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Objective: To explore the clinical efficacy effect of Yaotongning Capsules combined with thunder-fire moxibustion on lumbar disc herniation (LDH). Methods: A total of 80 LDH patients who met the inclusion criteria were randomly divided into observation group and control group, with 40 cases in each group. The observation group was treated with Yaotongning Capsules combined with thunder-fire moxibustion, and the control group was treated with ibuprofen sustained release capsule combined with thunder-fire moxibustion. VAS score, JOA score, ODI score and clinical efficacy were compared. Results: VAS scores and ODI scores of the two groups after treatment were lower than those before treatment (P < 0.05), and the JOA score was higher than that before treatment (P < 0.05); After treatment, the VAS score and ODI score in the observation group were lower than those in the control group (P < 0.05); After treatment, the JOA score was higher than that in the control group (P < 0.05). The clinical efficacy of the observation group was better than that of the control group (P < 0.05). Conclusion: The clinical treatment of Yaotongning Capsules combined with thunder-fire moxibustion treating LDH can obviously alleviate the pain symptoms and improve the daily function of the patients, which is worthy of further clinical application.
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Objective To evaluate the clinical effect of percutaneous intervertebral foramen and TLIF in the treatment of extreme lateral lumbar disc herniation and the SF-36 score.Methods A total of 90 patients with extreme lateral lumbar disc herniation admitted in our hos-pital from March 2015 to March 2017 were selected as the subjects,who were divided into the control group ( traditional therapy) and the study group(percutaneous intervertebral foramen treatment), according to the different surgical methods,45 cases in each group.The treat-ment,pain,SF-36 score and other indicators of two groups were observed.Results The rate of excellence and good was 97.78% in the study group and 86.67% in the control group,the difference was significant(P<0.05).The blood loss was (46.83 ± 3.64)mL in the study group and (79.32 ±5.47)mL in the control group,the difference was significant(P<0.05).There was no significant difference in the scores of SF-36 and JOA between the two groups(P>0.05).After treatment,the two groups were significantly improved(P<0.05),the improvement rate of the study group was more obvious (P<0.05).After treatment,TNF-α,IL-6 and CRP levels were significantly better than those in the control group (P<0.05).Conclusion Percutaneous intervertebral foramen treatment of extreme lateral lumbar disc herniation can reduce the intraoperative blood loss and improve the quality of life
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Objective To investigate the effect of super-aged multilevel cervical spondylosis different surgical treatment op tions Abstract Objective.Methods Selected July 2010 Ultra old multilevel cervical spondylosis March 2015 in our hospital 80 ca ses,the anterior cervical corpectomy and fusion (ACCF) and by anterior discectomy and fusion (ACDF) included anterior group,the posterior laminoplasty (PCL) included in the posterior group,the clinical efficacy of two groups were compared,and postoperative conditions and cervical spinal cord injury rates before and after treatment (JOA score),cervical Disability index (NDI index),lordosis and cervical spine.Results Anterior group of 43 cases,including 28 cases of excellent(65.12％),5 cases of good (11.63％),7 cases of moderate(16.28％),3 cases of poor(6.98％),the good rate was 76.74％;posterior group 37 cases,including 24 cases of excellent(64.86％),3 cases of good(8.l1％),6 cases of moderate(16.22％),4 cases of poor(10.81％),the good rate was 72.97 ％.The difference has no statistically significant (P＞0.05) in good rate.Anterior operative time was significantly higher than the posterior group (P＜0.05),blood loss,hospital stay was significantly lower than the posterior group (P＜0.05),the time of symptoms disappeared has no significant difference in two groups(P＞0.05).After treatment,patients in posterior group,the JOA score,cervical activity significantly were higher than the anterior group,lordosis anterior group were significantly higher than the posterior group,the difference was statistically significant (P＜0.05).Conclusion Anterior super aged multilevel cervical disease,posterior approach has achieved good clinical efficacy but greater advantage posterior surgery in patients with long term im provement in the cervical spine function.
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Objective To investigate the clinical effect of Zhanjinhuoxue Formula combined with the tower-type pad natural traction for the treatment of pure thoracolumbar compression fracture.Methods Fifty patients with thoracolumbar compression fractures treated in our hospital from January to December 2014 were selected and divided into the observation group(n=25) and control group(n=25).The control group was given the tower-type natural traction method,while the observation group was given Zhanjinhuoxue Formula combined with the tower-type pad natural traction method.The curative effect,pain score,activity ability score,analgesic drugs score,bone mineral density (BMD) and the Japanese Orthopedic Association(JOA) score were compared between the two groups.Results The effective rate was 92.00％ in the observation group and 68.00％ in the control group,the difference between the two groups was statistically significant (x2 =4.50,P＜0.05).The pain score,activity ability score and analgesic drugs score after 6-month treatment in the observation group were significantly lower than those in the control group (P＜0.05);the BMD and JOA scores in the observation group were significantly higher than those in the control group (P＜0.05).Condusion Zhanjinhuoxue Formula coordinated by the tower-type pad natural traction method can conduce to alleviate the pain symptom in the patients with pure thoracolumbar compression fracture,increases the movement function and improves the treatment effect.
