Treatment of the recurrent lumbar disc herniation:a comparison between endoscopic surgery and open surgery / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical effect,advantages and disadvantages of endoscopic surgery and open surgery in treating the recurrent lumbar disc herniation.</p><p><b>METHODS</b>From August 2008 to December 2010,the data of 35 patients with recurrent lumbar disc herniation were retrospectively analyzed. The patients were divided into endoscopic surgery group and open surgery group according to operative methods. Fourteen patients in endoscopic surgery group were treated with transforaminal lumbar interbody fusion by micro-endoscopic discectomy (MED) and the other 21 patients in open surgery the group were treated with posterior lumbar interbody fusion by open surgery. All patients were fixed by vertebral pedicle screw. The operation time,volume of bleeding and drainage after operation,analgesic dosage and time in bed after operation were observed. Visual Analogue Scale(VAS),Japanese Orthopedic Association(JOA)and Chinese Oswestry Disability Index(CODI) were used to evaluate the clinical effects before and after operation.</p><p><b>RESULTS</b>There was no significant difference in operation time between two groups(P>0.05). Volume of bleeding and drainage after operation,analgesic dosage and time in bed after operation,VAS score in endoscopic surgery group was less than that of open surgery group (P<0.01). All patients were followed up for 1 year. There was no significant difference in JOA between two groups (P>0.05). CODI in endoscopic surgery group was better than that of open surgery group (P<0.01).</p><p><b>CONCLUSION</b>Both operative methods can obtain good clinical effects,but the transforaminal lumbar interbody fusion operation by micro-endoscopic discectomy (MED) has advantage of less traumatic and less pain,better functional recovery,it is a first choice in treating the recurrent lumbar disc herniation.</p>

Postmenopausal osteoporosis of liver and kidney deficiency type treated with acupoint catgut embedding by stages / 中国针灸

<p><b>OBJECTIVE</b>To explore the better treatment of postmenopausal osteoporosis of liver and kidney deficiency type.</p><p><b>METHODS</b>One hundred and five cases were randomly divided into an observation group, a control group A and a control group B equally. In control group A, Calcichew D3 tablets were taken with oral administration; in control group B, Calcichew D3 tablets and Xianling Gubao capsule were taken with oral administration. In observation group, Calcichew D3 tablets and acupoint catgut embedding were applied; Shenshu (BL 23), Ganshu (BL 18), Jiaji (EX-B 2) and Weizhong (BL 40) etc. were selected at acute stage; Shenshu (BL 23) and Ganshu (BL 18) etc. were selected at remission stage, once every half a month and 6 months treatment in all. The Visual Analogue Scale (VAS), bone mineral density(BMD), estradiol (E2) and clinical effects were compared among groups.</p><p><b>RESULTS</b>After 3 and 6 months treatment, the scores of VAS were reduced among groups (all P < 0.01); the reduction in observation group and control group B was superior to that in control group A (all P < 0.001), and it was more obvious in observation group than that in control group B (both P < 0.001). After 6 months treatment, lumbar BMD and the serum level of Ez improved obviously in observation group and control group B (all P < 0.01). The comparison among groups after treatment showed that the BMD in observation group and control group B was superior o o that in control group A (P < 0.01, P < 0.05); the serum level of E2 in observation group was superior to that in control group B and control group A (both P < 0.001), and it in control group B was superior to that in control group A. The total effective rate was 91.4% (32/35) in observation group, superior to that in control group A (57.1%, 20/35); and the total effective rate was 82. 9% (29/35) in control group B, superior to that in control group A.</p><p><b>CONCLUSION</b>Calcichew D3 tablets and acupoint catgut embedding therapy can relieve the pain caused by postmenopausal osteoporosis of liver and kidney deficiency, improve the bone mineral density and serum level of estradiol; in brief, it is the better method.</p>

Controlled clinical trials on the treatment and prevention of shoulder and back fasciitis using horizontal bar exercises / 中国骨伤

<p><b>OBJECTIVE</b>To explore an exercise method for the prevention and treatment of the patients with shoulder and back fasciitis.</p><p><b>METHODS</b>From 2006.8 to 2008.3, 120 patients with shoulder and back fasciitis were randomly divided into control group (n = 60, including 21 females and 39 males, the average age was (47.0 +/- 12.0) years, and the average course of disease was (14.1 +/- 12.0) months) and treatment group (n = 60,including 19 females and 41 males, the average age was (43.7 +/- 9.9) years, and the average course of disease was (16.4 +/- 13.4) months). The patients in the control group received massage therapy and the ones in the treatment group were treated with massage therapy and horizontal bar exercise. After 3 weeks treatment, the curative effects of the patients in two groups were observed. All the patients were followed up for 6 to 26 months, the recurrence were observed.</p><p><b>RESULTS</b>After 3 weeks treatment, the scores of pain, sense of heaviness, strip sign, tenderness, shoulder and back function of the patients in two groups had significant differences compared with those before treatment (all P < 0.01). After treatment, the scores of pain, sense of heaviness, strip sign, tenderness, shoulder and back function of the patients in the treatment group were lower than those in the control group (P < 0.05). After 6 to 26 months following-up, the rate of recurrence in the treatment group was lower than that in the control group (P < 0.01).</p><p><b>CONCLUSION</b>Horizontal bar exercise is a simple, no expense and effective method in the prevention and treatment of shoulder and back fasciitis, which can improve the effect of the treatment and reduce the rate of recurrence.</p>

