Objective: To investigate epidural fat distribution patterns in patients with lumbar intervertebral disc protrusion. Methods: Medical records were selected randomly from 30 patients whose diagnoses were consistent wit...Objective: To investigate epidural fat distribution patterns in patients with lumbar intervertebral disc protrusion. Methods: Medical records were selected randomly from 30 patients whose diagnoses were consistent with the inclusion criteria of the study. Thickness of bilateral fat, the longest length of posterior fat, thickness of bilateral yellow ligament and the hernial distance of lumbar discs were measured by MRI at L3/L4, L4/L5 and L5/S1 levels. According to clinical symptoms of lumbar intervertebral disc protrusion, the patients were divided into two groups at all space levels. All data were analyzed by statistical software. Results: The longest length of posterior epidural fat at the symptomatic levels was shorter than that at the non-symptomatic levels in each disc space. The symptomatic levels had no effect on the whole thickness of the lateral fat and lateral yellow ligaments. Conclusion: Epidural fat distribution in patients with lumbar intervertebral disc protrusion is different from that in normal adults. It is affected by the hernial distance of lumbar discs. The diagnostic criteria for spinal epidural lipomatosis in normal adults may therefore prove to be inappropriate for patients with lumbar intervertebral disc protrusion.展开更多
In the present paper, 176 cases of lumbar intervertebral disc protrusion are treated with electroacupuncture (EA) and topical heat irradiation. Local tender-point is used as the main acupoint, combined with Tunzhong, ...In the present paper, 176 cases of lumbar intervertebral disc protrusion are treated with electroacupuncture (EA) and topical heat irradiation. Local tender-point is used as the main acupoint, combined with Tunzhong, Tiaoyue, Weizhong (BL 40) and Yanglingquan (GB 34). The treatment is conducted once daily, with 15 sessions being a therapeutic course. Following treatment, of 176 cases, 46 (26. 1%) are cured, 90 (51. 1%) have prominent improvement, 35 (19.8%) have amelioration and 5 (2.8%) have no apparent changes, with a total effective rate of 97.0%.展开更多
Objective: To analyse and explore the diagnostic significance of infrared thermography on the patients with lumbar intervertebral disc protrusion. Methods: Forty five hospitalized cases under conservative treatment (m...Objective: To analyse and explore the diagnostic significance of infrared thermography on the patients with lumbar intervertebral disc protrusion. Methods: Forty five hospitalized cases under conservative treatment (mainly manipulation) and 65 controls were consecutively selected. Both groups were examined with infrared thermography on lower back and lower extremities as well as physical examination before and after treatment. The study statistically analysed the temperature difference between the involved and healthy parts at different areas; and also compared the variation of the temperature difference after the treatment to the decreasing scores of physical examination afterward. Results: The statistic result showed that the temperature difference between two sides on patient group was significantly higher than those of the control group. The further analysis showed that the temperature difference at posterior femur area in the patients’ group correlated significantly to the severity of clinical signs caused by nerve root irritation. Conclusion: The thermogram was uncertain to the segmental diagnosis of lumbar disc protrusion and could only be considered as a reference in the final diagnosis. Nevertheless, it is helpful to discover the severity of radical signs according to the posterior femoral region of hypo (hyper )thermogram.展开更多
Objective:To compare the differences in pain mediators and inflammatory factors after percutaneous transforaminal endoscopic discectomy and traditional fenestration operation treatment of protrusion of lumbar interver...Objective:To compare the differences in pain mediators and inflammatory factors after percutaneous transforaminal endoscopic discectomy and traditional fenestration operation treatment of protrusion of lumbar intervertebral disc. Methods:80 patients with protrusion of lumbar intervertebral disc treated in our hospital between March 2013 and December 2015 were collected and divided into observation group and control group (n=40) according to randomized parallel contrast. Control group received traditional fenestration operation and observation group received percutaneous transforaminal endoscopic discectomy. Before operation and 1 week after operation, fluorescence spectrophotometry was used to determine serum pain medium levels;ELISA was used to determine pro-inflammatory factor and anti-inflammatory factor levels. Results:Before operation, differences in serum pain medium and inflammatory factor levels were not statistically significant between two groups (P>0.05). 1 week after operation, serum pain media norepinephrine (NE), dopamine (DA), 5-hydroxytryptamine (5-HT), prostaglandin E2 (PGE2) and substance P (SP) levels as well as pro-inflammatory factors interleukin-1β(IL-1β), interleukin-6 (IL-6), interleukin-18 (IL-18) and tumor necrosis factor alpha (TNF-α) levels of observation group were lower than those of control group (P<0.05) while serum anti-inflammatory factors interleukin-4 (IL-4), interleukin 10 (IL-10), soluble tumor necrosis factor receptor I (sTNF-RI) levels were higher than those of control group (P<0.05). Conclusions:Percutaneous transforaminal endoscopic discectomy can effectively treat protrusion of lumbar intervertebral disc and is more advantageous in alleviating patients’ perception of pain and reducing inflammation.展开更多
