侵入性的治療方法有限。病人近一年經歷下背痛合併逐漸加重之左下肢痠麻感，經放射線檢查發現並診斷為第五腰椎滑脫（Grade II）、下背痛合併左側坐骨神經痛。患者接受中醫整脊以及針灸治療六個月後，在症狀及影像皆有明顯改善。本文欲藉由分享此病例來探討中醫可提供早期腰椎滑脫患者的有效且低侵入性之治療手段。

This is a case of 66 year-old male with low back pain induced by spondylolisthesis treated by Traditional Chinese Medicine therapy. Low back pain, one of the most costly diseases in health insurance of Taiwan, seriously diminished patient's quality of life. Sprain or strain of lumbar muscle, hernia of vertebral disc, stenosis of nerve foramen, and spondylolisthesis are the most common causes of low back pain. Among these factors, spondylolisthesis, due to the structural change of spine, is more severe and often needed operation as an aggressive therapy.This case suffered from low back pain and progressive left-side sciatica for more than 1 year. The X-ray film revealed grade 2 spondylosithesis of 5th lumbar spine, and we choose dynamic spinal manipulation as our main therapy for the patient. After the treatment combined with dynamic spinal manipulation and acupuncture in three months, significant improvements were found in both low back pain relevant syndrome and X-ray images of lumbar spine. We would like to share this case to discuss the possibility of the lower invasive but effective Traditional Chinese Medicine therapy on early-grades spondylolisthesis.