Effect of traditional Chinese medicine massage on the rehabilitation of spinal function in scoliosis patients undergoing 3D printing orthopedic surgery / 中国骨伤

OBJECTIVE@#To explore the effect of Chinese massage on the rehabilitation of scoliosis patients undergoing 3D printing orthopedics.@*METHODS@#A retrospective selection of 262 patients with adolescent idiopathic scoliosis(AIS) who underwent 3D printing technology orthopedics admitted to the Department of Orthopedics in our hospital from January 2013 to January 2019 were selected for clinical research. According to the rehabilitation treatment methods adopted by the patients after the operation, the patients were divided into control group and observation group, there were 131 cases in each group. The observation group was treated with traditional Chinese acupuncture and massage after operation, and the control group was treated with conventional rehabilitation. The torso rotation angle and the maximum Cobb angle before and after intervention were measured and compared between two groups, Oswestry Disability Index(ODI) was used for functional evaluation, and the visual analogue scale(VAS) was used to evaluate the changes in pain before and after rehabilitation intervention.@*RESULTS@#After the intervention, the trunk rotation angle and maximum Cobb angle of the observation group were significantly better than those of the control group, the VAS score of the observation group was significantly lower than that of the control group, ODI in the observation group was significantly lower than that in the control group, and the difference was statistically significant(P<0.05).@*CONCLUSION@#After scoliosis patients undergo preoperative 3D printing correction, the scientific and reasonable implementation of TCM acupuncture and massage can effectively improve the patient's vertebral rotation angle, maximum Cobb angle, and improve the patient's spinal function.

Clinical characteristics analysis of lumbar disc herniation with symptom aggravated caused by spinal manipulative therapy / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the characteristics of lumbar disc herniation (LDH) with symptom aggravated caused by spinal manipulative therapy (SMT).</p><p><b>METHODS</b>Detailed clinical profiles of a total number of 10 LDH patients with symptoms aggravated after SMT were reviewed including 5 males and 5 females with age from 46 to 68 years old, 7 patients of them were more than 50 years old. The clinical data of 10 patients were analyzed involving age, gender, clinical symptoms, signs, imaging findings, surgical treatment and prognosis. Laminectomy and discectomy were performed, and follow-up was carried out in all patients.</p><p><b>RESULTS</b>The duration of symptoms in all the patients before SMT was 4 to 15 years. After the therapy, an acute exacerbation of back and radicular pain was observed within 24 hours. MRI showed intervertebral disc herniation, 7 patients were observed in L4-L5. The time internal between the exacerbation of presentation and surgery was 23.1 days. No perioperative complications occurred. All the patients were relieved of radicular pain a few days after surgery. During postoperative follow-up, all patients regained the ability to walk; Eight patients reported a complete resolution of presentation and the rest two patients were significantly improved.</p><p><b>CONCLUSIONS</b>SMT should be prohibited in some LDH patients to prevent neurological damages, in whom there are 5 possible risk factors.</p>

Clinical effect of massage therapy on infants and young children with asthmatic disease / 中国基层医药

Objective To study the clinical effect of massage therapy on infants and young children with asthmatic disease.Methods 100 infants and young children with asthmatic disease were selected.The children and parents who agreed to cooperate with massage therapy were enrolled as treatment group.The children and parents who were unwilling to cooperate with massage therapy,but willing to cooperate with home aerosol therapy were enrolled as control group,50 cases in each group.The two groups of children took comprehensive treatment measures,the treatment group was given massage therapy,the control group was given home aerosol therapy.The therapeutic effects of the two groups were compared and analyzed.Results The respite time,recurrent frequency of wheezing within 1 year,respiratory infection occurred within 1 year,number of re-hospitalization within 1 year of the control group were (5.6 ± 1.36) d,(2.35 ± 1.13) times,(2.96 ± 1.22) times,(0.85 ± 0.58) times,which of the treatment group were (5.82 ± 1.44) d,(2.31 ± 1.09) times,(2.89 ± 1.19) times,(0.86 ± 0.51) times,the differences were not statistically significant between the two groups (t=0.573,0.417,0.523,0.872,all P ＞0.05).The peak time before treatment,1 month after treatment and 6 months after treatment,and the peak volume ratio before treatment,1 month after treatment and 6 months after treatment between the two groups had no statistically significant differences(all P ＞ 0.05).Conclusion Massage therapy can achieve the same effect with the home aerosol therapy,the method is simple,easy,without any adverse reactions,it is worthy of clinical promotion.