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Objective To compare the clinical efficacy of intraspinal tumor resection under quadrant channel and hemilaminectomy surgery.Methods We retrospectively studied 33 patients with intraspinal tumor with the lesion length of less than 5 cm hospitalized in our hospital from July 2013 to July 201 5.Of the 33 patients,1 6 patients received intraspinal tumor resection under quadrant channel and 1 7 patients received intraspinal tumor resection under hemilaminectomy surgery.We compared various indicators in the two groups,including the length of surgical incision,surgical operation time,bleeding volume during operation,time for the first ground activity after surgery,length of hospital stay (LOS)after surgery,visual pain simulation (VAS)score 1 week after surgery, and JOA score excellent and good rates.Results The patients who received quadrant channel intraspinal tumor resection outperformed those who received hemilaminectomy surgery regarding the length of surgical incision, bleeding volume during operation,time for the first ground activity after surgery,LOS after surgery,and VAS score 1 week after surgery (P <0.05 ).Conclusion Intraspinal tumor resection under quadrant channel is a safe and effective therapy because of small trauma,less bleeding,quick recovery and curative effect.
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Objective To study intraoperative neural electrophysiological monitoring applied in lumbosacral spinal cord tumor resection.Methods We retrospectively reviewed the clinical data of 212 patients undergoing lumbosacral spinal cord tumor resection with or without intraoperative neural electrophysiological monitoring in our hospital.The patients were divided into two groups:124 patients in the monitored group received intraoperative neural electrophysiological monitoring while 88 ones in the control group did not.The monitoring was performed by recording the cortical somatosensory evoked potential (CSEP),dermatomal somatosensory evoked potential (DSEP) and electromyography (EMG).The patients were followed up for 3-6 months and their postoperative outcome was analyzed.Results There were significant differences in the outcome (P <0.05),but no difference was found in the incidence of complications between the monitored group and the control group.The sensitivity of CSEP +DSEP+EMG was 100%,and the specificity was 55.9% in the former group.Conclusion Combined monitoring with CSEP,DSEP and EMG during lumbosacral spinal cord tumor resection is valuable in protecting the spinal nerve roots and ensuring better operation safety.
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Objective To evaluate and compare the presence of the nerve root sedimentation sign in patients with lumbar spondylolisthesis (LS) and lumbar disc herniation(LDH). Methods One hundred and fifty-one patients with degen?erative lumbar spinal disease treated by surgery from July 2012 to March 2014 were reviewed retrospectively in Tianjin Hos?pital. All the patients were divided into two groups:LS group (48 cases) and LDH group (103 cases). The clinical outcomes were evaluated by Japanese Orthopedic Association (JOA). The probability of positive sedimentation sign was compared be?tween LS group and LDH group. Correlation between the JOA score and nerve root sedimentation sign were analysed in two groups. Results There was no statistical difference in JOA score between LS group and LDH group (15.83±3.57 vs 16.76± 3.10, t=1.624, P=0.107). A positive sedimentation sign was identified in 39 patients in the LS group (81.25%) but in 65 pa?tients in the LDH group (63.11%). The difference between LS group and LDH group was statistically significant(χ2=5.028, P=0.031). In LS group, JOA scores of patients with positive nerve root sedimentation sign were lower than those of patients with negative nerve root sedimentation sign(15.33±3.50 vs 18.00±3.20, t=2.092,P=0.042);but in LDH group, there was no statistical difference in JOA scores of patients between positive nerve root sedimentation sign and negative nerve root sedi?mentation sign (16.40±3.13 vs 17.37±2.99, t=1.539, P=0.127). Conclusion A positive sedimentation sign also occurs in pa?tients with LDH, but positive nerve root sedimentation sign are more likely to appear in patients with lumbar spondylolisthe?sis who have worse clinical symptoms.
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[Objective]The purpose of this study is to evaluate an effect of electroacupuncture therapy on low back pain of collegiate athletes. <BR>[Methods]Subjects were 28 collegiate athletes with low back pain who gave informed consent. They consulted a medical doctor beforehand. The electroacupuncture therapy was performed as acupuncture. The evaluation items were as follows:Visual Analogue Scale (VAS) which expresses the state of the pain (Pain-VAS), VAS which shows a training state (Training-VAS), five phases of evaluations to show a training state, pain at the time of the trunk movements, Roland-Morris Disability Questionnaire (RDQ), and Japanese Orthopedic Association (JOA) score. The correlation of each item was estimated.<BR>[Results]The chief complaint of 27 people was low back pain, and one person had pain of the low back and the lower extremities. In the diagnosis, 16 people had non-specific low back pain, 5people had lumbar vertebrae discopathy, and 3had a lumber vertebrae herniated disk. As a result of acupuncture, the training-VAS and five phases of evaluations to show the training state and JOA score were significantly improved. However, as for the pain-VAS and pain at the time of trunk movements and RDQ, a significant difference was not accepted. <BR>[Conclusion]Training-VAS is useful for measuring the outcome of an athlete with low back pain. It is important that athletes with low back pain evaluate their training.
