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Objective·To investigate the effect of early neurodynamic mobilization on the recurrence of sciatica after the minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF). Methods·Fifty-four patients who underwent MIS-TLIF were divided into treatment group (n=28) and control group (n=26). The control group received conventional rehabilitation treatment, while the treatment group received neurodynamic mobilization every day after the first post-operative day. The score of visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score were evaluated before and after the treatment. Results·There was no significant difference in the score of VAS or JOA between two groups before the treatment or three months after surgery (P>0.05). The score of VAS was significantly lower (P<0.05), and the JOA score was significantly higher (P<0.05) in the treatment group than in the control group four days after surgery. Conclusion·The early neurodynamic mobilization is effective to decrease the recurrence rate of sciatica in patients underwent MIS-TLIF.
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ObjectiveTo investigate clinical efficacy of reconstructing for old anterior cruciate ligament(ACL) injury with quadruple hamstring tendon,and application value of femoral intercondylar notch plasty.Methods Fifty-six cases of old ACL injury were reconstructed arthroscopically with quadruple hamstring tendon.Forty-five cases were used femoral intercondylar notch plasty.Preoperative Lachman test were positive,and ACL injury were confirmed by MRI.The curative effect was evaluated according to Lysholm knee score and KT-1000 measurement results.ResultsAll of the 56 patients were followed up for 6-24 (13.0 ± 4.2) months.Postoperative Lachman test of 53 cases were negative,and 3 cases were weak positive.The Lysholm knee score increased from preoperative (56.0 ± 7.3) scores to postoperative (93.0 ± 3.5 ) scores,comparison of preoperative had significant difference (t =34.20,P ＜ 0.01 ).The postoperative KT-1000 measurement showed ＜ 3.0 mm side difference of anterior laxity,moving average of(2.0 ± 0.6) mm,comparison of preoperative ≥ 3.0 mm,moving average of (3.0 ± 1.2 ) mm had significant difference (t =5.58,P ＜ 0.01 ).ConclusionsArthroscopic reconstruction of ACL with quadruple hamstring tendon have a good effect.The postoperative rehabilitation exercise can practise early.The femoral intercondylar notch plasty which used during operation is benefit of decreasing femoral intercondylar notch impingement syndrome,accurate positioning femur tunnel,and increasing curative effect.
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Objective To pursue the appropriate selection of radiographic examinations of low back pain and to reduce the expenses. Method In this study,61 cases of imaging tests were studied,including 38 cases of lumbar disc herniation,10 cases of lumbar spondylolisthesis,4 lumbar stenosis,4 lumbar infection and 5 lumbar neoplasm. Result Correct diagnosis was based on the clinical signs and symptoms.Imaging findings had its value only when basing on them.Conventional roentgenogram offered a cheap evaluation and high spatial resolution of bony structures.And it could give a clue to take further imaging studies.Low back disorders could be inferred from the contrast column defect of dura sac and nerve root sheath in the myelography.In the diagnosis of disc herniation,its limitations existed at far lacteral and L5S1 disc herniation.Computed tomography,a cross-sectional imaging modality,allows direct visualization of the bony structure of the spine.But routine imaging could only cover a limited number of levers.Another limitation was the difficulty in distinguishing the soft tissue changes in the spinal canal with the similar CT values.CT-myelography was performed to delineate more clearly the bony and soft tissue anatomy,and could determine whether lesions were medullary,intradual or extradual in location.MR imaging provided the larger anatomic region in multiple planes with high spatial resolution of soft tissue.One limitation of MR imaging was relatively low spatial resolution of bony structure. Conclusion Of all imaging studies conventional roentgenogram is the most important and the most fundamental.It could not be substituted by myelography,CT,CT-myelography,and MR imaging,which have their designated own roles respectively in the clinical decision-making process and in general were more complementary than competitive.