Effect of acupuncture combined with massage on clinical symptoms and function of cervical vertebra in patients with cervical spondylosis of vertebral artery type / 中国基层医药

Objective To research the improvement effect of acupuncture combined with massage on clinical symptoms and function of cervical vertebra in patients with vertebral artery type of cervical spondylosis.Methods 100 patients with vertebral artery type of cervical spondylosis were included in this study.They were divided into the observation group (52 cases) and the control group(48 cases) by the random number table method.The patients in the control group were treated with conventional treatment,and the observation group was given acupuncture combined with massage on the basis of the conventional treatment.The clinical efficacy,the improve degree of clinical symptoms and cervical vertebra function were compared between the two groups.Results The total effective rate of the observation group was 94.23 ％,which was significantly higher than 79.17 ％ of the control group,and there was statistically significant difference between the two groups (x2 =5.008,P =0.025).Before treatment,there were no significant difference between the two groups in terms of symptom scores and hemodynamic parameters (all P ＞ 0.05).After treatment,the clinical symptoms scores of the two groups were significantly higher.The average blood flow velocity (TMFV),peak systolic velocity(PSV),pulsatility index(PI) and resistance index(RI) of the observation group were (26.87 ±5.14) cm/s,(61.63 ± 10.11) cm/s,(0.74 ± 0.13),(0.53 ± 0.08),respectively,which of the control group were (24.18 ±4.48)cm/s,(54.47 ±9.34)cm/s,(0.92 ±0.22),(0.66 ±0.13),respectively,there were statistically significant differences between the two groups (t =2.779,3.669,5.026,6.073,P =0.006,0.000,0.000,0.000).Conclusion Acupuncture combined with massage in the treatment of vertebral artery type of cervical spondylosis,the local blood flow of patients is significantly increased,and the blood supply of the brain is effectively alleviated,so as to improve the clinical symptoms and cervical function.It can play a positive role in the treatment of vertebral artery type of cervical spondylosis.

Clinical observation on acupuncture at Jiaji (EX-B 2) points plus tuina in treating thoracic facet joint disorder / 针灸推拿医学（英文版）

Objective:To observe the clinical effects of acupuncture at Jiaji (EX-B 2) points plus tuina manipulation for thoracic facet joint disorder, and get new clinical evidence for treatment of thoracic facet joint disorder. Methods:Totally 106 patients with thoracic facet joint disorder were randomly allocated into an observation group and a control group based on the random number table. Patients in the control group were treated by tuina manipulation, while those in the observation group were treated by acupuncture at Jiaji (EX-B 2) points before tuina manipulation. Patients in the two groups were treated once a day. The improvements of signs and symptoms and the efficacy were observed after 3 treatments. Results:After treatment, there were intra-group statistical differences in scores of 8 signs and symptoms in both groups (P<0.01); the score of each item in the observation group was lower than that in the control group, and there was statistical significance in the inter-group difference (P<0.05). The cure rate of the observation group was 50.9%, versus 26.4% in the control group, and there was a significant difference between the two groups (P<0.05). Conclusion:In treating thoracic facet joint disorder, acupuncture plus tuina manipulation can restore the biomechanical balance of thoracic vertebrae, fully maximized the combined effect, and significantly improve the clinical efficacy.