Through electroacupuncture(EA) treatment of 51 cases of protrusion of lumbar interver-tebral disc, it was further demonstrated that the specific action and characteristics of Siyao and Wuyao acupoints were significant...Through electroacupuncture(EA) treatment of 51 cases of protrusion of lumbar interver-tebral disc, it was further demonstrated that the specific action and characteristics of Siyao and Wuyao acupoints were significant and elucidated by using some objective indexes and obvious therapeutic ef-fect, which lays a foundation for the development, research, popularization and application of shu-point and provides an effective and practicable way for treatment of lumbar intervertebral disc.展开更多
Sixty-four cases of protrusion of lumbarintervertebral disc were treated by massotherapy withheavy manipulations plus blocking therapy underanesthesia from August,1997 to July,1998,withsatisfactory therapeutic results...Sixty-four cases of protrusion of lumbarintervertebral disc were treated by massotherapy withheavy manipulations plus blocking therapy underanesthesia from August,1997 to July,1998,withsatisfactory therapeutic results as reported in thefollowing.Clinical DataNinety-four cases in the series were randomlydivided into two groups.All the 94 cases satisfied thecriteria for diagnosis of the disorder,and thediagnosis was confirmed by展开更多
In the present paper the authors sum up their research results about "She-Bie" (black-tail snake-ground beetle) Ointment-partition moxibustion for treatment of lumbar intervertebral disc protrusion (LIDP). A...In the present paper the authors sum up their research results about "She-Bie" (black-tail snake-ground beetle) Ointment-partition moxibustion for treatment of lumbar intervertebral disc protrusion (LIDP). Animal experiments showed that when used externally, "She-Bie" Ointment had striking anti-inflammation and pain-relief actions but had no irritant and no allergic effects to the skin. In the treatment of mild type of LIDP, "She-Bie" Ointment partition moxibustion could work well in improving clinical symptoms; and in the treatment of moderate type of LIDP, it could be used as a supplementary measure and raise the excellent and good rates of the therapeutic effect further. For this reason, "She-Bie" Ointment partition moxibustion deserves being popularized in clinical treatment of LIDP.展开更多
The aim of the present study was to compare the relationship of morphologically defined non-bulging/herni-ated, bulging and herniated intervertebral lumbar discs with quantitative apparent diffusion coefficient (ADC)....The aim of the present study was to compare the relationship of morphologically defined non-bulging/herni-ated, bulging and herniated intervertebral lumbar discs with quantitative apparent diffusion coefficient (ADC). Thirty-two healthy volunteers and 28 patients with back pain or sciatica were examined by MRI. All intervertebral lumbar discs from L1 to S1 were classified according to morphological abnormality and degenerated grades. The ADC values of nucleus pulposus (NP) were measured and recorded. The significant differences about mean ADC values of NP were found between non-bulging/herniated discs and bulging discs as well as herniated discs (P < 0.05), whereas there were no significant differences in ADC values between bulging and herniated discs (P > 0.05). Moreover, statistically significant relationship was found in the mean ADC values of NP between "non-bulging/herniated and non-degenerated discs" and "non-bulging/herniated degenerated discs" as well as herniated discs (P < 0.05). Linear regression analysis between ADC value and disc level revealed an inverse correlation (r = -0.18). The ADC map of the NP is a potentially useful tool for the quantitative assessment of componential and molecular alterations accompanied with lumbar disc abnormalities.展开更多
Objective: To observe the therapeutic effect of traction combined with acupuncture on lumbar intervertebral disc herniation (LIDH). Methods:Eighty-three patients diagnosed as LIDH were randomly divided into treatment ...Objective: To observe the therapeutic effect of traction combined with acupuncture on lumbar intervertebral disc herniation (LIDH). Methods:Eighty-three patients diagnosed as LIDH were randomly divided into treatment group (n=42)and control group (n=41). In the treatment group, besides lumbar traction, electroacupuncture at Jiaji (EX-B 2, L 3～5), Shenshu (BL 23), Qihai (CV 6), Mingmen (GV 4), Huantiao (GB 30), Chengshan (BL 57) and Yanglingquan (GB 34) was added. In the control group, only lumbar traction was applied. Results: In treatment group, the cure plus markedly effective rate was 80.95% with a total effective rate of 92.86%, while in control group, it was 39.02% with a total effective rate of 80.48%. The therapeutic effect in the treatment group was obviously better than that in the control group (P<0.001). Conclusion: Lumbar traction plus EA can effectively alleviate or even eliminate clinical symptoms and signs of lumbar intervertebral disc herniation.展开更多
Back pain associated with lumbar disc herniation is a common musculoskeletal disorder that leads to absence at work place worldwide. Studies have proven in addition to the traditional factors, microbes play a role in ...Back pain associated with lumbar disc herniation is a common musculoskeletal disorder that leads to absence at work place worldwide. Studies have proven in addition to the traditional factors, microbes play a role in disc herniation causing chronic back pain. A 34-year-old male who has not involved in any traumatic work but has a family history of disc herniation presented with lower back pain and numbness in his right leg. He had previously undergone lumbar discectomy at L4/L5 ten years back. Magnetic Resonance Imaging (MRI) showed L5/S1 right para central disc herniation impinging on the right S1 and S2 nerve roots. Standard protocols for disinfection of instruments, external skin and all transport media were adhered. Skin scrapings, muscle biopsy and excised disc tissue were obtained for anaerobic and aerobic bacterial cultures. Anaerobic microbial cultures of excised disc tissue following lumbar discectomy showed Gram positive growth. Further anaerobic isolation carried out using RapID ANA ID kit confirmed the growth as Gemella morbillorum. In addition, neither of the control samples (muscle nor skin) had any anaerobic growth indicating the absence of contamination. Aerobic bacterial growth was not present in the skin, muscles and disc cultures. The study findings add to the available literature, on the role of microorganisms in lumbar disc herniation and future treatment regimens with antibiotics.展开更多
