The clinical effect of Yaotongning capsule combined with etoricoxib in the treatment of lumbar pain and inflammatory status in elderly patients with lumbar osteoarthritis / 药学实践杂志

Objective To study the clinical effect of Yaotongning capsule combined with etoricoxib for the pain and inflammation of lumbar vertebrae in elderly patients with lumbar osteoarthritis. Methods 120 elderly patients with lumbar osteoarthritis admitted to our hospital from January 2016 to June 2018 were randomly divided into the control group and the observation group, with 60 patients in each group. Patients in the control group were treated with etoricoxib, while patients in the observation group were treated with etoricoxib plus Yaotongning capsule orally. Both groups received medications for 2 weeks. Spinal pain and quality of life score changes were recorded. The inflammatory cytokines in serum TNF-α, GM-CSF, COX-2 and BMP-2 levels were monitored. The clinical efficacy was compared and drug safety profile was evaluated for two groups. Results The effective rates of the control group and the observation group were 78.33% and 91.67% respectively. The effective rate in the observation group weas significantly higher (P<0.05). After treatment, the VAS score for the patients in the observation group was significantly lower than that in the control group (P<0.05). The SF-36 score in the observation group was significantly increased (P<0.05), and the levels of TNF-α,GM-CSF and COX-2 in the serum were significantly lower than those in the control group (P<0.05), and the levels of BMP-2 were significantly increased (P<0.05). Conclusion Yaotongning capsule combined with etoricoxib in the treatment of senile lumbar osteoarthritis has definite curative effect. It significantly reduced lumbar pain, improved quality of life, inhibited inflammatory reaction, and had a better drug safety profile. The further clinical investigation for the combination therapy is warranted.

Comparison of Clinical and Radiologic Results of Mini-Open Transforaminal Lumbar Interbody Fusion and Extreme Lateral Interbody Fusion Indirect Decompression for Degenerative Lumbar Spondylolisthesis

STUDY DESIGN: Retrospective study. PURPOSE: In this study, we compared the postoperative outcomes of extreme lateral interbody fusion (XLIF) indirect decompression with that of mini-open transforaminal lumbar interbody fusion (TLIF) in patients with lumbar degenerative spondylolisthesis. OVERVIEW OF LITERATURE: There are very few reports examining postoperative results of XLIF and minimally invasive TLIF for degenerative lumbar spondylolisthesis, and no reports comparing XLIF and mini-open TLIF. METHODS: Forty patients who underwent 1-level spinal fusion, either by XLIF indirect decompression (X group, 20 patients) or by mini-open TLIF (T group, 20 patients), for treatment of lumbar degenerative spondylolisthesis were included in this study. Invasiveness of surgery was evaluated on the basis of surgery time, blood loss, hospitalization period, and perioperative complications. The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ), disc angle (DA), disc height (DH), and slipping length (SL) were evaluated before surgery, immediately after surgery, and at 12 months after surgery. Cross-sectional spinal canal area (CSA) was also measured before surgery and at 1 month after surgery. RESULTS: There was no significant difference between the groups in terms of surgery time or hospitalization period; however, X group showed a significant decrease in blood loss (p < 0.001). Serious complications were not observed in either group. In clinical assessment, no significant differences were observed between the groups with regard to the JOABPEQ results. The change in DH at 12 months after surgery increased significantly in the X group (p < 0.05), and the changes in DA and SL were not significantly different between the two groups. The change in CSA was significantly greater in the T group (p < 0.001). CONCLUSIONS: Postoperative clinical results were equally favorable for both procedures; however, in comparison with mini-open TLIF, less blood loss and greater correction of DH were observed in XLIF.

Clinical and Radiological Outcomes after Microscopic Bilateral Decompression via a Unilateral Approach for Degenerative Lumbar Disease: Minimum 5-Year Follow-Up

STUDY DESIGN: A retrospective study. PURPOSE: To assess postoperative bone regrowth at surgical sites after lumbar decompression with >5 years of follow-up. Postoperative preservation of facet joints and segmental spinal instability following surgery were also evaluated. OVERVIEW OF LITERATURE: Previous reports have documented bone regrowth after conventional laminectomy or laminotomy and several factors associated with new bone formation. METHODS: Forty-nine patients who underwent microscopic bilateral decompression via a unilateral approach at L4–5 were reviewed. Primary outcomes included correlations among postoperative bone regrowth, preservation of facet joints, radiographic parameters, and clinical outcomes. Secondary outcomes included comparative analyses of radiographic parameters and clinical outcomes among preoperative diagnoses (lumbar spinal stenosis, degenerative spondylolisthesis, and degenerative lumbar scoliosis). RESULTS: The average value of bone regrowth at the latest follow-up was significantly higher on the dorsal side of the facet joint (3.4 mm) than on the ventral side (1.3 mm). Percent facet joint preservation was significantly smaller on the approach side (79.2%) than on the contralateral side (95.2%). Bone regrowth showed a significant inverse correlation with age, but no significant correlation was observed with facet joint preservation, gender, postoperative segmental spinal motion, or clinical outcomes. Subanalysis of these data revealed that bone regrowth at the latest follow-up was significantly greater in patients with degenerative lumbar scoliosis than in those with lumbar spinal stenosis. Postoperative segmental spinal motion at L4–L5 did not progress significantly in patients with degenerative spondylolisthesis or degenerative lumbar scoliosis compared with those with lumbar spinal stenosis. CONCLUSIONS: Microscopic bilateral decompression via a unilateral approach prevents postoperative spinal instability because of satisfactory preservation of facet joints, which may be the primary reason for inadequate bone regrowth. Postoperative bone regrowth was not related to clinical outcomes and postoperative segmental spinal instability.

