ABSTRACT
Objective To study the clinical efficacy of acupuncture combined with medication plus joint mobilization in the treatment of lumbar intervertebral disc protrusion accompanied with secondary lumbar spinal stenosis.MethodsTotally 66 cases of lumbar intervertebral disc protrusion accompanied with secondary lumbar spinal stenosis were collected randomly and divided into treatment group (34 cases) and control group (32 cases). The control group was given treatment of simple acupuncture and TCM medication, while the treatment group was given joint mobilization treatment besides acupuncture and TCM medication. Functions of lumbar vertebra were evaluated by ODI scale and the degrees of pain were evaluated by VAS. The clinical efficacy in the two groups was compared. Results ODI in both groups were significantly improved after treatment compared with that before treatment. However, the changing range of the ODI of the treatment group was more significant than that in control group (P<0.01). After treatment, VAS scores were relieved (P<0.05) in both groups, and treatment group was more significant than that in control group (P<0.05). The total clinical efficacy was 97.06% (33/34) in the treatment group, and 84.38% (27/32) in the control group, with statistical significance (P<0.05).Conclusion Acupuncture combined with medication plus joint mobilization in the treatment of lumbar intervertebral disc protrusion accompanied with secondary lumbar spinal stenosis has good efficacy.
ABSTRACT
Objective To evaluate the clinical effect of acupotomy therapy combined with acupuncture based on distal points selection for lumbar intervertebral disc protrusion ( LIDP) . Methods Sixty-eight LIDP patients were randomly divided into treatment group (N=33) and control group(N=35). The treatment group were given acupotomy therapy on the proximal positive response points in the lumbosacral region for relaxing the tendons,and acupuncture therapy based on distal points selection of Shugu, the Shu-stream point of the foot Taiyang bladder meridian, Zulinqi and Weizhong, the shu-stream point and the blood xi-cleft point of the foot Shaoyang gallbladder meridian respectively, twice a week, 2 weeks constituting one course of treatment. The control group was given conventional electroacupuncture therapy on Huatuo clip points, Dachangshu point, bilateral Shenshu points, Yinmen point, bilateral Zibian points and bilateral Yanglingquan points, and together with TDP radiation therapy, 5 times a week, 2 weeks constituting one course of treatment. The two groups received follow-up for one month. The low back pain scores of Japanese orthopaedic society ( JOA) and visual analog scores ( VAS) of pain were used for the evaluation of therapeutic effect after the treatment. Results ( 1) After treatment, the JOA scores were increased and VAS scores were decreased in both groups compared with those before treatment ( P< 0.05) , and the increase of JOA scores and the decrease of VAS in the treatment group were superior to those in the control group ( P< 0.05) . There was statistically significant difference of VAS scores between the two groups ( P < 0.05) during the follow-up period. ( 2) The total effective rate was 87.9%in the treatment group, and was 77.1%in the control group, the difference being significant (P<0.05) . Conclusion The acupotomy therapy combined with acupuncture based on distal points selection is effective and safe for lumbar intervertebral disc protrusion, which has the advantages of reliable long-term effect and low recurrence rate, showing good prospects for extensive clinical application.
ABSTRACT
BACKGROUND:There are stil about 10%-30%of patients presenting no obvious improvement of symptoms after lumbar disc herniation surgery, which are col ectively known as the lumbar spine post-surgery failure syndrome, and lumbar instability is one of the important reasons. OBJECTIVE:To evaluate the feasibility and efficacy of surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation on lumbar intervertebral disc protrusion concurring lumbar instability via MAST Quadrant retractor. METHODS:From December 2011 to October 2012, 62 cases of lumbar intervertebral disc protrusion concurring lumbar instability were treated with posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor. There were 38 female and 24 male ranging in age from 37 to 69 years (average 53.7 years). After operation, al patients were fol owed-up to evaluate the effect of the treatment. RESULTS AND CONCLUSION:The operative time was 90-210 minutes, average 145 minutes, and the amount of blood loss was 50-300 mL, average 120 mL. The hospitalization time was 5-9 days, average 6 days. Al incisions healed by first intention. Al patients were fol owed up 7.2 months on average (from 3 to 10 months). The preoperative JOA score was (10.25±2.34) points. The postoperative JOA score decreased to (18.31±3.12) points at the fol ow-up after 1 month and (25.35±2.61) points at the last fol ow-up, showing significant difference when compared with preoperative score (P<0.01). The preoperative VAS score was (8.24±1.15) points. The postoperative VAS score decreased to (2.97±1.12) points after 1 month and (1.13±0.39) points at the last fol ow-up, showing significant difference when compared with preoperative score (P<0.01). According to reforming Macnab standard, the results were excel ent in 53 cases and good in 9 cases at the last fol ow-up. The surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor is a safe, effective and minimal y invasive surgical technique in treating lumbar intervertebral disc protrusion concurring lumbar instability.