Objective: To assess glycosaminoglycan (GAG) content of lumbar intervertebral discs (IVDs) in patients with radiculopathy compared with healthy volunteers with glycosaminoglycan chemical exchange saturation transfer (...Objective: To assess glycosaminoglycan (GAG) content of lumbar intervertebral discs (IVDs) in patients with radiculopathy compared with healthy volunteers with glycosaminoglycan chemical exchange saturation transfer (gagCEST). Methods: The lumbar spines of 15 patients with radiculopathy (9 women, 6 men;mean age 45 years;range: 19 - 80 years) and 13 healthy controls (10 women, 3 men;mean age 29 years;range: 19 - 38 years) without lumbar back pain or previous spine surgery were examined at a 3 Tesla (T) magnetic resonance imaging (MRI) scanner in this prospective study. The MRI protocol included standard morphological, sagittal, and transverse T2-weighted (T2w) images of the five lumbar IVDs (L1-S1) to assess Pfirrmann score and to detect disc disorders according to the Combined Task Force classification. To analyze biochemically the lumbar IVDs, a gagCEST sequence was applied to measure the GAG content of the nucleus pulposus (NP) and annulus fibrosus (AF). Results: Patients with radiculopathy indicated significantly lower gagCEST values in NP than healthy volunteers (2.82% ±3.12% vs. 4.09% ±2.25%, P = 0.017). The GAG content of AF showed no significant difference between volunteers and patients (2.66% ±2.01% vs. 1.92% ±2.56%;P = 0.175). Conclusions. Patients with radiculopathy presented with lower GAG values than healthy volunteers in NP, indicating an association between pain and IVD degeneration. gagCEST of lumbar IVDs is a powerful, non-invasive tool to investigate early disc degeneration, which we could demonstrate in the NP in our study collective.展开更多
Objective:To compare the application effects of percutaneous percutanuous intervertebral foraminal BEIS(Broad Easy Immediate Surgery)technique on patients with lumbar disc herniation.Methods:Eighty-six patients with l...Objective:To compare the application effects of percutaneous percutanuous intervertebral foraminal BEIS(Broad Easy Immediate Surgery)technique on patients with lumbar disc herniation.Methods:Eighty-six patients with lumbar disc herniation treated in the Seventh People’s Hospital of Zibo City from Mary 2016 to May 2019 were selected and divided into control group and study group according to the simple randomization of random number table method,with 43 cases in each group.Patients in control group were treated with lamina fenestration while patients in study group were treated with percutanuous intervertebral foraminal BEIS technique.The surgical status and hospital stay,complications,pain[Visual Analogue Scale(VAS)score],Oswestry Disability Index(ODI)score and quality of life[MOS 36-item Short From Health Survey(SF-36)]were compared between the two groups.Results:The surgical time in study group was longer than that in control group,and the incision length was shorter than that in control group,and the fluoroscopy frequency was more than that in control group,and the intraoperative blood loss was less than that in control group,and the hospital stay was shorter than that in control group(P<0.05).There were no significant differences in the incidence rates of postoperative complications between the two groups(P>0.05).There were statistically significant differences in the between-group effects,timepoint effects and interaction effects of VAS pain score(P<0.05),and the VAS pain score in study group at 24 h and 1 w after surgery was significantly lower than that in control group(P<0.05).There were no statistically significant differences in the group-between effects and interaction effects of ODI score(P>0.05),and there were statistically significant differences in the time-point effects(P<0.05).There were statistically significant differences in the betweengroup effects,time-point effects and interaction effects of SF-36 score(P<0.05).The ODI score at 3 months after surgery in study group was lower than that in control group while the SF-36 score was higher than that in control group(P<0.05).Conclusion:Compared with traditional lamina fenestration,percutanuous intervertebral foraminal BEIS technique has the advantages of less trauma and quicker postoperative recovery in the treatment of lumbar disc herniation.Self-made simple locator can reduce the fluoroscopy frequency,improve the accuracy of positioning,further reduce surgical trauma and promote recovery of patients.展开更多
Objective:To explore the clinical effect of governor meridian moxibustion on lumbar intervertebral disc protrusion.Methods:Randomized controlled trials on treatment of lumbar intervertebral disc protrusion with govern...Objective:To explore the clinical effect of governor meridian moxibustion on lumbar intervertebral disc protrusion.Methods:Randomized controlled trials on treatment of lumbar intervertebral disc protrusion with governor meridian moxibustion and combined governor meridian moxibustion were retrieved from CNKI,VIP,Wan Fang Data,CBM,Web of ScienceTM Core Collection,EBSCO Medline,PubMed,OVID,the Cochrane Library,and other databases.The time was from the inception of the database until October 2021.The studies were screened according to the inclusion and exclusion criteria,extracted,and evaluated for quality assessment.The data were analyzed with Review Manager 5.3 software.Results:A total of 24 randomized controlled trials(2379 cases in total)were included.Meta-analysis results showed that compared with control groups such as acupuncture,electroacupuncture,and massage,the governor meridian treatment improved the clinical efficacy[RR=1.17,95%CI(1.13,1.20),P<0.001],relieved patients'pain[MD=-1.56,95%CI(-1.89,-1.22),P<0.001],and improved patients’dysfunction to a certain extent[MD=4.84,95%CI(3.87,5.82),P<0.001].Funnel plot analysis showed that the included literature may be potentially biased in publication.Conclusion:Governor meridian moxibustion has a significant effect on the treatment of lumbar disc protrusion and is worthy of widespread use.However,given the small number of high-quality literature included in the study,the small sample size,and the short follow-up time,high-quality randomized controlled trials are needed to further study the long-term therapeutic effect of governor meridian moxibustion.展开更多