Clinical efficacy of Yaotongning capsule in the treatment of lumbar osteoarthritis patients / 中国生化药物杂志

Objective To analyze the effect of Yaotongning capsule in the treatment of lumbar osteoarthritis patients.Methods From March 2013 to March 2015 in our hospital, 80 cases of lumbar osteoarthritis patients according to the digital table method were divided into two groups: the control group and the experimental group.The patients of the control group were given Bitongning, and the patients of the experimental group were given Yaotongning capsule, and the therapeutic effect, serum indexes and Japanese Orthopaedic Association ( JOA ) of two groups were compared. Results The curative effect of the experimental group was higher than control group(95.00%vs.67.50%) , the JOA score of the experimental group was higher than control group [(27.46 ±1.07)points vs.(21.06 ±1.89)points] (P<0.05).After treatment, the MMP-3(65.28 ±4.37) ng/L and IL-1β(12.43 ±1.01) ng/L of the experimental group were significantly lower than MMP-3(79.56 ±5.36) ng/L, IL-1β(16.44 ±1.03) ng/L of the control group, and the difference was significant (P<0.05).Conclusion The lumbar osteoarthritis patients with Yaotongning capsule has obvious effect, and the function of lumbar intervertebral joint improves obviously, and the serum index is normal, safe and reliable.

Clinical Study on Huoxue Bitong Plaster Treating Lumbar Osteoarthritis with Blood Stasis and Cold-dampness Blocking Collaterals Syndrome / 中国中医药信息杂志

Objective To observe the clinical efficacy of Huoxue Bitong Plaster on lumbar osteoarthritis with blood stasis and cold-dampness blocking collaterals syndrome. Methods Totally 120 patients were randomly divided into treatment group (60 cases) and control group (60 cases). Huoxue Bitong Plaster was applied externally in the treatment group, while Goupigao Plaster was used externally in the control group, once a day, for two weeks. The clinical efficacy was evaluated by observing TCM symptom scores, VAS, Oswestry dability index (ODI), and onset time in both groups before and after treatment. Results The total effective rate was 86.67%(52/60) in treatment group, and 85.00% (51/60) in the control group, with no statistical significance (P>0.05). TCM symptom scores of both groups decreased after treatment (P<0.05). For the effect of relieving back pain and morning stiffness, the treatment group was superior to control group (P<0.05). For the effect of relieving waist heaviness, the control group was better than the treatment group (P<0.05). Besides, VAS and ODI of the treatment group were lower than the control group after treatment (P<0.05). The onset time of lightening back pain, morning stiffness in the treatment group was quicker than control group (P<0.05). For waist heaviness, the onset time in control group was quicker than treatment group (P<0.05). Conclusion Huoxue Bitong Plaster has good efficacy for lumbar osteoarthritis with blood stasis and cold-dampness blocking collaterals syndrome.

Characteristics of Back Muscle Strength in Patients with Scheduled for Lumbar Fusion Surgery due to Symptomatic Lumbar Degenerative Diseases

STUDY DESIGN: Cross sectional study. PURPOSE: To evaluate characteristics of back muscle strength in patients scheduled for lumbar fusion surgery. OVERVIEW OF LITERATURE: Little is known regarding muscle strength in patients with symptomatic lumbar degenerative diseases who require fusion surgery. METHODS: Consecutive 354 patients scheduled for posterior lumbar interbody fusion due to symptomatic degenerative diseases were approached for participation. 316 patients were enrolled. Before surgery, muscle strength was assessed by measuring maximal isometric extension strength at seven angular positions (0degrees, 12degrees, 24degrees, 36degrees, 48degrees, 60degrees, and 72degrees) and mean isometric strength was calculated. The Oswestry Disability Index (0-100) and visual analogue scale (0-100) for back pain were recorded. Muscle strength was compared according to gender, age ( or =70 years) and scheduled fusion level (short, or =3). RESULTS: Isometric strength was significantly decreased compared with previously reported results of healthy individuals, particularly at extension positions (0degrees-48degrees, p0.05). Isometric strengths showed significant, but weak, inverse correlations with age and Oswestry Disability Index (r<0.4, p<0.05). CONCLUSIONS: In patients with symptomatic lumbar degenerative diseases, back muscle strength significantly decreased, particularly at lumbar extension positions, and in females and older patients.

Radiographic Results of Single Level Transforaminal Lumbar Interbody Fusion in Degenerative Lumbar Spine Disease: Focusing on Changes of Segmental Lordosis in Fusion Segment

BACKGROUND: To assess the radiographic results in patients who underwent transforaminal lumbar interbody fusion (TLIF), particularly the changes in segmental lordosis in the fusion segment, whole lumbar lordosis and disc height. METHODS: Twenty six cases of single-level TLIF in degenerative lumbar diseases were analyzed. The changes in segmental lordosis, whole lumbar lordosis, and disc height were evaluated before surgery, after surgery and at the final follow-up. RESULTS: The segmental lordosis increased significantly after surgery but decreased at the final follow-up. Compared to the preoperative values, the segmental lordosis did not change significantly at the final follow-up. Whole lumbar lordosis at the final follow-up was significantly higher than the preoperative values. The disc height was significantly higher in after surgery than before surgery (p = 0.000) and the disc height alter surgery and at the final follow-up was similar. CONCLUSIONS: When performing TLIF, careful surgical techniques and attention are needed to restore and maintain the segmental lordosis at the fusion level.