Efeitos da manipulação cervical alta sobre a atividade eletromiográfica dos músculos mastigatórios e amplitude de movimento de abertura da boca em mulheres com disfunção temporomandibular: ensaio clínico randomizado e cego / Los efectos de la manipulación cervical en la actividad electromiográfica de los músculos masticatorios y la amplitud del movimiento de apertura de la boca en mujeres con trastorno temporomandibular: un ensayo clínico aleatorizado y ciego / Effects of upper cervical manipulation on the electromyographic activity of the masticatory muscles and the opening range of motion of the mouth in women with temporomandibular disorder: randomized and blind clinical trial

RESUMO Avaliou-se os efeitos da manipulação cervical alta sobre a atividade eletromiográfica de superfície (sEMG) dos músculos mastigatórios e amplitude do movimento de abertura da boca em mulheres com disfunção temporomandibular (DTM). Foram avaliadas 10 mulheres com diagnóstico de DTM miogênica, segundo o Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD), divididas, aleatoriamente, em grupo experimental (GE) n=5, que recebeu manipulação cervical alta e grupo placebo (GP) n=5, que recebeu manobra sem efeito terapêutico. Cinco intervenções foram aplicadas para ambos os grupos uma vez por semana, e avaliações de pré-intervenção, pós-imediato (após a 1ª intervenção) e pós-tardio (48 horas após a 5ª intervenção) foram realizadas. A atividade sEMG foi processada via raiz quadrada da média e normalizada pelo valor de pico (RMS EMGn). Utilizou-se para comparação os testes t de Student e ANOVA two-way (medidas repetidas), adotando-se como significância o valor de 5%, e o Cohen's d para tamanho de efeito de tratamento. Constatou-se a interação significativa grupo × tempo (p<0,05) no RMS EMGn dos músculos temporal direito e esquerdo, na condição de repouso, assim como para todos os músculos mastigatórios durante contração isométrica máxima de elevação e depressão da mandíbula. Os tamanhos de efeito de tratamento moderado a alto foram observados no GE, destacando-se na avaliação pós-tardia. Foi observado também um aumento significativo (p<0,05) e um alto efeito de tratamento na abertura da boca para o GE. A manipulação cervical alta demonstrou equilibrar o RMS EMGn dos músculos mastigatórios e aumentar a amplitude de movimento de abertura da boca em mulheres com DTM miogênica.

RESUMEN En este estudio se evaluaron los efectos de la manipulación cervical alta sobre la actividad electromiográfica de superficie (SEMG) de los músculos masticatorios y de amplitud del movimiento de apertura de la boca en mujeres con trastorno temporomandibular (TTM). Se evaluaron 10 mujeres con diagnóstico de TTM miogénico, con base en el Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD), las que fueron aleatoriamente divididas en grupo experimental (GE) n=5, que recibió manipulación cervical alta, y grupo placebo (GP) n=5, que recibió maniobra sin efecto terapéutico. Se aplicaron cinco intervenciones para ambos grupos una vez por semana, y se realizaron evaluaciones preintervención, posintervención inmediata (después de la 1a. intervención) y posintervención tardía (48 horas después de la 5a. intervención). La actividad SEMG fue calculada mediante raíz cuadrada de la media y normalizada por el valor de pico (RMS EMGn). Se empleó para comparación los test t de Student y ANOVA two-way (medidas repetidas), y el nivel de significancia de 5%, y para el efecto del tratamiento el Cohen's d. Se encontró la interacción significativa grupo × tiempo (p<0,05) en el RMS EMGn de los músculos temporales derecho e izquierdo, en reposo, así como para todos los músculos masticatorios durante la contracción isométrica máxima de elevación y depresión de la mandíbula. Se observaron efectos de tratamiento moderado a alto en el GE, destacando en la etapa posevaluación tardía. También se observó un aumento significativo (p<0,05) y un alto resultado del tratamiento en la apertura de la boca en el GE. La manipulación cervical alta demostró equilibrar el RMS EMGn de los músculos masticatorios y aumentar la amplitud del movimiento de la apertura de la boca en mujeres con TTM miogénica.