Objective:A meta-analysis was performed to evaluate the difference of curative effect of Huoxue huayu Chinese medicine compound combined with intervertebral pore lens in the treatment of lumbar disc herniation.Methods...Objective:A meta-analysis was performed to evaluate the difference of curative effect of Huoxue huayu Chinese medicine compound combined with intervertebral pore lens in the treatment of lumbar disc herniation.Methods:CNKI,VIP,CBM,PubMed and Web of Science were searched by computer and included in the clinical trial data about the treatment of lumbar disc herniation by the Huoxue huayu Chinese medicine compound and intervertebral pore lens.Data were extracted and Cochrane system was used to evaluate the quality of the study.Cochrane system in ReMan 5.1 was used to evaluate the publication bias and Stata 12.0 was used for meta analysis.Results:A total of 1039 patients were included in 16 articles,including 519 patients in the treatment group and 520 patients in the control group.The results showed that the total effective rate of the treatment group was higher than that of the control group(RR=1.20,95%CI(1.11,1.30),P<0.05);The excellent rate of the treatment group was higher than that of the control group(RR=1.20,95%CI(1.08,1.32),P<0.05);The JOA score of the treatment group was higher than that of the control group(MD=3.39,95%CI(1.90,4.87),P<0.00001);the VAS score of the treatment group was lower than that of the control group(MD=-1.13,95%CI(-1.84,-0.42),P=0.002);The ODI score of the treatment group was lower than that of the control group[MD=-3.34,95%CI(-4.49,-2.19),P<0.00001].Conclusion:Huoxue huayu Chinese medicine compound and intervertebral pore lens can improve the clinical effect and is worth popularizing.However,due to the poor quality of the literature,more high-quality double-blind randomized controlled trials with large samples are needed.展开更多
Objective To observe therapeutic effect in the near future of the operation of verte brascope in route of retreat to treat lumbar disc protrusion and complications.Method According to symptoms,signs,myelo graphy and C...Objective To observe therapeutic effect in the near future of the operation of verte brascope in route of retreat to treat lumbar disc protrusion and complications.Method According to symptoms,signs,myelo graphy and CTM results to determine p rotrusion interspace and side type,applied the operation of verte brascope in route of retreat to treat lumbar disc protrusion and perform f unctional exercises.Results86patients were followed up,and within these pa tients,58appeared excellent (67%),25appeared good(29%),2appeared not bad(2%),and 1appeared bad(1%).Conclusion The technology has many advantages,such as little wound,little hemorrh age,little pain and fast restoration,which provide advanta geous conditions for early function al exercises after operation.展开更多
Objective: To observe the effect of ginger-separated moxibustion for treatment of lumbar intervertebrai disc prolapse. Methods: 29 Iumbar intervertebral disc protrusion patients including 21 males and 8 females were t...Objective: To observe the effect of ginger-separated moxibustion for treatment of lumbar intervertebrai disc prolapse. Methods: 29 Iumbar intervertebral disc protrusion patients including 21 males and 8 females were treated with ginger-separated moxibustion of Ashi-point and Jiaji (EX-B 2 , the affected region), 5 - 6 cones every time, once every other day, continuously for 5 times. Then the therapeutic effect was analyzed. Results: After treatment, of the 29 cases, 23(79.3% ) were cured, and the rest 6(20.7% ) experienced improvement. Conclusion: Ginger-separated moxibustion is fairly effective and safe in treatment of lumbar intervertebral disc protrusion.展开更多
Objective:To investigate the early efficacy of two approaches for lumbar disc herniation under spinal endoscopy.Methods:45 cases of lumbar disc herniation were divided into interlaminar approach(27 cases)and intervert...Objective:To investigate the early efficacy of two approaches for lumbar disc herniation under spinal endoscopy.Methods:45 cases of lumbar disc herniation were divided into interlaminar approach(27 cases)and intervertebral foramen approach(18 cases)according to different surgical approaches.Postoperative pain visual analogue scale(VAS)was used.Japanese Orthopaedic Association(JOA)lumbar spine score(JOA)and modified Macnab criteria were used to evaluate the postoperative outcome.Results:(1)VAS score.There is no interaction effect between the access mode and the time factor(F=0.620,P=0.603).There were statistically significant differences in pain VAS scores between preoperative and postoperative time points,that is,there was a time effect(F=2157.488,P=0.000).The overall VAS scores of the two groups were compared,and the difference was not statistically significant,that is,there was no grouping effect(F=2.610,P=0.114).The VAS score of pain in both groups decreased with time,and the differences between the two groups were not statistically significant before surgery,at discharge,1 month after surgery and 3 months after surgery(t=0.067,P=0.947;t=1.415,P=0.164;t=0.564,P=0.575;t=0.442,P=0.660);JOA score.There is no interaction effect between the access mode and the time factor(F=1.296,P=0.280).The difference of JOA score between preoperative and postoperative time points was statistically significant,that