ABSTRACT
Objective To study the mechanisms of vertebrae semi-dislocation of Tuina manipulation for treating patients with lumbar intervertebral disc protrusion (LIDP) by observing the three-dimensional (3D) displacement of lumbar before and after Tuina manipulation. Methods Ten LIDP patients were selected and evenly divided into two groups: Group 1 as tendon-smoothing manipulation group (relaxing group), Group 2 as tendon-smoothing plus adjusting manipulation group (adjusting group). Besides, Group 3 as control group was established by 5 healthy volunteers treated with tendon-smoothing manipulation. Before and after manipulation intervention, all subjects were scanned from L1 to L5 segment by using Philips 64 spiral CT under equal conditions for accessing the volume data. ITK reconstruction software was used to reconstruct each lumbar skeleton for finite element analysis. The 3D displacements and angular displacements among three groups were compared. Results 3D displacement from L1 to L5 segment all changed in three groups. For adjusting group, the angular displacements at X-axis in L3 segment was (1.77±0.46)°, and that in L4 segment at X-axis and Y-axis was (1.78±0.53)° and (1.89±0.75)°, respectively, which was significantly larger than relaxing group and control group (P<0.05); the angular displacements at X-axis from L1 to L5 segment were (1.50±0.47)°, (1.55±0.57)°, (1.77±0.46)°, (1.78±0.53)°, (1.61±0.39)°, respectively, which were significantly larger than control group (P<0.05); displacement at Y-axis in L3 segment was (2.87±0.74) mm, and that at X-axis in L4 segment was (1.68±0.64) mm, which were significantly larger than relaxing group and control group (P<0.05); displacement at X-axis in L1, L4 and L5 segment was (1.28±0.21),（1.68±0.64）, (1.30±0.51） mm, and that at Y-axis in L1 to L3 segment was (1.92±0.42), (2.25±0.61), (2.87±0.74) mm, which was significantly larger than control group (P<0.05). The angular displacements and displacements of L1 to L5 segment in relaxing group were larger than those in control group, but without any significant differences. Conclusions Compared with relaxing manipulation, adjusting manipulation played a more obvious adjusting role in instability and degenerative lumbar vertebra, especially for angular displacements in X-axis, and displacements in X-axis and Y-axis. Namely, the mechanisms of vertebrae semi-dislocation of adjusting manipulation were to make horizontal and rotational displacements at lumbar vertebra other than upper and lower displacement. The effect of relaxing manipulation was not so obvious on lumbar structure of LIDP patients.
ABSTRACT
Objective To observe the clinical effects and safety of radiofrequency thermocoagulation in treating the lumbar intervertebral disc protrusion.Methods Thirty patients with lumbar intervertebral disc protrusion,whose diagnoses were confirmed by clinical manifestations and CT findings,were involved in this study.The needle was punctured to the target point of the diseased intervertebral space under C-arm fluoroscopic guidance.After the testing of sensory nerve,motor nerve and temperature was made,the target needles were heated until the nerve radiofrequency temperature meter reached the point of 92℃.This point of temperature was held for 100 seconds and the procedure was repeated for four cycles.Results Six months after the treatment,all patients showed an obvious improvement in VAS,which decreased from 7.83±0.33before operation to 2.37±0.48 after treatment(P＜0.05).According to the modified Macnab therapeutic evaluation criteria,excellent result was seen in 9,good result in 12,fair result in 5 and poor result in 4cases,with a total effective rate of 86.7%.No serious complications occurred in all patients.Conclusion Radiofrequency thermocoagulation is an effective and safe method for the treatment of lumbar intervertebral disc protrusion.
ABSTRACT
Objective To explore the effectiveness of TCM(Traditional Chinese Medicine)care on community patients with lumbar intervertebral disc protrusion(LIDP). Methods 80 patients with LIDP were randomly allocated to the control group and the experimental group with 40 in each one. Differentiated TCM care was applied to the experimental group, which included diet modification, environment adjustment,emotion conciliation, function improvement activities and massage. The control group was applied with routine care in community context. The treatment effect between the two groups was compared. Results The experimental group showed better consequences and life quality than the control group, the differences were statistically significant. The physical and functional condition was also better than the control group. Conclusions TCM care is applicable in community patients with LIDP, and it has significantly positive effects on rehabilitation and life quality of these patients.
ABSTRACT
@# Objective To observe the therapeutic effect of warm magnetic field combined with medium frequency electric current on lumbar intervertebral disc protrusion of old patients.Methods By retrospective analysis, 120 old patients with lumbar intervertebral disc protrusion were divided into the therapeutical group (treated with warm magnetic field combined with medium frequency electric current) and control group (treated with ultrashort wave combined with medium frequency electric current), and therapeutic effects of two groups were compared.Results There was no significant difference between the therapeutic effects of two groups ( P>0.05).Conclusion Warm magnetic field combined with medium frequency electric current is same effect as ultrashort wave combined with medium frequency electric current on lumbar intervertebral disc protrusion of old patients.
