Abstract:

Objective To evaluate the efficacy of four-dimensional traction in elderly patients with degenerative lumbar spinal stenosis （DLSS）， focusing on changes in lumbar muscle morphology and mechanical properties. Methods Elderly patients with DLSS admitted to the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2022 to February 2024 were enrolled. Based on the treatment method， they were categorized into the study group （muscle exercise combined with four-dimensional traction， n = 40） and the control group （routine muscle exercise， n = 40）. All participants underwent a 4-week treatment regimen and subsequently received multimodal ultrasound examinations. The morphology and mechanical properties of the lumbar muscle group， lumbar range of motion， walking distance in intermittent claudication， Visual Analogue Scale （VAS）， and Oswestry Disability Index （ODI） scores were compared between the two groups. Results After treatment， the study group exhibited significantly greater improvements in multifidus muscle thickness， circumference， cross-sectional area， pressure pain threshold， and lumbar range of motion （P < 0.05）. In contrast， the shear wave velocity （SWV）， Young's modulus， muscle tension， and flexion-extension ratio of the multifidus muscle were significantly lower in the study group （P < 0.05）. Additionally， the walking distance in intermittent claudication for the study group was markedly longer （P < 0.05）. During the 12-month follow-up period after treatment， the VAS and ODI scores of the study group remained significantly lower （P < 0.05）. Conclusion Four-dimensional traction in combination with muscle exercise can effectively alleviate clinical symptoms， enhance muscle function， and improve mechanical properties in elderly patients with DLSS.

Key words: elderly, degenerative lumbar spinal stenosis, four-dimensional traction, muscle exercise, multimodal ultrasound, multifidus muscle