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STUDY DESIGN: This retrospective study was designed to investigate and define the factors affecting the results of surgery for cervical spondylotic myelopathy. OBJECTIVE: This study was performed in an attempt to investigate and define the factors affecting the results of surgery for cervical spondylotic myelopathy. SUMMARY OF THE LITERATURE REVIEW: There have been few studies about the factors affecting the results of surgery for cervical myelopathy, including MEP (Motor evoked potential) studies and gait analysis, so we investigated the factors that affect the results of surgery for cervical myelopathy. MATERIALS AND METHODS: We retrospectively studied 59 cervical spondylotic myelopathy patients who underwent operation from Nov. 1994 to Oct. 2002. We analyzed 13 prognostic factors: age, disease duration, the pre-op JOA score, the pre-op. AP canal diameter, the Pavlov ratio, disease level, the AP and lateral cord diameter, the transverse area and the compression ratio at the level of the maximal cord compression on MRI, the cord signal changes on MRI, the MEP(Motor evoked potential) and the gait analysis. The mean follow up period was 29 months. The clinical results were evaluated according to the JOA score. Statistical analysis was performed using the Pearson correlation test, ANOVA and the Kruskal-Wallis test. RESULTS: The mean pre-op JOA score was 11.1 and the post-op. JOA score was improved to 14.7. The average recovery rate was 67%. The following factors were proved to an influence on the surgical outcomes: age and multiplicity of involvement, and the signal changes of the cord on MRI showed a negative correlation with the recovery rate. The pre-op JOA score, the mean sagittal diameter and the transverse area of the spinal cord at the level of maximum compression showed a positive correlation with the recovery rate. Spasticity on the gait analysis and central conduction block on MEP had an influence on the surgical outcomes. CONCLUSIONS: The prognostic factors affecting the results of surgery for cervical myelopathy are age, the pre-op JOA score, the disease level, the mean sagittal diameter and the transverse area of the spinal cord at the level of maximum compression, signal change of the cord on MRI, spasticity on the gait analysis and central conduction block on MEP.
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Humains , Études de suivi , Démarche , Imagerie par résonance magnétique , Spasticité musculaire , Études rétrospectives , Moelle spinale , Maladies de la moelle épinièreRÉSUMÉ
PURPOSE: This study was performed to investigate and define the factors affecting the results of surgery for a cervical myelopathy. MATERIALS AND METHODS: Seventy-eight cervical myelopathy cases, who underwent surgery from Jan. 1991 to Sep. 2001, were retrospectively reviewed. The patients were composed of developmental stenosis in 9, spondylosis in 21, OPLL in 12, HIVD in 34 and trauma in 2 cases. The causes of the disease, age, onset, pre-op JOA score, pre-op and post-op spinal canal diameter, Pavlov ratio and cord diameter and signal changes of cord on MRI were examined. The mean follow-up period was two years. The clinical results were evaluated according to the JOA score. Statistical analysis was made using the Pearson correlation coefficient and the Kruskal-Wallis method. RESULTS: The mean pre-op and post-op JOA score were 11.2 and 14.8 respectively. The mean recovery rate was 68.0%. The preoperative JOA score showed a positive correlation with recovery rate, and age, sagittal diameter and transverse area of the cord on MRI correlated negatively with the recovery rate. The result was poorer the higher the level involved. Patients with signal changes in the cord on MRI had a poor outcome after surgery. CONCLUSION: The prognostic factors affecting the results of the surgery for cervical myelopathy were age, pre-op JOA score, disease level, and sagittal diameter, transverse area and the signal changes in the cord on MRI.
Sujet(s)
Humains , Sténose pathologique , Études de suivi , Imagerie par résonance magnétique , Études rétrospectives , Canal vertébral , Maladies de la moelle épinière , SpondyloseRÉSUMÉ
Treatment of tender points has widely been used for diagnosis and treatment, but there are few studies elucidating the usefulness of this approach to diagnosing knee pain. This study investigated the diagnostic importance of tender points. The symptoms and the pressure pain threshold (PPT) in osteoarthritis of the knee (pain and motion of knee joint) were measured in 45 patients being treated at the Acupuncture Center of Meiji University of Oriental Medicine. The change in PPT was related to symptoms of knee pain (staircase and flexion pain). It is suggested that changes in PPT around the knee joints are a useful indicator for evaluating knee pain.
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The tender points treatment has been widely used for both treatment and diagnosis, but there have been very few studies that have examined its diagnostic usefulness. Thus, the purpose of this study was to clarify the diagnostic importance of tender points. The subject was a patient who had osteoarthritis of the knee of Meiji University of Oriental Medicine Hospital. The relationship between pressure pain thresholds (PPTs) and symptoms in osteoarthritis of the knee (painful knee motion) were evaluated with the Japanese Orthopaedic Association scale (JOA scale), a knee scale and the subject's knee pain diary (starting pain, flexion pain, walking pain and total pain Wong-Baker faces pain rating scale). After 40 acupuncture treatments, improvement was noted in the symptoms and PPTs. The changes in PPTs were related to the symptoms of the knee (flexion and walking pain). This suggests that changes in PPTs (around the knee) are a useful indicator for evaluating knee pain.