is,there was a time effect(F=1464.830,P=0.000).JOA scores of the two groups showed an increasing trend with time,and the differences between the two groups were not statistically significant before surgery,at discharge,1 month after surgery and 3 months after surgery(t=0.067,P=0.947;t=1.415,P=0.164;t=0.564,P=0.575;t=0.442,P=0.660);(2)The improved Macnab standard was used to evaluate the excellent and good rate at 3 months after surgery.In the interlaminar group,12 cases were excellent,13 cases were good and 2 cases were fair.The excellent and good rate was 92.6%.In the intervertebral foramen group,7 cases were excellent,10 cases were good and 1 case was fair.The excellent and good rate was 94.4%.The overall excellent and good rate of the two groups was 93.3%.Conclusion:Both approaches can achieve satisfactory efficacy in the treatment of lumbar intervertebral disc herniation,which is worthy of clinical application.However,for beginners,l5-s1 lumbar disc herniation is more suitable for intervertebral disc approach,so as to achieve satisfactory efficacy.展开更多
文摘Objective: To investigate epidural fat distribution patterns in patients with lumbar intervertebral disc protrusion. Methods: Medical records were selected randomly from 30 patients whose diagnoses were consistent with the inclusion criteria of the study. Thickness of bilateral fat, the longest length of posterior fat, thickness of bilateral yellow ligament and the hernial distance of lumbar discs were measured by MRI at L3/L4, L4/L5 and L5/S1 levels. According to clinical symptoms of lumbar intervertebral disc protrusion, the patients were divided into two groups at all space levels. All data were analyzed by statistical software. Results: The longest length of posterior epidural fat at the symptomatic levels was shorter than that at the non-symptomatic levels in each disc space. The symptomatic levels had no effect on the whole thickness of the lateral fat and lateral yellow ligaments. Conclusion: Epidural fat distribution in patients with lumbar intervertebral disc protrusion is different from that in normal adults. It is affected by the hernial distance of lumbar discs. The diagnostic criteria for spinal epidural lipomatosis in normal adults may therefore prove to be inappropriate for patients with lumbar intervertebral disc protrusion.
文摘In the present paper, 176 cases of lumbar intervertebral disc protrusion are treated with electroacupuncture (EA) and topical heat irradiation. Local tender-point is used as the main acupoint, combined with Tunzhong, Tiaoyue, Weizhong (BL 40) and Yanglingquan (GB 34). The treatment is conducted once daily, with 15 sessions being a therapeutic course. Following treatment, of 176 cases, 46 (26. 1%) are cured, 90 (51. 1%) have prominent improvement, 35 (19.8%) have amelioration and 5 (2.8%) have no apparent changes, with a total effective rate of 97.0%.
文摘Objective: To analyse and explore the diagnostic significance of infrared thermography on the patients with lumbar intervertebral disc protrusion. Methods: Forty five hospitalized cases under conservative treatment (mainly manipulation) and 65 controls were consecutively selected. Both groups were examined with infrared thermography on lower back and lower extremities as well as physical examination before and after treatment. The study statistically analysed the temperature difference between the involved and healthy parts at different areas; and also compared the variation of the temperature difference after the treatment to the decreasing scores of physical examination afterward. Results: The statistic result showed that the temperature difference between two sides on patient group was significantly higher than those of the control group. The further analysis showed that the temperature difference at posterior femur area in the patients’ group correlated significantly to the severity of clinical signs caused by nerve root irritation. Conclusion: The thermogram was uncertain to the segmental diagnosis of lumbar disc protrusion and could only be considered as a reference in the final diagnosis. Nevertheless, it is helpful to discover the severity of radical signs according to the posterior femoral region of hypo (hyper )thermogram.
基金Research Project of Sichuan Provincial Health Department(No:130914).
文摘Objective:To compare the differences in pain mediators and inflammatory factors after percutaneous transforaminal endoscopic discectomy and traditional fenestration operation treatment of protrusion of lumbar intervertebral disc. Methods:80 patients with protrusion of lumbar intervertebral disc treated in our hospital between March 2013 and December 2015 were collected and divided into observation group and control group (n=40) according to randomized parallel contrast. Control group received traditional fenestration operation and observation group received percutaneous transforaminal endoscopic discectomy. Before operation and 1 week after operation, fluorescence spectrophotometry was used to determine serum pain medium levels;ELISA was used to determine pro-inflammatory factor and anti-inflammatory factor levels. Results:Before operation, differences in serum pain medium and inflammatory factor levels were not statistically significant between two groups (P>0.05). 1 week after operation, serum pain media norepinephrine (NE), dopamine (DA), 5-hydroxytryptamine (5-HT), prostaglandin E2 (PGE2) and substance P (SP) levels as well as pro-inflammatory factors interleukin-1β(IL-1β), interleukin-6 (IL-6), interleukin-18 (IL-18) and tumor necrosis factor alpha (TNF-α) levels of observation group were lower than those of control group (P<0.05) while serum anti-inflammatory factors interleukin-4 (IL-4), interleukin 10 (IL-10), soluble tumor necrosis factor receptor I (sTNF-RI) levels were higher than those of control group (P<0.05). Conclusions:Percutaneous transforaminal endoscopic discectomy can effectively treat protrusion of lumbar intervertebral disc and is more advantageous in alleviating patients’ perception of pain and reducing inflammation.