ABSTRACT We evaluated the effects of upper cervical manipulation on the surface electromyographic activity (sEMG) of masticatory muscles and range of motion of the opening movement of the mouth in women with temporomandibular disorders (TMD). We evaluated 10 women with myogenic a TMD diagnosis, according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and divided randomly into an experimental group (EG) n=5, which received upper cervical manipulation, and a placebo group (PG) n=5, which received maneuvers without therapeutic effects. Five interventions were performed in both groups, once a week, with performance of pre-intervention assessments, post-immediate assessments (after 1st intervention) and post-delayed assessments (48 hours after the 5th intervention). The sEMG activity was processed using the root mean square and normalized by the peak value (RMS EMGn). We used for comparison the Student's t-test and ANOVA two-way repeated measures, adopting as significance the amount of 5%, and the Cohen d for treatment effect size. We found a significant interaction of group vs time (p<0.05) in the RMS EMGn of the left and right temporal muscles at rest, as well as for all masticatory muscles during maximal isometric contraction during jaw-elevation and jaw-depression. Treatment effect size, high to moderate, was observed in the EG, especially in the post-delayed assessment. We also observed a significant increase (p<0.05) and a high treatment effect during mouth opening in the EG. The upper cervical manipulation demonstrated a balance of the RMS EMGn of the masticatory muscles and increase the opening range of motion of the mouth in women with myogenic TMD.

Melanotic schwannoma of the lumbar spine: a case report and literature review / Schwannoma melanocítico da coluna lombar: relato de caso e revisão de literatura / Schwannoma melanótico de la columna lumbar: reporte de un caso y revisión de la literatura

Schwannomas are benign tumors, usually solitary, encapsulated, slow-growing, which have their origin in differentiated neoplastic Schwann cells with extramedullary intradural usual development related to nerve roots. The melanotic schwannoma is a variant of these tumors whose location in almost one third of cases is on the posterior spinal nerve root, with a nonspecific clinical presentation. Magnetic resonance imaging is the most widely used test for the diagnosis, revealing hyperintense T1-weighted sequences and hypointense T2-weighted sequences. Diagnostic confirmation is obtained by histological and immunohistochemical studies, in which there is intense cytoplasmatic pigmentation. There are two distinct types of melanotic schwannomas: sporadic and psammomatous, the latter related to the called Carney complex, a form of multiple endocrine neoplasm with familiar character. In literature we found few cases of these neoplasms, the largest series consisting of five cases. The objective of this study is to report a rare case of melanotic schwannoma of the lumbar spine of the sporadic type of extramedullary location. We also present a brief review of the literature containing the main characteristics of the tumor, including its different forms, differential diagnoses, data from histological and immunohistochemical studies as well as the currently recommended approach in order to contribute to a better understanding of this neoplasm.

Os schwannomas são tumores benignos, geralmente solitários, encapsulados e de crescimento lento, que têm sua origem nas células de Schwann neoplásicas diferenciadas, com desenvolvimento habitual extramedular intradural relacionado com as raízes nervosas. O schwannoma melanocítico é uma variante dessas neoplasias cuja localização em quase um terço dos casos está na raiz nervosa posterior, com apresentação clínica inespecífica. A ressonância magnética é o exame de imagem mais utilizado no diagnóstico, revelando imagens hiperintensas em T1 e hipointensas em T2. A confirmação diagnóstica é obtida através do estudo histológico e imuno-histoquímico, em que se observa intensa pigmentação citoplasmática. Existem dois tipos distintos de schwannomas melanocíticos: o esporádico e o psamomatoso, este último relacionado ao chamado complexo de Carney, uma forma de neoplasia endócrina múltipla de caráter familiar. Na literatura, encontramos poucos casos dessas neoplasias, sendo a maior série composta por cinco casos. Assim, o objetivo deste trabalho é relatar um raro caso de schwannoma melanocítico da coluna lombar do tipo esporádico de localização extramedular. Apresentamos ainda uma breve revisão de literatura contendo as principais características do tumor, incluindo suas diferentes formas, diagnósticos diferenciais, dados do estudo histológico e imuno-histoquímico, bem como a abordagem atualmente preconizada, a fim de colaborar para o melhor entendimento desta neoplasia.

