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External treatment of Traditional Chinese Medicine (TCM) is a common treatment for lumbar disc herniation, which mainly includes fumigation and washing of TCM, and hot ironing therapy. It can cooperate with oral administration of TCM, Tuina, acupuncture and other therapies to play a synergistic effect and enhance the efficacy. External application of TCM in the treatment of lumbar intervertebral disc herniation is effective with long duration, easy-operated and safe It has showed curative effect in alleviating clinical symptoms and improving lumbar function. Its mechanism mainly includes regulating nerve inflammatory reaction, improving hemorheology and exerting analgesic effect.
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OBJECTIVE@#To observe the clinical effect of single acupoint [Yaotu (extra)] electroacupuncture (EA) therapy on lumbar intervertebral disc herniation (LIDH) and its promotion and application in community medical institutions.@*METHODS@#This research adopted a three-level promotion model, and used multi-center collaboration topics as a platform. A total of 240 patients with LIDH were divided into a group A (top three hospital, 80 cases, 3 cases dropped off), a group B (secondary hospital, 80 cases, 8 cases dropped off), and a group C (community health center, 80 cases, 7 cases dropped off). All groups were treated with EA at a single acupoint [Yaotu (extra)] under the guidance of a unified experimental protocol. The EA was given 60 min each time and performed 3 times a week for a total of 2 weeks. The changes of visual analogue scale (VAS) scores of three groups before and after each treatment were compared, and the clinical efficacy was evaluated.@*RESULTS@#Compared with before each treatment, the VAS scores of three groups after each treatment decreased (@*CONCLUSION@#The single acupoint EA therapy has a significant effect in the treatment of LIDH, can quickly relieve the pain symptoms, and has the characteristics of simple operation and easy control, suitable for promotion and application in primary hospitals.
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Humans , Acupuncture Points , Electroacupuncture , Intervertebral Disc , Intervertebral Disc Degeneration , Intervertebral Disc Displacement/therapyABSTRACT
Introduction: Intraspinal tumors were primary and secondarytumors that occurred in the spinal cord, nerve roots, meningesand the tissue of the wall of vertebral canal. Study aimedto analyze the misdiagnosis causes of intraspinal tumorsmisdiagnosed as lumbar intervertebral disc herniation, and toreduce the rate of clinical misdiagnosis.Material and Methods: Clinical data of 19 patients withintraspinal tumors misdiagnosed as lumbar intervertebral discherniation were retrospectively analyzed, and the respectivecharacteristics, essentials for diagnosis and differentialdiagnosis of the two different kinds of diseases weresummarized. The misdiagnosis causes were analyzed, and theprevention measures were put forward.Results: All the misdiagnosed patients’ data on MRI werecollected, and then they received operative treatment.Histological diagnosis results showed that there were 13cases of schwannomas, 3 cases of meningiomas, 2 casesof ependymomas, and 1 case of angiomyolipoma. In 1~36months’ follow-up, pain of all the patients was alleviated.Eighteen patients were healed, and only one patient still feltnumbness at left hip and left leg. No patient reoccurred ordied.Conclusion: Though there were similarities in early clinicalmanifestations between intraspinal tumors and lumbarintervertebral disc herniation, these two different kinds ofdiseases can be identified by collecting the case historydetailedly, performing physical examination carefully, andchoosing the imaging examination appropriately to avoidmisdiagnosis.
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OBJECTIVE@#To evaluate the predictive value of ODI, SBI and SF-36 in patients with recurrent lumbar disc herniation undergoing reoperation.@*METHODS@#The patients of recurrent lumbar disc herniation underwent surgical treatment from June 2013 to December 2015 were enrolled in the study. Patients were assigned to A, B, C groups according to the excellent, good, poor of clinical efficacy, and divided into training set and test set by 70:30 ratio according to random number table. we use ordered Logistic regression to construct prediction model, and test set to verify the effect of the model and calculate the accuracy of the model.@*RESULTS@#Both ODI and SBI were lower in group A and group B than group C, and the SF-36 scale was significantly higher than group C (<0.05). The predictive efficacy model by ordered Logistic regression construction showed that the ODI coefficient was 0.67, the SF-36 coefficient was -0.43, and the SBI coefficient was 0.52. In the group A with excellent clinical efficacy, the prediction accuracy rate of the model was 80%; in the group B with good clinical efficacy, the prediction accuracy rate was 76.92% and in the group C with poor clinical efficacy, the prediction accuracy rate was 44.44%.@*CONCLUSIONS@#Comprehensive consideration of ODI, SBI and SF-36 to construct a clinical prediction model for patients with recurrent intervertebral disc herniation after surgery can better predict patients' prognosis. It has a value for clinical application.