文摘Through electroacupuncture(EA) treatment of 51 cases of protrusion of lumbar interver-tebral disc, it was further demonstrated that the specific action and characteristics of Siyao and Wuyao acupoints were significant and elucidated by using some objective indexes and obvious therapeutic ef-fect, which lays a foundation for the development, research, popularization and application of shu-point and provides an effective and practicable way for treatment of lumbar intervertebral disc.
文摘Sixty-four cases of protrusion of lumbarintervertebral disc were treated by massotherapy withheavy manipulations plus blocking therapy underanesthesia from August,1997 to July,1998,withsatisfactory therapeutic results as reported in thefollowing.Clinical DataNinety-four cases in the series were randomlydivided into two groups.All the 94 cases satisfied thecriteria for diagnosis of the disorder,and thediagnosis was confirmed by
文摘In the present paper the authors sum up their research results about "She-Bie" (black-tail snake-ground beetle) Ointment-partition moxibustion for treatment of lumbar intervertebral disc protrusion (LIDP). Animal experiments showed that when used externally, "She-Bie" Ointment had striking anti-inflammation and pain-relief actions but had no irritant and no allergic effects to the skin. In the treatment of mild type of LIDP, "She-Bie" Ointment partition moxibustion could work well in improving clinical symptoms; and in the treatment of moderate type of LIDP, it could be used as a supplementary measure and raise the excellent and good rates of the therapeutic effect further. For this reason, "She-Bie" Ointment partition moxibustion deserves being popularized in clinical treatment of LIDP.
基金Fund： The Natural Science Fund Project in Guangxi （GUI science nature： 2011GXNSFA018181 ） The Program for Excellent Talents in Guangxi Higher Education Institutions （GUI teaching finance basis [2010]92） The National Natural Science Foundation of China （ NSFC） （grant number： 81060300）
基金supported by the National Natural Foundation of China (No.30970797)Shaanxi Science and Technology Plan Projects (No. 2008k09-1)
文摘The aim of the present study was to compare the relationship of morphologically defined non-bulging/herni-ated, bulging and herniated intervertebral lumbar discs with quantitative apparent diffusion coefficient (ADC). Thirty-two healthy volunteers and 28 patients with back pain or sciatica were examined by MRI. All intervertebral lumbar discs from L1 to S1 were classified according to morphological abnormality and degenerated grades. The ADC values of nucleus pulposus (NP) were measured and recorded. The significant differences about mean ADC values of NP were found between non-bulging/herniated discs and bulging discs as well as herniated discs (P < 0.05), whereas there were no significant differences in ADC values between bulging and herniated discs (P > 0.05). Moreover, statistically significant relationship was found in the mean ADC values of NP between "non-bulging/herniated and non-degenerated discs" and "non-bulging/herniated degenerated discs" as well as herniated discs (P < 0.05). Linear regression analysis between ADC value and disc level revealed an inverse correlation (r = -0.18). The ADC map of the NP is a potentially useful tool for the quantitative assessment of componential and molecular alterations accompanied with lumbar disc abnormalities.
文摘Objective: To observe the therapeutic effect of traction combined with acupuncture on lumbar intervertebral disc herniation (LIDH). Methods:Eighty-three patients diagnosed as LIDH were randomly divided into treatment group (n=42)and control group (n=41). In the treatment group, besides lumbar traction, electroacupuncture at Jiaji (EX-B 2, L 3～5), Shenshu (BL 23), Qihai (CV 6), Mingmen (GV 4), Huantiao (GB 30), Chengshan (BL 57) and Yanglingquan (GB 34) was added. In the control group, only lumbar traction was applied. Results: In treatment group, the cure plus markedly effective rate was 80.95% with a total effective rate of 92.86%, while in control group, it was 39.02% with a total effective rate of 80.48%. The therapeutic effect in the treatment group was obviously better than that in the control group (P<0.001). Conclusion: Lumbar traction plus EA can effectively alleviate or even eliminate clinical symptoms and signs of lumbar intervertebral disc herniation.
文摘Back pain associated with lumbar disc herniation is a common musculoskeletal disorder that leads to absence at work place worldwide. Studies have proven in addition to the traditional factors, microbes play a role in disc herniation causing chronic back pain. A 34-year-old male who has not involved in any traumatic work but has a family history of disc herniation presented with lower back pain and numbness in his right leg. He had previously undergone lumbar discectomy at L4/L5 ten years back. Magnetic Resonance Imaging (MRI) showed L5/S1 right para central disc herniation impinging on the right S1 and S2 nerve roots. Standard protocols for disinfection of instruments, external skin and all transport media were adhered. Skin scrapings, muscle biopsy and excised disc tissue were obtained for anaerobic and aerobic bacterial cultures. Anaerobic microbial cultures of excised disc tissue following lumbar discectomy showed Gram positive growth. Further anaerobic isolation carried out using RapID ANA ID kit confirmed the growth as Gemella morbillorum. In addition, neither of the control samples (muscle nor skin) had any anaerobic growth indicating the absence of contamination. Aerobic bacterial growth was not present in the skin, muscles and disc cultures. The study findings add to the available literature, on the role of microorganisms in lumbar disc herniation and future treatment regimens with antibiotics.
