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Objective To conduct Meta analysis and trial sequential analysis (TSA) on warm acupuncture treatment on lumbar intervertebral disc protrusion (LIDP); To provide references for evidence-based medicine of this disease.Methods Articles about warm acupuncture treatment for LIDP clinical randomized controlled trials in CNKI, Wanfang database, Chonging Wepu, CBM, OubMed, Cochrane Library, and Emnase were retrieved by computer. The retrieval range was from the database establishing to March, 2017. According to Cochrane Handbook for Systematic Reviews of Interventions 5.2.0 Bias risk assessment tool, included articles were under quality evaluation. Revman5.2 software was used to carry out Meta analysis, and TSAv0.9 software was used to conduct TSA.Results Ten articles were included, involving 1035 cases. Meta analysis showed that the total effective rates of warm acupuncture treatment for LIDP [95％CI (2.43, 5.40),Z=6.31,P<0.00001], pain index [95％CI (-1.05, -0.58),Z=6.77,P<0.00001], lumbar function [95％CI (2.56, 8.61),Z=3.62,P=0.0003] were better than other therapies, with statistical significance. Funnels included in the study suggest publication bias. TSA results suggested that the total efficiency and pain index Meta analysis results of this study were reliable.Conclusion Warm acupuncture treatment for LIDP has confirmed efficacy, with certain advantages. However, the literature included is not with good quality, so more large sample, multicenter, methodological RCTs are needed for further validation.
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Objective To investigate the clinical efficacy of ozone injection combined with radiofrequency ablation (RFA) for the treatment of far lateral lumbar disc herniation (FLLDH). Methods A total of 60 patients with FLLDH, who were admitted to authors’ hospital during the period from March 2013 to March 2014, were randomly and equally divided into the study group (n=30) and the control group (n=30). Simple ozone injection treatment was employed for the patients of the control group, while ozone injection combined with radiofrequency ablation was adopted for the patients of the study group. The same other adjunctive medication was used in both groups. All the patients were followed up at one week as well as at one, 3 and 6 months after the treatment. The clinical effect and the complications of both g roups were recorded. Results Successful operation was obtained in all 60 patients, no perioperative complications occurred, and the technical success rate was 100%. The excellent clinical results evaluated at one week, and one, 3 and 6 months after the treatment in the control group and in the study group were 73.3%, 76.7%, 70%, 60% and 70%, 76.7%, 83.3%, 90% respectively. The 3-month and 6-month clinical results of the study group were significantly better than those of the control group. Conclusion For the treatment of FLLDH, ozone injection combined with radiofrequency ablation is safe and effective. This technique should be recommended in clinical practice.
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Objective To study the clinical effect of the minimally invasive surgery for treating recurrent lumbar disc protrusion . Methods Thirty operative cases of recurrent lumbar disc protrusion treated with the minimally invasive surgery from July 2009 to July 2013 were retrospectively analyzed for statistically describing the age ,body mass index ,recurrent segment ,operating time ,intr-aoperative bleeding volume and postoperative painless walking time .The recurrence segments were 1 case of L34 ,10 cases of L45 and 19 cases of L5 S1 ;the visual analogue scale (VAS) was adopted to evaluate the operative effect .Results The operating time was 65 min on average (50-100)min;mean intraoperative bleeding volume was 145 mL(100-180)mL ;average length of hospital stay was 13 d (9-16)d;average hospitalization costs were 7 300 Yuan;average postoperative painless walking time was 11 d (7-15)d;post-operative non-manual labor work time was 27 .3 d .The VAS score was reduced from (7 .3 ± 1 .3) before operation to (3 .1 ± 0 .9) after operation and (2 .2 ± 0 .6) at the last follow-up ,which was statistically significant(P<0 .05) .Followed up for 6-33 months , average 16 .5 months .Superior efficacy in 16 cases ,gord in 7 cases ,average in 5 cases ,bad in 2 cases ,the rate of good efficacy was 76% .Conclusion The minimally invasive surgery is one of effective methods to treat postoperative recurrence of lumbar disc pro-trusion .
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Objective To research the relationship among the disc protrusion on MRI, sex, age, course and the clinical types. Methods MRI was performed for 102 patients. The disc protrusion was divided into three types. According to clinical types, the patients were divided into four types. Statistically, age, course, clinical type and protrusion on MRI were analyzed by SPSS13.0. Results The age was not related with the clinical types and disc protrusion on MRI. There were obvious relations between clinical types and course. There were obvious relations between clinical types and disc protrusion. Conclusion The clinical types are very important on diagnosis of disease stages and choice of therapy in treating lumbar disc protrusion.
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Objective To investigate curative outcomes of the limited-incision surgery under cold light source for treating calcified lumbar disc protrusion. Methods A total of 36 patients with calcified lumbar disc protrusion underwent limited-incision surgery under cold light visualization from January 2000 to June 2005. The patients were maintained at a prone position. The operation was carried out under local anesthesia. A longitudinal skin incision around 3 cm in length was made. After the inferior border of the vertebral plate and the intervertebral space were exposed, a lamina retractor was inserted above the superior border of the articular process. Then a fenestration and a discectomy were performed under cold light visulization. Results The operative time was 75.3?3.5 min and the intraoperative blood loss was 100.6?5.5 ml. Cerebrospinal fluid leakage occurred in 3 patients. All the 36 patients were followed for 6~60 months (mean, 27 months). Symptoms of low back pain, lower limb pain, and intermittent limping disappeared completely in all the 36 patients. According to the Nakai standard, the rate of excellent or good results was 94.4% ( 34/36 ). Conclusions Limited-incision surgery under cold light source for the treatment of calcified lumbar disc protrusion offers advantages of simplicity of performance, minimal invasion, and satisfactory outcomes.
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Objective To observe therapeutic effect in the near future of the operation of vertebrascope in route of retreat to treat lumbar disc protrusion and complications.Method According to symptoms,signs,myelography and CTM results to determine protrusion interspace and side type,applied the operation of vertebrascope in route of retreat to treat lumbar disc protrusion and perform functional exercises.Results 86 patients were followed up,and within these patients,58 appeared excellent (67% ),25 appeared good (29% ), 2 appeared not bad (2% ),and 1 appeared bad(1% ).Conclusion The technology has many advantages, such as little wound, little hemorrhage, little pain and fast restoration,which provide advantageous conditions for early functional exercises after operation.
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Objective To investigate the clinical characteristics and treatment of senile patients with lumbar disc protrusion . Methods The clinical data of 56 cases of senile lumbar disc protrusion from 1990 to 2000 were reviewed retrospectively. Results 48 patients had been followed for 6 months to 7.5 years with average 4 years. Excellent and good results were 41 cases (85.4%).Conclusions There was atypical symptom in the senile patients with lumbar disc protrusion. CT was an important methods for diagnosis. The after concomitant diseases were controlled, resecting half vertebral lamina and enlarging fenestration were performed. The therapeutic results were satisfactory.
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@#Peak Torque(PT),Total Work(TW),Average Power(AP),Torque Acceleration Energy(TAE),Set Total Work(STW),Endurance Ratio (ER)and DOrsal/plantar ratio of ankle dorsal and plantarflexion were tested in 101 patients with lumbar disc protrusion using a Cybex一6000 isokinetic muscle test-ing instrument.The results showed the most tested of the affected side was signficantly lower than that onthe opposite side. The PT,TW and STW of the affected side was lower 70一80%than that on the oppo-site side. The rest was lower 20一30%than another side. No significant difference of endurance ratios be-tween the affected and unaffected sides was noted.