ABSTRACT
Objective This study was designed to describe the localization and the extent of lumbar disc herniations (LDH) by three-dimensional radiological classification and to investigate their potential correlation with symptom and function evaluation.Methods The study retrospectively analyzed 261 patients (284 segments of herniated discs) who were diagnosed with LDH by computerized tomography (CT) or magnetic resonance imaging (MRI) from January 2006 to April 2010.There were 162 males and 99 females,with an average age of 42.1 years old (range,14-67 years) and the mean duration of history is 14.6 months (range,1-38 months).There were 35 cases of heavy manual workers,133 cases of moderate manual workers,and 93 cases of comfortable manual workers.The data were consisted of 188 MRI and 73 CT reports.The three-dimensional radiological classification was applied to describe the localization and the extent of LDH.Oswestry disability index (ODI) scores,Japanese Orthopaedic Association (JOA) scores and visual analogue scores (VAS) were applied to evaluate the vertebral symptom and function.The relationship between three-dimensional radiological classification and their functional status was probed.Results Herniations of lumbar discs located mainly sagittally at Level Ⅰ (151 segments,53.2％) and Level Ⅲ(122 segments,43.0％); horizontally at Area 2 (209 segments,73.6％)and Area 3 (61 segments,21.5％); and frontally at Area b (162 segments,57.0％),Area a (78 segments,27.5％) and Area c (41 segments,14.4％).The ODI scores at visit were 56.91％±13.62％,ranging from 20％ to 90％;JOA scores were ranging from 0 to 24 (mean,13.57±4.68); while VAS scores were ranging from 3 to 10 (mean,6.09±1.89).There was no significant difference on ODI scores,JOA scores and VAS scores between different herniation locations.Conclusion According to the three-dimensional radiological classification,most of the lumbar disc herniations located at Level Ⅰ sagittally,Area 2 horizontally,and Area b frontally.Clinical symptoms and lumbar function did not depend on the location of the lumbar disc herniations by the three-dimensional classification.
ABSTRACT
Objective To explore the clinical effects and application value of microendoscopic discectomy via spinal posterior access in the treatment of lumbar disc herniation. Methods Microendoscopic intervertebral space discectomy was performed for 152 patients with prolapse of lumbar intervertebral disc. The follow-up of clinical effects was carried out. Results 113 patients were followed up for 3 to 19 months. By Macnab standards, the rusult was excellent in 86 patients, good in 21, fair in 4, and poor in 2. The excellent and good rate was 94.6%. Conclusion Microendoscopic discectomy is an ideal method to treat lumbar disc herniation if the indications are suitable, for it is minimally invasive, and provides rapid postoperative recovery, good operation safety, as well as reliable effects.
ABSTRACT
Thirty-two cases of calcaneodynia were treated with high-energy vibration wave combined with external application of Shuangbo Ointment (Group 1) and other 32 with high-energy vibration wave only (Group 2) as control. The results showed that the markedly effective rates of short-term treatment (3 weeks) and long-term treatment (3 months) were 56.25% and 84.37% in Group 2, and 81.25% and 93.75% in Group 1 respectively. It is suggested that high-energy vibration wave combined with external application of Shuangbo Ointment exerts a better effect for calcaneodynia, and can decrease the occurrence of hematoma and periosteum stripping induced by high-energy vibration wave.