文摘Objective: To assess glycosaminoglycan (GAG) content of lumbar intervertebral discs (IVDs) in patients with radiculopathy compared with healthy volunteers with glycosaminoglycan chemical exchange saturation transfer (gagCEST). Methods: The lumbar spines of 15 patients with radiculopathy (9 women, 6 men;mean age 45 years;range: 19 - 80 years) and 13 healthy controls (10 women, 3 men;mean age 29 years;range: 19 - 38 years) without lumbar back pain or previous spine surgery were examined at a 3 Tesla (T) magnetic resonance imaging (MRI) scanner in this prospective study. The MRI protocol included standard morphological, sagittal, and transverse T2-weighted (T2w) images of the five lumbar IVDs (L1-S1) to assess Pfirrmann score and to detect disc disorders according to the Combined Task Force classification. To analyze biochemically the lumbar IVDs, a gagCEST sequence was applied to measure the GAG content of the nucleus pulposus (NP) and annulus fibrosus (AF). Results: Patients with radiculopathy indicated significantly lower gagCEST values in NP than healthy volunteers (2.82% ±3.12% vs. 4.09% ±2.25%, P = 0.017). The GAG content of AF showed no significant difference between volunteers and patients (2.66% ±2.01% vs. 1.92% ±2.56%;P = 0.175). Conclusions. Patients with radiculopathy presented with lower GAG values than healthy volunteers in NP, indicating an association between pain and IVD degeneration. gagCEST of lumbar IVDs is a powerful, non-invasive tool to investigate early disc degeneration, which we could demonstrate in the NP in our study collective.
基金Key research project of Shandong province(No.2018GSF118185)。
文摘Objective:To compare the application effects of percutaneous percutanuous intervertebral foraminal BEIS(Broad Easy Immediate Surgery)technique on patients with lumbar disc herniation.Methods:Eighty-six patients with lumbar disc herniation treated in the Seventh People’s Hospital of Zibo City from Mary 2016 to May 2019 were selected and divided into control group and study group according to the simple randomization of random number table method,with 43 cases in each group.Patients in control group were treated with lamina fenestration while patients in study group were treated with percutanuous intervertebral foraminal BEIS technique.The surgical status and hospital stay,complications,pain[Visual Analogue Scale(VAS)score],Oswestry Disability Index(ODI)score and quality of life[MOS 36-item Short From Health Survey(SF-36)]were compared between the two groups.Results:The surgical time in study group was longer than that in control group,and the incision length was shorter than that in control group,and the fluoroscopy frequency was more than that in control group,and the intraoperative blood loss was less than that in control group,and the hospital stay was shorter than that in control group(P<0.05).There were no significant differences in the incidence rates of postoperative complications between the two groups(P>0.05).There were statistically significant differences in the between-group effects,timepoint effects and interaction effects of VAS pain score(P<0.05),and the VAS pain score in study group at 24 h and 1 w after surgery was significantly lower than that in control group(P<0.05).There were no statistically significant differences in the group-between effects and interaction effects of ODI score(P>0.05),and there were statistically significant differences in the time-point effects(P<0.05).There were statistically significant differences in the betweengroup effects,time-point effects and interaction effects of SF-36 score(P<0.05).The ODI score at 3 months after surgery in study group was lower than that in control group while the SF-36 score was higher than that in control group(P<0.05).Conclusion:Compared with traditional lamina fenestration,percutanuous intervertebral foraminal BEIS technique has the advantages of less trauma and quicker postoperative recovery in the treatment of lumbar disc herniation.Self-made simple locator can reduce the fluoroscopy frequency,improve the accuracy of positioning,further reduce surgical trauma and promote recovery of patients.
基金It was supported by the National Natural Science Fundation of C hina(No.81774340,81973875)Funds from Clinical Medicine Research Center of Chronic Muscle and Bone Diseases of Shanghai City(No.20MC1920600)+2 种基金Cons truction Project of High-level Universities and Colleges in Shanghai City(Guide Strategy for TCM Standardization),Key Clinical Specialty“Orthopedics of Chinese Medicine”(No.shslczdzk03901)Pilot Construction Project of Innovation Model for TCM Diagnosis and Treatment in Shanghai City[No.ZY(2018-2020)-FWTX-6033]Clinical Science and Technology Innovation Project of Development Center of Shanghai Shenkang Hospital(No.SHDC2020CR1051B)。
文摘Objective:To explore the clinical effect of governor meridian moxibustion on lumbar intervertebral disc protrusion.Methods:Randomized controlled trials on treatment of lumbar intervertebral disc protrusion with governor meridian moxibustion and combined governor meridian moxibustion were retrieved from CNKI,VIP,Wan Fang Data,CBM,Web of ScienceTM Core Collection,EBSCO Medline,PubMed,OVID,the Cochrane Library,and other databases.The time was from the inception of the database until October 2021.The studies were screened according to the inclusion and exclusion criteria,extracted,and evaluated for quality assessment.The data were analyzed with Review Manager 5.3 software.Results:A total of 24 randomized controlled trials(2379 cases in total)were included.Meta-analysis results showed that compared with control groups such as acupuncture,electroacupuncture,and massage,the governor meridian treatment improved the clinical efficacy[RR=1.17,95%CI(1.13,1.20),P<0.001],relieved patients'pain[MD=-1.56,95%CI(-1.89,-1.22),P<0.001],and improved patients’dysfunction to a certain extent[MD=4.84,95%CI(3.87,5.82),P<0.001].Funnel plot analysis showed that the included literature may be potentially biased in publication.Conclusion:Governor meridian moxibustion has a significant effect on the treatment of lumbar disc protrusion and is worthy of widespread use.However,given the small number of high-quality literature included in the study,the small sample size,and the short follow-up time,high-quality randomized controlled trials are needed to further study the long-term therapeutic effect of governor meridian moxibustion.