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Humans , Intervertebral Disc Displacement , Lumbar Vertebrae , Reoperation , Treatment OutcomeABSTRACT
Objective To study the relationship between the pain of the patients with lumbar intervertebral disc herniation (LIDH) and the changes of serum cytokine,and to discuss the clinical significance.Methods From January 2014 to December 2016,74 cases of LIDH diagnosed in the 323rd Hospital of the PLA were selected,including 45 males and 29 females,whose age was 46.2± 16.1 years,and the duration 22.6± 7.8 months.According to the VAS pain score,37 cases were mild,23 cases were moderate and 14 cases were severe.The control was 30 cases of healthy physical examination in the same period,18 males and 12 females,age 45.3 ± 15.8 years.All subjects were collected for venous blood on fasting.MDA,superoxide dismutase (SOD),interleukin-6 (IL-6),tumor necrosis factor (TNF),thromboxane (TX),endothelin (ET),prostaglandin E (PGE) and calcitonin (CA) were all measured by radioimmunoassay.The results were analyzed statistically.Results The compared with normal control group,serum cytokines MDA,SOD,IL-6,TNF,TX,ET,PGE and CA increased in different degrees (P＜0.05～0.01).The VAS assessment of severe pain in LIDH was significantly higher than that of mod erate or mild pain (P＜0.05～0.01).Logistic analysis showed that these serum cytokines were closely related to the pain of LIDH (OR=2.415～4.127,95％CI=1.146～11.735,P＜0.05).Conclusion The serum cytokines in patients with LIDH are closely related to the degree of pain,suggesting that these cytokines in serum may affect biochemical metabolism in the process of pain.
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Objective To investigate the clinical efficacy of heat-sensitive point medicinal moxibustion plus percutaneous administration of tetrandrine in treating lumbar intervertebral disc herniation. Methods One hundred and twenty patients with lumbar intervertebral disc herniation were randomized to treatment and control groups, 60 cases each. The treatment group received heat-sensitive point medicinal moxibustion plus percutaneous administration of tetrandrine and the control group, heat-sensitive point medicinal moxibustion alone. The VAS score and the JOA Score for Back Pain score were recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the JOA Score for Back Pain score and the VAS score in the two groups (P<0.01). There were statistically significant post-treatment differences in the JOA Score for Back Pain score and the VAS score between the treatment and control groups (P<0.01). The excellent and good rate was 80.0％ in the treatment group and 55.0％ in the control group; there was a statistically significant difference between the two groups (P<0.01). Conclusion Heat-sensitive point medicinal moxibustion plus percutaneous administration of tetrandrine is an effective way to treat lumbar intervertebral disc herniation.
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Objective To observe the clinical efficacy of Bai Xiao moxibustion plus electroacupuncture in treating lumbar intervertebral disc herniation (LIDH). Method Ninety-six LIDH patients were randomized into a treatment group and a control group, 48 cases each. The treatment group was intervened by Bai Xiao moxibustion plus electroacupuncture, while the control group was intervened by electroacupuncture alone. Before and after the treatment, the lower back pain scores of Japanese Orthopedic Association (JOA) and Visual Analogue Scale (VAS) were evaluated, and the clinical efficacies of the two groups were compared. Result The JOA and VAS lower back pain scores were changed significantly after the treatment in both groups (P<0.05). After the treatment, the JOA and VAS lower back pain scores of the treatment group were significantly different from those of the control group (P<0.05). The pain release time was (2.95±0.59)d after the intervention in the treatment group versus (4.26±0.68)d in the control group, and the between-group difference was statistically significant (P<0.05). The total effective rate was 95.7％ in the treatment group versus 91.7％ in the control group, and the between-group difference was statistically significant (P<0.05). Conclusion Bai Xiao moxibustion plus electroacupuncture is an effective method in treating LIDH and it can reduce the lower back pain.