Analysis of intermediate and long term clinical effects on discectomy with diskoscope / 中国骨伤

<p><b>OBJECTIVE</b>To estimate intermediate and long term clinical effects of lumbar intervertebral disc herniation on discectomy with diskoscope.</p><p><b>METHODS</b>A hundred and nine patients with lumbar intervertebral disc herniation were retrospectively analyzed. The patietnts were operated with diskoscope. There were 61 males and 48 females. The age was from 25 to 68 years old with an average of 37.7 years. The affected region of patients were L(3,4) (5 cases), L(4,5) (42 cases), L5S1 (49 cases), L(4.5) and L5S1 (13 cases). Among them, 88 cases with single side and one segment, 13 cases with homolateral and two segments, 8 cases with hibateral and one segment were operated. The curative effects were followed up and estimated by recording satisfaction degrees at 1 year and 5.2 years(average) after operation. Moreover,intervertebral space height and the spinal stability of the patients were compared by imaging data before and after operation.</p><p><b>RESULTS</b>At 1 year and 5.2 years (average) after operation,the scores by JOA standard were improved from 6.40 +/- 1.68 to 13.40 +/- 1.42, 13.15 +/- 1.35 (P < 0.01) respectively;the scores by VAS standard were reduced from 7.10 +/- 1.55 to 1.90 +/- 0.84, 2.10 +/- 0.58 (P < 0.01) respectively; the excellent and good rate was 91.7% (100/109) and 89.9% (98/109) respectively; the satisfaction degree of the patients was 95.4% and 94.5% respectively. The average time before working was 1 month. The imaging data of 45 patients were complete in the study, no lumbar instability sign were found. The loss rates of intervertebral space height were 57.8% (26/45), 93.3% (42/45) respectively at 1 year and 5.2 years (average) after operation.</p><p><b>CONCLUSION</b>Discectomy with diskoscope has a good intermediate and long term clinical effects, it is a reliable method in the treatment of lumbar intervertebral disc herniation. It doesn't uncertainly cause instability of intervertebral space and root compression, though it can't avoid the loss of intervertebral space height.</p>

Case-control study on embracing knee and rolling lumbar training for preventing and treating degenerative osteoarthritis of lumbar spine / 中国骨伤

<p><b>OBJECTIVE</b>To study therapeutic effects of embracing knee and rolling lumbar (EKRL) training on the pain and the function of lumbar of patients with degenerative osteoarthritis of lumbar spine.</p><p><b>METHODS</b>From 2006.8 to 2008.1, 150 patients with degenerative osteoarthritis of lumbar spine were randomly divided into the control group, EKRL training group and the combined group. In the control group (n=50), there were 16 females and 34 males, the average age was (58.8 +/- 10.2) years and the average course of diseases was (16.3 +/- 14.9) months. In the EKRL training group (n=50), there were 13 females and 37 males, the average age was (60.1 +/- 8.2) years and the average course of disease was (17.1 +/- 15.3) months. In the combined group (n=50), there were 15 females and 35 males, the average ages was (59.9 +/- 11.4) years and the average course of diseases was (19.8 +/- 17.2) months. The patients in three groups were treated with Meloxicam tablets, EKRL training and two above methods combination respectively. After 3 weeks treatment, the curative effect, the visual analogous scores and the ODI indexes were observed. All the patients were followed up and the duration ranged from 6 to 24 months; the changes of average ODI indexes were observed monthly.</p><p><b>RESULTS</b>After 3 weeks treatment, the therapeutic effects in three groups had obvious difference after Ridit analyses: there were significant differences between the combined group and other two groups (P<0.01), but no obvious differences existed in other two groups. Compared with before treatment, the visual analogue scale scores and the ODI indexes in three groups reduced significantly (P<0.01). After treatment, the visual analogue scale scores and the ODI indexes of the combined group had significant differences compared with those of other two groups (P<0.01), but the ODI indexes of other two groups had no obvious differences. After 6 to 24 months following-up, the monthly changes of average ODI indexes of EKRL training and combined groups had obvious differences compared with that of the control group (P<0.01).</p><p><b>CONCLUSION</b>EKRL training is a simple, no expense and effective methods for preventing and treating degenerative osteoarthritis of lumbar spine.</p>