文摘Objective:A meta-analysis was performed to evaluate the difference of curative effect of Huoxue huayu Chinese medicine compound combined with intervertebral pore lens in the treatment of lumbar disc herniation.Methods:CNKI,VIP,CBM,PubMed and Web of Science were searched by computer and included in the clinical trial data about the treatment of lumbar disc herniation by the Huoxue huayu Chinese medicine compound and intervertebral pore lens.Data were extracted and Cochrane system was used to evaluate the quality of the study.Cochrane system in ReMan 5.1 was used to evaluate the publication bias and Stata 12.0 was used for meta analysis.Results:A total of 1039 patients were included in 16 articles,including 519 patients in the treatment group and 520 patients in the control group.The results showed that the total effective rate of the treatment group was higher than that of the control group(RR=1.20,95%CI(1.11,1.30),P<0.05);The excellent rate of the treatment group was higher than that of the control group(RR=1.20,95%CI(1.08,1.32),P<0.05);The JOA score of the treatment group was higher than that of the control group(MD=3.39,95%CI(1.90,4.87),P<0.00001);the VAS score of the treatment group was lower than that of the control group(MD=-1.13,95%CI(-1.84,-0.42),P=0.002);The ODI score of the treatment group was lower than that of the control group[MD=-3.34,95%CI(-4.49,-2.19),P<0.00001].Conclusion:Huoxue huayu Chinese medicine compound and intervertebral pore lens can improve the clinical effect and is worth popularizing.However,due to the poor quality of the literature,more high-quality double-blind randomized controlled trials with large samples are needed.
文摘Objective To observe therapeutic effect in the near future of the operation of verte brascope in route of retreat to treat lumbar disc protrusion and complications.Method According to symptoms,signs,myelo graphy and CTM results to determine p rotrusion interspace and side type,applied the operation of verte brascope in route of retreat to treat lumbar disc protrusion and perform f unctional exercises.Results86patients were followed up,and within these pa tients,58appeared excellent (67%),25appeared good(29%),2appeared not bad(2%),and 1appeared bad(1%).Conclusion The technology has many advantages,such as little wound,little hemorrh age,little pain and fast restoration,which provide advanta geous conditions for early function al exercises after operation.
文摘Objective: To observe the effect of ginger-separated moxibustion for treatment of lumbar intervertebrai disc prolapse. Methods: 29 Iumbar intervertebral disc protrusion patients including 21 males and 8 females were treated with ginger-separated moxibustion of Ashi-point and Jiaji (EX-B 2 , the affected region), 5 - 6 cones every time, once every other day, continuously for 5 times. Then the therapeutic effect was analyzed. Results: After treatment, of the 29 cases, 23(79.3% ) were cured, and the rest 6(20.7% ) experienced improvement. Conclusion: Ginger-separated moxibustion is fairly effective and safe in treatment of lumbar intervertebral disc protrusion.
基金Anhui Province from Cong Qingwu Old Chinese Medicine Studio Project.Project No:2100601.
文摘Objective:To investigate the early efficacy of two approaches for lumbar disc herniation under spinal endoscopy.Methods:45 cases of lumbar disc herniation were divided into interlaminar approach(27 cases)and intervertebral foramen approach(18 cases)according to different surgical approaches.Postoperative pain visual analogue scale(VAS)was used.Japanese Orthopaedic Association(JOA)lumbar spine score(JOA)and modified Macnab criteria were used to evaluate the postoperative outcome.Results:(1)VAS score.There is no interaction effect between the access mode and the time factor(F=0.620,P=0.603).There were statistically significant differences in pain VAS scores between preoperative and postoperative time points,that is,there was a time effect(F=2157.488,P=0.000).The overall VAS scores of the two groups were compared,and the difference was not statistically significant,that is,there was no grouping effect(F=2.610,P=0.114).The VAS score of pain in both groups decreased with time,and the differences between the two groups were not statistically significant before surgery,at discharge,1 month after surgery and 3 months after surgery(t=0.067,P=0.947;t=1.415,P=0.164;t=0.564,P=0.575;t=0.442,P=0.660);JOA score.There is no interaction effect between the access mode and the time factor(F=1.296,P=0.280).The difference of JOA score between preoperative and postoperative time points was statistically significant,that is,there was a time effect(F=1464.830,P=0.000).JOA scores of the two groups showed an increasing trend with time,and the differences between the two groups were not statistically significant before surgery,at discharge,1 month after surgery and 3 months after surgery(t=0.067,P=0.947;t=1.415,P=0.164;t=0.564,P=0.575;t=0.442,P=0.660);(2)The improved Macnab standard was used to evaluate the excellent and good rate at 3 months after surgery.In the interlaminar group,12 cases were excellent,13 cases were good and 2 cases were fair.The excellent and good rate was 92.6%.In the intervertebral foramen group,7 cases were excellent,10 cases were good and 1 case was fair.The excellent and good rate was 94.4%.The overall excellent and good rate of the two groups was 93.3%.Conclusion:Both approaches can achieve satisfactory efficacy in the treatment of lumbar intervertebral disc herniation,which is worthy of clinical application.However,for beginners,l5-s1 lumbar disc herniation is more suitable for intervertebral disc approach,so as to achieve satisfactory efficacy.