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Objective To investigate the clinical efficacy of She medicine therapy in rehabilitation after endoscopic surgery for lumbar intervertebral disc herniation.Methods Sixty patients with lumbar intervertebral disc herniation were allocated, using random number table method following registration order, to treatment and control groups, 30 cases each. The treatment group received She medicine therapy and the control group, oral administration of conventional drugs. The excellent and good rate was observed in the two groups after treatment. Post-treatment active straight leg raising times and analgesic dosages were compared between the two groups.Results Active straight leg raising time was significantly advanced (P<0.01) and the number of potent analgesic uses was significantly decreased (P<0.01) in the treatment group after endoscopic surgery for lumbar intervertebral disc herniation. The excellent and good rate was 93.3％ in the treatment group and 80.0％ in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion She medicine therapy can help rapid rehabilitation after endoscopic surgery for lumbar intervertebral disc herniation.
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A 55-year-old male presented with dysesthesia of the right anteromedial thigh. A magnetic resonance image revealed a globular mass at the right extraforaminal area of the L3/4 level. Based on the diagnosis of neurogenic tumor, surgical excision was performed. The surgical impression and pathology confirmed extrusion of intervertebral disc. In a retrospective review of the magnetic resonance image, we noticed a fibrillary pattern directed from the intervertebral disc space to the lesion, and disrupted annulus fibrosus and indentation caused by the ring apophysis. We suggest aforementioned features, indicative of intervertebral disc lesions, to be checked when interpreting mass lesions around the intervertebral foramen.
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Humans , Male , Middle Aged , Diagnosis , Intervertebral Disc , Magnetic Resonance Imaging , Paresthesia , Pathology , Retrospective Studies , ThighABSTRACT
A 55-year-old male presented with dysesthesia of the right anteromedial thigh. A magnetic resonance image revealed a globular mass at the right extraforaminal area of the L3/4 level. Based on the diagnosis of neurogenic tumor, surgical excision was performed. The surgical impression and pathology confirmed extrusion of intervertebral disc. In a retrospective review of the magnetic resonance image, we noticed a fibrillary pattern directed from the intervertebral disc space to the lesion, and disrupted annulus fibrosus and indentation caused by the ring apophysis. We suggest aforementioned features, indicative of intervertebral disc lesions, to be checked when interpreting mass lesions around the intervertebral foramen.
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Humans , Male , Middle Aged , Diagnosis , Intervertebral Disc , Magnetic Resonance Imaging , Paresthesia , Pathology , Retrospective Studies , ThighABSTRACT
Objective To investigate the effect of Supplementing Qi and activating blood and tonifying kidney therapy on the function and quality of life in patients with prolapse of lumbar intervertebral disc after operation.Methods92 cases of lumbar disc herniation treated in Fuyang Hangzhou Hospital of traditional Chinese Medicine hospital from November 2015 to October 2016 were selected,divided into observation group and control group, there were 46 cases in each group, the observation group were treated with Supplementing Qi and activating blood and tonifying kidney therapy,the control group were given conventional western medicine treatment, the improvement of VAS score, JOA score and WHQOL-BREF score were compared between the two groups after treatment, and the clinical effects were compared between the two groups after treatment and the incidence of adverse reaction.ResultsAfter treatment,the VAS scores of the two groups were decreased, the observation group (1.85±0.43) is lower than the control group (2.97±0.69), the difference between the two groups was statistically significant(P<0.05);After treatment, patients withthe JOA scores of the two groups were increased, the observation group (25.78±5.89) higher than the control group (20.45±4.82), the difference between the two groups was statistically significant(P<0.05);After treatment, the total efficiency of observation group was 93.48% higher than 76.09% in the control group, the difference between the two groups was statistically significant(P<0.05);There was no significant difference in WHOQOL-BREF scores between the two groups before treatment;After treatment, the WHOQOL-BREF scores of the two groups were increased, the observation group was higher than the control group, the difference between the two groups was statistically significant(P<0.05), there was no significant difference in the incidence rate of complications between the two groups after treatment.ConclusionThe patients with lumbar disc herniation after operation to give Supplementing Qi and activating blood and tonifying kidney therapy,can effectively helpe patients to recover, improve the pain of patients, improve the patient's functional activities and quality of life, the effect is significant.
