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Objective:To compare the morphological differences of psoas major muscles between patients with lumbar disc herniation (LDH) of lower limb pain and lumbocrural pain based on CT imaging data.Methods:Sixty patients with LDH admitted to Department of Neurosurgery, 900 th Hospital of PLA Joint Logistic Team from January 2012 to February 2023 were included. According to clinical symptoms, they were divided into lower limb pain group and lumbocrural pain group ( n=30). 3D CT images of the psoas major muscles in the 2 groups were reconstructed; the longest transverse axis perpendicular to the longitudinal axis of the psoas major muscle was chosen as the cross-sectional area, and the maximum psoas major muscle cross-sectional area was calculated; maximum psoas major muscle cross-sectional area index (PI max) was defined as ratio of maximum psoas major muscle cross-sectional area and L 5 vertebral cross-sectional area. PI max difference between lower limb pain group and lumbocrural pain group was compared; PI max difference among patients with different pain degrees (visual analog scale [VAS] scores) or pain courses was further compared in both lower limb pain group and lumbocrural pain group. Pearson correlation was used to analyze the correlations of PI max with pain degree and pain course in the 2 groups. Results:PI max in lower limb pain group was significantly larger than that in lumbocrural pain group (0.62±0.05 vs. 0.54±0.04, t=7.320, P<0.001). PI max in patients with severe pain from both lower limb pain group and lumbocrural pain group was significantly smaller than that in patients with moderate pain (0.61±0.05 vs. 0.65±0.04, t=2.422, P=0.022; 0.53±0.03 vs. 0.58±0.04, t=3.502, P=0.002). PI max in patients with short pain course from both lower limb pain group and lumbocrural pain group was significantly larger than that in patients with long pain course (0.64±0.05 vs. 0.59±0.04, t=2.570, P=0.016; 0.57±0.04 vs. 0.53±0.03, t=2.941, P=0.007). Pearson correlation showed that PI max was negatively correlated with pain degree and pain course in LDH patients from both groups ( P<0.05). Conclusion:Atrophy of psoas major muscles in LDH patients is aggravated with increased pain degree and pain course.
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[Objective]To summarize the clinical experience of Professor ZHU Xiaoying on treating lumbar disc herniation and sciatica with acupuncture.[Method]Via studying with Professor ZHU, and collecting some cases, consulting the related literature and data. Finally, discuss and summarize it. [Result] Professor ZHU believes in TCM holism and distinguishes different types of syndrome from sign, tongue, pulse and so on. She emphasizes warming kidney, smoothing Du meridian, strengthening spine in therapeutical principle. In the treatment of it, she combines the theory of Du meridian with foot-sanyang meridians to choose the points and method. There are also acupuncture and Chinese herbs, and treating both root causes and symptoms. In clinic, the curative effects are remarkable. She chooses Du meridian as a main therapy and uses also acupuncture and Chinese herbs. Clinically, the curative effects are remarkable. [Conclusion]Application of the theory of Du meridian on treating lumbar disc herniation has obvious curative effect. It is worth a deep study and spreading.
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Objective To investigate the mechanism and clinical value of sacral plexus perfusion method in the treatment of rachi lumbocrural pain.Methods 80 cases of patients with rachi lumbocrural pain in our hospital from May 2014 to May 2016 were selected, they were randomly divided into sacral plexus perfusion method treatment group ( study group) and infrared short medium long frequency therapeutic instrument combined with acupuncture and massage therapy group (control group) two groups, 40 cases in each group.The main clinical symptoms scores, main clinical signs scores, thoracolumbar spine flexion, VAS scores, clinical efficacy of the two groups were statistically analyzed.Results The low back pain, cold limbs, numbness, leg redicular pain scores of the study group were significantly lower, the difference was statistically significant (P<0.05), the both sides L3 transverse tip tenderness scores, VAS score were significantly lower, the difference was statistically significant (P<0.05), the thoracolumbar flexion was significantly higher, the difference was statistically significant (P<0.05), the total treatment efficiency 92.5%(37/40) was significantly higher than the control group 67.5%(27/40), the difference was statistically significant (P<0.05).Conclusion The clinical value of sacral plexus perfusion method in the treatment of rachi lumbocrural pain is higher than infrared short medium long frequency therapeutic instrument combined with acupuncture and massage therapy, it can more effectively improve the clinical symptoms and signs, relieve the pain, enhance the thoracolumbar flexion and total treatment efficiency of patients.
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Objective To investigate clinical efficacy of the CT guided mixture Danshen injection into the periganglionic space in the treatment of lumbocrural pain.Methods Mixture Danshen infiltrations were performed in 63 patients with lumbocrural pain under CT guidance.Scores of VAS were compared at 3 and 6 months after the therapeutic procedure with evaluation of the efficacy.Results Significant pain reduction was observed in 51 patients (51/63,80.95%),with the score of VAS 7.60± 2.00 (before therapy) dropping to 3.85 ± 1.60 (after 1 month) and 4.05± 1.70 (after 6 month).Differences of VAS scores before and after the therapy were statistically significant.Differences between one-month and three-month follow-up were not statistically significant.Conclusion Mixture Danshen injection around the spinal nerve roots under CT guidance is safe and useful in the treatment of lumbocrural pain.