ABSTRACT
BACKGROUND: In recent years, the finite element analysis of lumbar biomechanics has become a hot topic. Lumbar lordosis is considered to reduce the pressure load on the lumbar intervertebral disc and protect the lumbar spine. OBJECTIVE: To study the biomechanical effects of lumbar traction on L1-L5 lumbar segments in normal physiological curvature, flexion position and maximum overextension position, and to evaluate the optimal physiological curvature of lumbar traction. METHODS: A healthy male volunteer, aged 26 years, with a height of 174 cm and a weight of 60 kg, was selected, who had no history of lumbar spine diseases. With the L3 segment as the traction site, a finite element model of the whole lumbar spine was established based on lateral radiographs of the lumbar spine at the initiation site and during the maximal overextension as photographed by a DR machine. Based on the three-dimensional finite element model of the lumbar spine, the stress values and distributions of the lumbar vertebrae, the intervertebral joints, the intervertebral discs and the anterior longitudinal ligaments of the whole lumbar spine under different physiological curvatures were calculated. The patient was fully informed of the study protocol and signed an informed consent. The study protocol was approved by the Ethics Committee of Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine. RESULTS AND CONCLUSION: (1) Under six kinds of simulated working conditions, the range of motion of L1-L2 was 9.31° for flexion and extension, 9.84° for right and left bending, and 4.43° for right and left rotation; the range of motion of L2-L3 was 10.22° for flexion and extension, 12.35° for left and right bending, and 4.57° for left and right rotation; the range of motion of L3-L4 was 11.20° for flexion and extension, 11.63° for left and right bending, and 5.32° for left and right rotation; the range of motion of L4-L5 was 13.16° for flexion and extension, 11.58° for left and right bending, and 5.05° for left and right rotation. Under the normal physiological curvature of the lumbar vertebrae, the stress value of different lumbar spine structures was much greater than the stress value of hyperextension traction. The normal curvature of the anterior longitudinal ligament was 2.47 MPa, and the curvature of hyperextension traction value was 21.20 MPa. The stress value of L3 was the highest, which was four times that of the hyperextension traction. The stress value of the intervertebral joints at L2-L3 and intervertebral disc was highest than that of any other segment of the lumbar spine. These findings indicate that the pressure of lumbar vertebrae, intervertebral joints and intervertebral discs in hyperextension position is less than that in normal physiological curvature traction, and the pressure of anterior longitudinal ligament is always within the safe range. Lumbar traction may have better clinical efficacy and definite security in hyperextension position.
ABSTRACT
Objective To analyze the clinical effects of Shenzhuo Decoction combined with massage manipulation, acupotomy and lumbar traction in treatment of lumbar disc herniation. Methods A total of 495 cases of lumbar disc herniation from January 2015 to December 2018 were divided into the observation group and control group, with 259 and 236 cases respectively in observation and control groups. The patients in control group were only given regular massage manipulation, acupotomy and lumbar traction, and the patients in observation group were given Shenzhuo Decoction based on the treatment of control group. The clinical effects of the two groups was analyzed after 2 weeks of treatment. Results The total effective rate and JOA Score of observation group were significantly better than that in the control group (P < 0.05). Conclusion Shenzhuo Decoction in the treatment of lumbar disc herniation has good curative effect. It has the advantages of quick curative effect and short courses of treatment with the regular massage manipulation, acupotomy and lumbar traction, which can be promoted in clinical practice as a conservative treatment for lumbar disc herniation.
ABSTRACT
Objective To investigate the clinic technique and effect of treating lumbar disc herniation (LDH) with decompressor and ozone injection combined lumbar traction after surgery.Methods 110 contained LDH patients were randomly divided into two group:decompressor and ozone group,decompressor and ozone combined lumbar traction after surgery group.Under the guidance of CT,fifty-five patients in group A were treated by disc decompression with Decompressor through poster olateral approach,then ozone was injected into the lumbar disc or out side the lumbar disc,and the other fifty-five patients in group B were treated by lumbar traction after surgery that disc decompression and ozone injection same as the group A in once a day and one week of treatment.The theraputic effect was evaluated by comparing VAS,effective rate of therapy before and after treatment.Results The VAS score of two groups at 1,3,7 days between pre-and post-treatment had singificantly different(t =2.159,2.163,2.169,2.167,2.173,2.192,all P ＜0.05).110 case were followed up after 6 and 12 months,The good-excellent rate of therapy in B group 12 months were better than those of A group (x2 =74.23,75.11,all P ＜ 0.05).Conclusion Decompressor combined ozone injection and lumbar traction after surgery is an effective menthod for treatment of the central type mbar disc herniation.
ABSTRACT
Background: Herniated lumbar disc is a very common disease in the age group of 20-50 year olds the worldwide, likewise in Vietnam. There are many traditional therapies for treating this disease, such as electro-acupuncture, traditional massage, and traditional drugs... Objectives: To evaluate the effects and side-effects of combining electro-acupuncture, traditional massage, magnet-heating and lumbar traction in treating herniated lumbar disc. Subjects: 60 patients with herniated lumbar disc, over 20 years of age, were treated at the Department of Traditional Medicine and Rehabilitation, Hospital of Traditional Medicine between July 2006 and October 2007. Method: Prospective, clinical case-controlled trial. Participants were divided equally into two groups: intervention and control group. The treatment lasted for 30 days. Data was analyzed by SPSS software, version 11.5. Results: After 30 days of treatment, there were significant improvements in intervention patients about Lasegue sign, elasticity of lumbar spine, and daily movements when compared to control group. Outcomes after 30 days of treatment in the control group were 16.7% of very good, 43.3% of good, and 40% of moderate. Intervention group had better results, with 46.7% of very good, 46.7% of good, and 6.6% of moderate (p <0.01). There was not any side-effect observed in this trial. Conclusion: The combination of electro-acupuncture, traditional massage, magnet - heating and lumbar traction is a safe method and is an effective treatment for herniated lumbar disc.