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By sorting out 2005-2015's literature on the mechanism of acupuncture and moxibustuion treatment for lumbar intervertebral disc herniation, this article concludes that the studies focused mainly on six aspects: improvement in nail fold microcirculation, improvement in neural ultrastructure, regulation of bodily autoimmunity, improvement in hemorheological indicators, regulation of neuroelectrophysiology and regulation of chemical neuroinflamma- tory mediators. A summary is made from the six aspects.
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Objective To study the effect of herbal reyanbao combined with rehabilitation training on the rehabilitation of patients with lumbar disc herniation.Methods 120 cases with lumbar disc prolapse as the research object from January 2015 to December 2016 in Wuhan integrated traditional Chinese and western medicine hospital were divided into two groups(the control group and the observation group).The control group were treated with routine conservative+conventional nursing plan, and the observe group were given herbal reyanbao combined with rehabilitation training.Clinical data were compared in the two groups.Results The clinical effect and rehabilitation degree in the observation group were better than those in the control group, the difference was statistically significant(P< 0.05).Conclusion It can help patients with lumbar disc herniation recover as soon as possible which herbal reyanbao combined with rehabilitation training were used on the rehabilitation of patients, and it is worthy of application.
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Objective To investigate the application of lower limb electromyography in guiding preoperative localization for multiple segment intervertebral disc herniation treated with ozone injection and in predicting the curative efficacy.Methods A total of 51 patients with MRI-proved multiple segment lumbar intervertebral disc herniation,who were admitted to authors' hospital during the period from January 2012 to December 2013 and who had complete clinical materials,were included in this study.Guided by DSA,intradiscal injection of ozone together with the injection of ozone plus compound betamethasone and bupivacaine into the space around the spinal nerve was carried out in all patients.The degree of lower lumbago was evaluated with M-JOA score,and Oswestry disability index (ODI) was adopted to assess the curative effect.Results Preoperative electromyography showed that 43 patients had nerve root injury,the positive rate was 84.3％.The positive HIZ sign was detected in 30 patients,with the positive rate being 58.8％.The positive Modic sign was observed in 24 patients,the positive rate was 47.1％.Postoperative MJOA scores indicated that one-,3-and 6-month effective rates were 90.1％,86.2％ and 78.5％ respectively;and postoperative ODI values showed that one-,3-and 6-month effective rates were 87.3％,79.5％ and 74.6％ respectively.Conclusion In treating multiple segment intervertebral disc hemiation with ozone injection,lower limb electromyography is very valuable in accurately making preoperative localization as well as in precisely predicting the curative efficacy,thus this technique is worth popularizing in clinical practice.
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Objective To investigate the clinical improving effect on the symptoms of acupuncture at point Weizhong(BL40) plus following lumbar vertebra-stabilizing core muscle group training in patients with lumbar intervertebral disc herniation. Method Sixty patients with lumbar intervertebral disc herniation were randomized to a treatment group (30 cases) and a control group (30 cases). The treatment group received acupuncture at point Weizhong plus following lumbar vertebra-stabilizing core muscle group training and the control group, oral administration of celecoxib capsules. After treatment, the clinical improving effect on the symptoms was evaluated in the patients using the NRS, JOA Lumbar Scoring and ODI. Result The total efficacy rate was 100% in the treatment group and 53.3%in the control group. Post-treatment NRS, JOA and ODI scores were better in the treatment group than in the control group; there were statistically significant differences (P<0.001). Conclusion Acupuncture at point Weizhong plus following lumbar vertebra-stabilizing core muscle group training can effectively treat lumbar intervertebral disc herniation.
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Objective To investigate the clinical efficacy of electroacupuncture plus indirect moxibustion treating lumbar intervertebral disc herniation of blood stasis type. Method Sixty patients diagnosed with lumbar intervertebral disc herniation (blood stasis type) were randomized to treatment and control groups, 30 cases each. The treatment group received electroacupuncture plus medicine separated moxibustion and the control group, electroacupuncture alone. treatment was given once daily, 10times as a course. Pre- and post-treatment JOA lumbar scores were compared in the patients after two courses of treatment. The clinical therapeutic effects were evaluated in the patients using the TCM Criteria of the Diagnosis of and Therapeutic Effect on Diseases. Result Lumbar function was improved significantly in both treatment and control groups of patients (P<0.01) but improved more significantly in the treatment group than in the control group (P<0.05). The total efficacy rate was 96.7% in the treatment group and 83.3% in the control group. There was a statistically significant difference in the total efficacy rate between the two groups (P<0.05). Conclusion Electroacupuncture plus indirect moxibustion is a better way to treat lumbar intervertebral disc herniation of blood stasis type. Its therapeutic effect is better than that of electroacupuncture alone.