Los schwannomas son tumores benignos, generalmente solitarios, encapsulados y de crecimiento lento, que tienen su origen en las células de Schwann neoplásicas diferenciadas con desarrollo habitual intradural extramedular relacionado con las raíces nerviosas. El schwannoma melanótico es una variante de estos tumores cuya localización en casi un tercio de los casos se encuentra en la raíz nerviosa posterior, con presentación clínica no específica. La resonancia magnética es el examen más ampliamente utilizado en el diagnóstico, con hiperintensidad en secuencias T1 e hiposeñal en T2. La confirmación del diagnóstico se obtiene por el estudio histológico e inmunohistoquímico, en el que existe una intensa pigmentación citoplásmica. Hay dos tipos distintos de schwannoma melanótico: el esporádico y el psamomatoso, este último relacionado con el llamado complejo de Carney, una forma de neoplasia endocrina múltiple de carácter familiar. En la literatura encontramos pocos casos de estos tumores, la serie más grande consta de cinco casos. El objetivo de este trabajo es presentar un caso raro de schwannoma melanótico lumbar del tipo esporádico y de localización extramedular. También presentamos una breve revisión de la literatura que contiene las principales características del tumor, incluyendo sus diferentes formas, los diagnósticos diferenciales, los datos del estudio histológico e inmunohistoquímico, así como el tratamiento recomendado actualmente, a fin de contribuir a una mejor comprensión de esta neoplasia.

“Tongmai songjin yigu” massage therapy for lumbar spinal stenosis：a randomized controlled trial / 中国组织工程研究

BACKGROUND:Chinese medicine therapy is effective for patients with mild-to-moderate lumbar spinal stenosis and also has a better long-term effect than surgical patients, which can enhance perioperative efficacy and prevent spinal restenosis. OBJECTIVE:To evaluate the clinical efficacy of “Tongmai songjin yigu” massage therapy on lumbar spinal stenosis. METHODS:Eighty-four patients with degenerative lumbar spinal stenosis were randomly and equaly divided into treatment group and control group. Treatment group were treated with “Tongmai songjin yigu” massage therapy; patients in the control group were treated according to the guidelines for diagnosis and treatment of common disease in orthopedics and traumatology promulgated by China Association of Chinese Medicine, once a day, continuous for 2 weeks. RESULTS AND CONCLUSION:After treatment, the visual analog scale score in the treatment group was improved significantly (P < 0.05), and there was a significant difference in the Japanese Orthopaedic Association Scores on subjective symptom and daily life between the treatment and control groups (P < 0.05). The effective rate of the treatment group was higher than that of the control group (P< 0.05). These findings indicate that “Tongmai songjin yigu” massage therapy is better than traditional massage, but clinical large-sample studies are required.

Subtle adjustment of the cervical spine combined with Shu Jing Ding Xuan Decoction for cervical vertigo / 针灸推拿医学（英文版）

Objective:To observe the effect of subtle adjustment of the cervical spine combined with Shu Jing Ding Xuan (Neck-relaxing and Dizziness-alleviating) Decoction for cervical vertigo. Methods:An open-label, randomized and parallel controlled clinical study was designed. Subtle adjustment of the cervical spine combined with Shu Jing Ding Xuan (Neck-relaxing and Dizziness-alleviating) Decoction was used for patients in the treatment group, whereas subtle adjustment alone was used for patients in the control group. The results in the two groups were statistically analyzed after two courses of treatment. Results:The recovery rate and total effective rate in the treatment group were 20.6%and 88.2%respectively, versus 14.7%and 73.5%in the control group. The inter-group differences were statistically significant (both P Conclusion: Subtle adjustment of the cervical spine combined with Shu Jing Ding Xuan (Neck-relaxing and Dizziness-alleviating) Decoction is better than subtle adjustment alone for cervical vertigo.

Spinous process fractures after chiropractic massage in a previously healthy subject / Fratura de processo espinhoso após terapia quiroprática em um indivíduo previamente saudável

Increasing available alternative therapies to the treatment of back pain and sometimes difficult access to specialized medical evaluations allowed a widespread use of alternative therapies for the treatment of back pain. We describe a case with a consequence of massage therapy in a patient with initial symptoms of back pain resulting in spinous process fractures. She promptly searched medical attendance and cervical plain radiograph revealed avulsion of spinous processes of C6 and C7 in their outer third. Due to benign nature of lesion, without evidence of instability and spinal cord injury, the subject was managed conservatively, with application of a Philadelphia collar and analgesic medication. We reinforce the needof medical attention before beginning any therapeutic method in order to identify previous alterations and plan an adequate programming.

