ABSTRACT
Objective:To observe the clinical effect of modified Shishi Niubangzi Decoction combined with strengthening muscle-waist exercise on lumbar disc herniation (LDH).Methods:Randomized controlled trial. A total of 60 patients with LDH admitted to the Pinggu Hospital, Beijing Traditional Chinese Medicine Hospital, were enrolled as the research objects between September 2020 and September 2021. According to the random number table, they were randomly divided into the treatment group and control group, 30 in each group. Both groups were given routine basic treatments (strengthening tendons-waist exercise and three-position six-step manipulation). On this basis, the treatment group was treated with modified Shishi Niubangzi Decoction, while the control group was treated with non-steroidal anti-inflammatory drugs (ibuprofen codeine sustained-release tablets). Both groups were treated for 4 weeks. The responsive rates, back pain intensity, leg pain and numbness by Visual Analogue Scale (VAS) and lumbar function by Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) were compared between the two groups.Results:The response rate of treatment group was significantly higher than that of control group (93.3% vs. 73.3%; χ2=4.32, P=0.038). After treatment, scores of JOA (subjective symptoms, signs, activities of daily living) in the treatment group were significantly higher than those in the control group ( t=3.86, 2.71, 2.21, P<0.05). After treatment, scores of back pain (2.12±0.21 vs. 3.02±0.32, t=12.88), leg pain (2.04±0.64 vs. 2.64±0.66, t=3.58), lower limb numbness (1.75±0.24 vs. 2.41±0.70, t=4.89) in the treatment group were significantly lower than those in the control group ( P<0.01). At 1 week and 1 month after treatment, ODI scores in treatment group were significantly lower than those in control group ( t=10.22, 5.59; P<0.05). Conclusion:The modified Shishi Niubangzi Decoction combined with strengthening tendons-waist exercise can improve responsive rates, improve lumbar pain and function in LDH patients.
ABSTRACT
Objective@#To study the application value of nerve root decompression through posterior approach in minimally invasive surgery of lumbar disc herniation (LDH).@*Methods@#From June 2016 to June 2018, 80 patients with unilateral single segment LDH were selected and diagnosed in Yunnan Puer People′s Hospital.The patients were divided into control group and observation group according to the random number table method, 40 cases in each group.The control group was treated with posterior fenestration and nucleus pulposus extraction, and the observation group was treated with posterior neurolysis and decompression through 5.3 mm intervertebral foramen.The incision length, operation time, intraoperative blood loss and postoperative hospital stay were compared between the two groups.The visual analog scale (VAS) of pain before operation and 1, 2, 7 days after operation was compared.The Japanese Orthopedic Association (JOA) score and the Oswestry disability index (ODI) questionnaire score before operation and 1, 3, 12 months after operation were compared.The effect of lumbar function recovery 12 months after operation was compared.@*Results@#The incision length, operation time, days in-hospital after operation, and bleeding amount in observation group were (0.9±0.2) cm, (50.8±8.6) min, (16.5±5.9) ml, (4.3±0.5)d, and in control group were (4.6±0.8) cm, (72.3±15.2) min, (52.5±10.3) ml, (7.2±0.9)d.The differences between the two groups were statistically significant (t=8.625, 14.623, 32.625, 6.524, all P<0.001). The VAS scores of the observation group and the control group were (5.7±1.1), (3.3±0.6), (1.2±0.3), (0.5±0.1) and (5.5±1.2), (4.2±0.8), (1.9±0.4), (1.1±0.3) before and 1, 3 and 7 days after the operation, respectively.The differences 1, 3, 7 days after operation between the observation group and the control group were statistically significant (all P<0.05). The JOA scores of the observation group were (8.1±1.6), (19.3±4.2), (23.2±4.9), (25.8±5.2) before and 1, 3 and 12 months after operation, respectively, and those of the control group were (8.3±1.5), (15.2±3.3), (19.3±4.2), (20.6±5.5) after operation.The differences 1, 3, 12 months after operation between the observation group and the control group were statistically significant (all P<0.05). The ODI scores of the observation group were (43.7±10.6), (18.3±5.2), (10.2±3.9), (1.8±0.5) before and 1, 3 and 12 months after the operation, respectively, and those of the control group were (42.5±9.4), (25.2±5.3), (14.3±4.2), (4.6±0.9) after the operation.The differences 1, 3, 12 months after operation between the observation group and the control group were statistically significant (all P<0.05). The effective rate of the observation group was significantly higher than that of the control group (92.5%(30/40) vs.75.0%(37/40), χ2=4.501, all P=0.034).@*Conclusion@#It can bring less trauma and faster recovery with 5.3mm intervertebral endoscopy by posterior approach of nerve root decompression for LDH patients, which is better safety and efficacy.
ABSTRACT
Objective:To observe the therapeutic effect of nerve block therapy guided by electric stimulation on the relief of pain and the improvement of function in patients with low back pain(LBP).Method:A total of 78 LBP patients were divided into nerve block treatment group(n=40)and traditional treatment group(n=38)randomly.The nerve block treatment group was injected with Betamethasone compound 2mg and Lidocaine 2ml guided by electric stimulation.The physical modalities and exercises therapy were applied in the traditional treatment group.The pain was evaluated with visual analogue scale(VAS)before treatment and 1 d,1 and 2 weeks after treatment.The function of lumbar was assessed before and after the treatment with performance assessment scale for the treatment of lumbar vertebral diseases.Result:The effective rate in treatment group was 100.0%,in traditional group was 86.8%:the improvement rate in treatment group was 96.6%.in traditional group was 64.3%:there were significant differences between two groups (P<0.01).Conclusion:Nerve block therapy guided by electric stimulation display significant effect on relief the low back pain and improve the function of lumbar vertebrae.
ABSTRACT
The purpose of this study was to obtain the normative values for variable parameters of lumbar function with the isoinertial triaxial dynamometer in normal subjects and to compare these values with those of the patients with chronic low back pain. In 82 normal subjects and 27 patients with chronic low back pain, the variable parameters including lumbar range of motion (ROM), maximum isometric torques, and maximum isoinertial velocities were measured with the isoinertial triaxial dynamometer in three axes (rotation, flexion-extension, and lateral flexion). In normal subjects, all parameters except lumbar ROM of all three axes were significantly higher in the male group than the female group. However, other anthropometric variables such as age, height, weight, and body mass index were little correlated with each parameter. Therefore, the normative values were obtained only in consideration of the gender. In patients with chronic low back pain, all parameters except the maximum isometric torques in the female group were significantly lower than those in normal subjects. In addition, the decrease of maximum velocities during the isoinertial exercise was highly correlated to verbal rating scales (VRS) in most axes, especially in the female patient group, but the duration of low back pain was little correlated with the various parameters measured with the isoinertial triaxial dynamometer. In conclusion, all parameters measured with the isoinertial triaxial dynamometer in all three axes were significantly lower in patients with chronic low back pain than those in normal subjects except maximum isometric torques of female group. It was suggested that maximum isoinertial velocities were more reliable and significant than maximum isometric torques for the objective assessment of chronic low back pain.