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Objective To investigate the clinical efficacy of She medicine therapy in rehabilitation after endoscopic surgery for lumbar intervertebral disc herniation.Methods Sixty patients with lumbar intervertebral disc herniation were allocated, using random number table method following registration order, to treatment and control groups, 30 cases each. The treatment group received She medicine therapy and the control group, oral administration of conventional drugs. The excellent and good rate was observed in the two groups after treatment. Post-treatment active straight leg raising times and analgesic dosages were compared between the two groups.Results Active straight leg raising time was significantly advanced (P<0.01) and the number of potent analgesic uses was significantly decreased (P<0.01) in the treatment group after endoscopic surgery for lumbar intervertebral disc herniation. The excellent and good rate was 93.3％ in the treatment group and 80.0％ in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion She medicine therapy can help rapid rehabilitation after endoscopic surgery for lumbar intervertebral disc herniation.
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Intervertebral disc herniation (IVDH) with nucleus pulposus extrusion, traumatic or not, is a devastating clinical condition accompanied by neurological problems. Here we report a cynomolgus macaque suffering from acute and progressive neurological dysfunction by a blunt trauma due to neck collar, an animal handling device. Tetraplegia, urinary incontinence, decreased proprioception, and imperception of pain were shown on physical and neurological examinations. MRI sagittal T2 weighted sequences revealed an extensive protrusion of disc material between C2 and C3 cervical vertebra, and this protrusion resulted in central stenosis of the spinal cord. Histopathologic findings showed a large number of inflammatory cells infiltrated at sites of spinal cord injury (SCI). This case is the first report of compressive cervical SCI caused by IVDH associated with blunt trauma.
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Animals , Constriction, Pathologic , Intervertebral Disc , Macaca , Magnetic Resonance Imaging , Neck , Neurologic Examination , Proprioception , Quadriplegia , Spinal Cord , Spinal Cord Diseases , Spinal Cord Injuries , Spine , Urinary IncontinenceABSTRACT
Objective To compare clinical efficacy between microendoscopic discectomy (MED) and open discectomy (OD) in the treatment of patients with lumber intervertebral disc herniation (LIDH).Methods 116 cases of LIDH who were given surgical treatment were selected as research subjects to retrospectively analyze their clinical data.Then,these cases were divided into MED group (n=54) and OD group (n=62) according to operation type.The curative efficacy,operation situation and incidence of complications were compared.Results All patients' operations were successful.After the one-year follow-up,the MED group had an excellent and good rate of 96.3％,which was statistically same with that of 93.5％ in the OD group (P ＞0.05) In comparison with the OD group,MED group had a statistically shorter operation time,less bleeding volume in the operation,shorter length of incision and shorter rest time on bed after operation (all P＜0.05).After operation,there's no case of severe complication,and the incidence of complications between the two groups was statistically same (P＞0.05) Conclusions MED and OD are both effective operations for LIDH,which have high excellent and good rate.But in comparison with OD,MED has advantages of less damage and faster recovery.
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Objective To compare the therapeutic efficacy between medicinal cupping and collateral-pricking bloodletting therapy in treating lumbar intervertebral disc herniation (LIDH) and non-specific low back pain.Method Sixty LIDH patients were randomized into treatment group 1 and control group 1, 30 cases in each group. Sixty non-specific low back pain patients were randomized into treatment group 2 and control group 2, 30 cases in each group. Treatment group 1 and 2 were intervened by medicinal cupping, while control group 1 and 2 were by collateral-pricking bloodletting. The Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were observed before and after intervention.Result The VAS and ODI scores were significantly changed after intervention in treatment group 1, treatment group 2, and control group 2 (P0.05). After treatment, there was a significant difference in comparing the ODI score between control group 1 and control group 2 (P<0.05).Conclusion Medicinal cupping and collateral-pricking bloodletting are both effective in treating chronic low back pain, and medicinal cupping has its advantage in improving ODI compared to the bloodletting therapy.