A disponibilidade de terapias alternativas para o tratamento da dor lombar e o difícil acesso a serviço médico especializado têm permitido um uso indiscriminado de terapias para o tratamento dessa dor. Descrevemos um caso de uma paciente submetida à terapia quiroprática por causa de dor cervical que evoluiu posteriormente com persistência da dor. A investigação radiológica evidenciou fratura com avulsão de processos espinhosos de C6 e C7. Por causa da natureza estável da lesão, o caso foi conduzido conservadoramente com colar Philadelphia, no entanto reforçamos a necessidade do correto diagnóstico da dor de coluna espinhal, especialmente se persistente e associada a sinais localizatórios.

Terapia manipulativa ortopédica na dor vertebral crônica: uma revisão sistemática / Manipulative orthopedic therapy for chronic spinal pain: a systematic review

Analisar a eficácia da Terapia Manipulativa Ortopédica (TMO) nos casos de dores vertebrais crônicas. Métodos: Uma busca sistematizada foi realizada nas bases de dados PEDro, Medline e Science Direct no mês de junho de 2010, reunindo ensaios clínicos randomizados recentes que documentassem os efeitos da TMO na Dor Vertebral Crônica. Todos os trabalhos tiveram suas qualidades metodológicas avaliadas pela escala de PEDro e somente os estudos com notas acima de cinco foram revisados. Os dados foram extraídos de forma padronizada de cada estudo. Resultados: Foram revisados oito artigos sobre dor cervical crônica e onze sobre dor lombar crônica. Quanto a dor cervical crônica, seis estudos mostraram que a TMO associada a exercícios são eficazes, mantendo a melhora dos sintomas por até 24 meses. Um estudo mostrou que a TMO (sem exercícios) é superior à massagem e outro estudo mostrou que a TMO proporciona alívio imediato da dor. Quanto a dor lombar crônica, cinco ensaios clínicos mostraram que a TMO associada a exercícios são eficazes a curto e longo prazo; dois trabalhos mostraram que a TMO é mais eficaz do que analgésicos e anti-inflamatórios. Três estudos mostram que a TMO como único tratamento é eficaz, um estudo mostra que a manipulação não é mais eficaz que exercícios de extensão. Conclusão: As técnicas de TMO (exceto osteopatia) são recursos eficazes nos casos de dores crônicas da coluna. Entretanto, seus efeitos de redução da dor ocorrem somente a curto prazo, sendo necessário a associação de exercícios terapêuticos para um resultado eficaz a longo prazo. Mais estudos devem ser feitos para comparar diferentes técnicas de TMO e diferentes técnicas de exercícios entre si nos casos de dores crônicas da coluna.

To examine the effectiveness of Manipulative Orthopedic Therapy (MOT) in cases of Chronic Vertebral Pain. Methods: a systematic search was performed in PEDro, Medline, and Science Direct databases in June 2010, retrieving recent randomized clinical trials that documented the effects of MOT in Chronic Vertebral Pain. All of the studies had their methodological quality assessed by the PEDro scale and only those studies with scores higher than five were reviewed. Data were extracted in a standardized manner for each study. Results: Eight articles about chronic cervical pain and eleven articles about chronic low back pain were reviewed. On chronic cervical pain, six papers showed that MOT associated with exercises was effective, maintaining the improvement of symptoms for up to 24 months. One study showed that MOT (with no exercises) was better than massage and another study showed that MOT provided immediate pain relief. In chronic low back pain, five clinical trials showed that MOT associated with exercises was effective in the short and long term; two papers showed that MOT was more effective than analgesics and anti-inflammatory drugs. Three studies showed that MOT is effective as a single treatment and one study showed that MOT is no more effective than stretching exercises. Conclusion: The MOT techniques (except osteopathy) are effective remedies in cases of chronic spinal pain. However, its effects in reduction of pain occur only in the short term and the combination of therapeutic exercises is needed for an effective long term result. More studies should be made to compare different MOT techniques and different exercise techniques with each other in cases of chronic spinal pain.