ABSTRACT
Objective To study clinical application value of sacral and epidural block in treating lumbar intervertehral disc protrusion (LIDP), and explore technical operation methods, indications and con-traindications of sacral block. Methods Sacral block was adopted in 120 patients with LIDP(sacral group), they were injected triamcinolone acetonide 40 mg, vitamin B1 100 mg, vitamin B12 1 mg, 2% lidocaine 100 mg, added physiological saline 20-30 ml, twice a week, three times as a period. Compared therapy effect with epidural block (120 cases, epidural group). Results The achievement ratio of once puncture was 93.3% (112/120) in sacral group and 82.5% (99/120) in epidural group, P < 0.05. After treatment, the excellent and good rate of sacral group and epidural group were 85.0%(102/120) and 93.3%(112/120), there was not obvious difference, P>0.05, but the fair and bad rate were 15.0%(18/120) and 6.7%(8/120), there was ob-vious difference, P<0.05. Conclusions Sacral block and epidural block are effective methods to treat LIDP. They can relieve the stress at nerve root, especially sacral block, which has the advantages of easily operation, less pain, less side effect and safety.
ABSTRACT
Objective To observe the mid-term effectiveness of percutaneous lumbar puncture and injection of medical ozone and collagenase in treating lumbar disc herniation.Methods CT-guided percutaneous lumbar puncture and medical ozone injection into the intervertebral disc was performed in 78 patients with lumbar disc herniation, which was confirmed by imaging study or clinical manifestations.After 2-4 days, neucleolysis was carried out.Collagenase 12 000 U was injected via the anterior epidural space onto the surface or into the inside of the prominence of the protruded disc.Results The clinical results were evaluated in 6-25 months after the procedure.Of 78 patients treated with this technique, the result was excellent in 58(74.3%), good in 16(20.5%) and poor in 4(5.1%).Symptoms returned in 12 cases in 2 months after the procedure, and the reappeared symptoms were relieved in 9 of them within 2 months without giving any treatment.In 3 cases the symptoms disappeared after repeated injection of medical ozone.No serious complications occurred.Conclusion Percutaneous lumbar puncture and injection of medical ozone combined with collagenase is an effective, safe and minimally-invasive therapy for lumbar disc herniation.
ABSTRACT
[Objective] Explore the combination therapy to lumbar intervertebral disc protrusion on clinical efficacy.[Methods]Treat a total of 206 cases of lumbar intervertebral disc protrusion.All cases were diagnosed by CT location;Use automatic lumbar traction bed,manipulation and cheirapsis,Chinese Fomentation,intraspinal injection and intravenous drug delivery,with functional exercise.[Results] 192 cases of patients with follow-up,period 8 months,148 cases curable,32 cases markedly,improvement in 9 cases,3 cases invalid.The total effective rate 98.43%.[Conclusion] The comprehensive treatment of Chinese and western medicine will enable the majority of patients with lumbar intervertebral disc protrusion be more satisfied with the treatment effect.
ABSTRACT
[Objective] To observe imaging changes of Lumbar Intervertebral Disc Protrusion(LIDP)treated by Leverage Location manipulation.[Methods] 33 patients with lumbar intervertebral disc protrusion were observed(male=19,female=14),4 cases of expand type,25 cases of the outstanding type,4 cases of the free type.Using lever to observe the CT imaging of the cases.[Results]The 24 cases had no change in degree of Intervertebral Disc Protrusion while 9 cases had the changes.29 cases changed the compression relation between the nerve root and the lumbar intervertebral protrusion.Another 4 cases had nothing changed.[Conclusion] Leverage location manipulation has a little effect on changing the degree of the lumbar intervertebral protrusion,but can change compression relation between the nerve root and the lumbar intervertebral protrusion which proves that leverage location manipulation has effect on curing the LIDP.
ABSTRACT
Objective To evaluate the curative effect of comprehensive rehabilitative treatment for lumbar intervertebral disc protrusion by using the MRI tests before and after the treatment. Methods Forty patients with lumbar intervertebral disc protrusion were treated by a comprehensive rehabilitative treatment program composed of physical modalities, medications, traction, massage and medical gymnastics, for 30 days. MRI test were performed with all the patients, and comparison of the MRI manifestations before and after the treatment was conducted to evaluate the therapeutic efficacy. Results The clinical effective rate was 82.5%. There was no significant difference between the MRI manifestations, including MRI signal intensity, thickness and degree of the protrusion, anteroposterior and transverse diameter, width of lateral recess, before and after the treatment. Conclusion The comprehensive rehabilitative treatment program used in this study did not significantly decrease the size of lumbar intervertebral disc protrusion, but did relieve or cure the clinical symptoms of the patients.
ABSTRACT
Objective To investigate the pathogenesis,clinical manifestations and CT findings of lumbar intervertebral disc protrusion in the adolescent.Methods The clinical and CT representations of 21 cases with lumbar intervertebral disc protrusion in the adolescent were retrospectively analysed.There were 15 males and 6 females,ranged from 13~20 years in age with a mean of 18.3years.Results The main CT findings included:①central type(16 cases,76.19%);②para-central type(3 cases,14.29%);③forminal type(2 cases,9.52%).The location of disc herniation occurred frequently at the level of L_4~S_1 intervertebral space.Conclusion The lumbar intervertebral disc protrusion in the adolesent is mostly central type,the complicated CT signs are little.This disease was closely related to trauma and developmental anomaly.