Spinal fixed-point rotating reduction in treating lumbar disc herniation by three-dimensional MRI / 中国骨伤

<p><b>OBJECTIVE</b>To observe three-dimensional space position change of nucleus pulposus and nerve root before and after treatment of lumbar disc herniation by spinal fixed-point rotating reduction, and explore the mechanisms.</p><p><b>METHODS</b>Totally 52 patients with L5S1 lumbar disc hernation treated by spinal fixed-point rotating reduction were collected from April 2009 to June 2011. There were 33 males and 19 females with an average age of 34.6 years old (ranged, 19 to 55). Three-dimensional MRI were performed to observe relationship between nucleus pulposus and related nerve root,configuration change of spine and pelvic on coronary MRI.</p><p><b>RESULTS</b>MRI showed relationship between nucleus pulposus and related nerve root mainly located on axillary, shoulder, front and surround. Vertebral displacement disappeared, lumbocrural pain alleviated after manipulative therapy. All patients were followed up from 2 to 28 months with an average of 12 months, and no recurred. All patients recovered work. Nucleus pulposus had no change,while lumbral spinal and pelvic curve changed before and after admission.</p><p><b>CONCLUSION</b>Lumbar disc herniation combined with single (multiple) vertebral displacement,can cause biomechanical properties of nucleus puplosus and related nerve root, while spinal fixed-point rotating reduction can correct vertebral displacement, recover balance between inside and outside of spinal.</p>

Study on the efficacy of orthopedic footwear in treating lumbar intervertebral disc herniation with spinal manipulation / 中国骨伤

<p><b>OBJECTIVE</b>To observe the efficacy and mechanism of orthopedic footwear in treating lumbar intervertebral disc herniation with spinal manipulation.</p><p><b>METHODS</b>From September 2009 to September 2010, 44 patients with the lumbar intervertebral disc herniation with posture change were selected in the study. There were 28 males (aged from 24 to 58 years) and 16 females (aged from 21 to 60 years). Firstly, the average EMG (AEMG) and spectrum area (SPA) of bilateral lumbar erector spinae of the patients were tested by surface electromyogram (sEMG), and then absolute value of the difference between AEMG and SPA (larAEMG and larSPA) were compared. After that, they were randomly divided into two groups (experiment group and control group), each group had 22 cases. The patients of experiment group received the spinal manipulation treatment assisted with orthopedic footwear and the other group received the spinal manipulation treatment only. Orthopedic footwear was put on by leg with lower iliac crest line, sole thickness of which depended on the degree of pelvic tilt. According to mitigation degree of symptom and sign, sole thickness was modified till removal of orthopedic footwear. Manipulative therapeutic method which was manipulative by doctors set spinal process to normal anatomical position. Manipulative treatment was 2 - 3 times every week. The clinical healing time were observed in the two groups.</p><p><b>RESULTS</b>The larSPA was 0.12 +/- 0.73, 0.65 +/- 0.61 and the larAEMG was 3.43 +/- 25.56, 21.74 +/- 20.34 in standing 1 minute of two positions of patients with orthopedic footwear and without orthopedic footwear, respectively; the larSPA was 0.15 +/- 0.36, 0.57 +/- 0.24 and the larAEMG was 4.65 +/- 12.87, 25.18 +/- 16.58 in walking 1 minute of two positions of patients with orthopedic footwear and without orthopedic footwear. There were significant difference between the two groups (P < 0.01). The time of healing well in experiment group and control group were respectively (20.36 +/- 4.92) d and (28.14 +/- 7.13) d, experiment group was shorter than that of control group (P < 0.01).</p><p><b>CONCLUSION</b>Orthopedic footwear can obviously improve the unsymmetrical shrink of bilateral lumbar erector spinae and balance lumbar muscle. Therefore,orthopedic footwear can create favourable conditions for the spinal manipulation in treatment of lumbar intervertebral disc herniation, which can shorten the healing well.</p>

Study on the mechanism of Feng's spinal manipulation for treatment of lumbar disk hernation with a calcified herniated mass using 3D CT / 中国骨伤

<p><b>OBJECTIVE</b>To measure position changes of lumber disk herniation before and after treatment of Feng's spinal manipulation to study the mechanism of the manipulation for lumber disk herniation.</p><p><b>METHODS</b>In 2010, 8 patients with lumber disk herniation were treated by Feng's spinal manipulation, including 3 males and 5 females who ranged in age from 14 to 53 years with a mean of 35.4 years. The patients received CT scan before and after treatment. All images were reconstructed to measure the distance between the apex of the calcified lumber disk herniation and the top of the next adjacent spinal process.</p><p><b>RESULTS</b>The position of calcified lumber disk herniation underwent change after Feng's spinal manipulation, with a slight subluxation between the two adjacent vertebrae.</p><p><b>CONCLUSION</b>If subluxation is restored,the relation between the nerve root and the hernation will undergo change, followed by subsequent change of the hernation mass, thus restoring the inner-outer balance of the spinal column system.</p>

Clinical meaning of the surrounding compression on the nerve root by the protruded nucleus pulposus and facet or lamina (ligamentum flavum): analysis of CT (MRI) axial slice images of 71 patients with lumbar disc herniation / 中国骨伤

<p><b>OBJECTIVE</b>To observe the pinching action to the nerve root by the lumbar disc herniation and facet or lamina (ligamentum flavum) and evaluate its clinical meaning.</p><p><b>METHODS</b>Seventy-one patients were divided into 3 groups according to the size of distance between protrusion of nuclear and facet or lamina (ligamentum flavum). The degree of the straight leg raising of the affected side (SLR) and the sagittal index (SI) of lumbar disk herniation were measured and analyzed among them.</p><p><b>RESULTS</b>There was no corelation between the affected degree of SLR and sex, age and SI of patient (P > 0.05). The coefficient between distance group and the affected degree of SLR is-0.878 7 (P < 0.01).</p><p><b>CONCLUSION</b>The degree of the surrounding compression by the protrusion of nuclear and facet or lamina (ligamentum flavum) reflects the injuried severity of the nerve root.</p>

Treatment of the lumbar disc herniation of sequestered type with Feng's spinal manipulation / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effect of the treatment for sequestered type lumbar disk herniation (SLDH) with FENG's spinal manipulation.</p><p><b>METHODS</b>Forty-one patients (27 male, 14 female) were treated by FENG's spinal manipulation. The clinical results were measured by the Japanese and FENG's lumbar treatment standard and evaluated by scoring system for assessment of treatment for low back pain between pre- and post-treatment. To measure MRI sagittal index (SI) of lumbar disc herniation between pre- and post-treatment.</p><p><b>RESULTS</b>The score of subjective symptoms and clinical signs increased obviously after treatment. There was no statistical difference of SI between pre- and post-treatment (P<0.05). The outcome of treatment was satisfying.</p><p><b>CONCLUSION</b>The major pathologic change of SLDH is the single/multiple vertebral subluxation. FENG's spinal manipulation can correct the vertebral subluxation which leading to the series of clinical manifestations. The good clinical outcome may due to the alleviation of distortion and tension of dura and nerve root with the recovery of the spinal column's stability.</p>