A Flat Sagittal Spinal Alignment Is Common among Young Patients with Lumbar Disc Herniation

Background: Recent studies suggest a correlation between spinal sagittal alignment and different types of lumbar pathologies due to different load patterns on the lumbar spine. The main objective of this study was to investigate the preoperative spinal sagittal alignment in young patients (Methods: Information regarding preoperative clinical examinations was collected from the patient medical charts. Preoperative MRI examinations were used to classify lumbar types according to four sagittal spinal alignment groups (1: a long thoracic kyphosis, 2: a flat back, 3: a normal spine and 4: an increased thoracic kyphosis). Other MRI findings were also noted. Classification of lumbar types was performed independently by three spine surgeons. To compare two sample proportions the 2-sample z-test was performed. Results: The distribution of lumbar curve types was: Type 1, 17% (9 patients);Type 2, 62% (33 patients);Type 3, 17% (9 patients) and Type 4, 4% (2 patients). The distribution of operated levels was: L3 - L4, 2% (1 patient);L4 - L5, 47% (25 patients);L5 - S1, 42% (22 patients) and L4 - L5 + L5 - S1, 9% (5 patients). Conclusions: A majority of the young patients (62%) that underwent surgery due to herniated disc in the lumbar spine were classified as Type 2 indicating a flat back. Future studies are needed to increase the knowledge about spinopelvic sagittal alignment and the correlation to spinal pathologies.

Effects of Duhuojisheng Tang and combined therapies on prolapse of lumbar intervertebral disc:a systematic review of randomized control trails

OBJECTIVE： A systematic review of the literature was conducted to evaluate the curative effect and safety of Duhuojisheng Tang on prolapse of the lumbar intervertebral disc. METHODS： The databases of PubMed, China Na- tional Knowledge Infrastructure （CNKI）, Chinese Sci- entific Journals Database （VlP）, Chinese Biomedical Literature Database （CBM） and Chinese Medical Ci- tation Index （CMCl） were searched up to January 30, 2012. Randomized controlled trials were select- ed to compare Duhuojisheng Tang with one ormore of the following treatments： traction, acu- puncture, massage, cupping and Western medical treatment. The quality-evaluating standard and the software RevMan 5.1 in Cochrane coordinative net were used to analyze the data. The effective index- es of the results were clinical curative rate, effective- ness of alleviating clinical symptoms and adverse reaction. RESULTS： Thirty-one randomized controlled trials of low quality, involving 3915 patients were system- atically evaluated. Statistical analyses showed that good curative effect was achieved in both the group using Duhuojisheng Tang alone and with combined therapies. CONCLUSION： Using Duhuojisheng Tang alone or combined with other therapies can effectively im- prove pain, leg-raising height and other clinical symptoms of patients with prolapse of lumbar in- tervertebral disc. Due to low methodological quali- ty of the articles, no exact recommendations can be made.

Observation on therapeutic effect of acupuncture at abdomen acupoints plus tuina for lumbar intervertebral disc herniation

Objective: To observe the clinical efficacy of acupuncture at abdomen acupoints plus tuina for lumbar intervertebral disc herniation (LIDH). Methods: A total of 70 patients with LIDH were randomized into an observation group and a control group, with 35 cases in each group. The observation group was treated with acupuncture at abdomen acupoints plus tuina, while the control group was treated only with tuina treatment. The clinical efficacy was observed after one course of treatment. Results: The cure rate and the total effective rate of the observation group were 83.3% and 96.7%, respectively. The cure rate and the total effective rate of the control group were 39.4% and 78.8%, respectively. There were significant differences in the cured rate and the total effective rate between the two groups (both P<0.05). There was no significant differenee in Japanese Orthopedic Association (JOA) score between the two groups before treatment (P>0.05). After treatment, the JOA scores of both groups in creased sign ifica ntly, and the in tra-group differe nces were statistically sign ifica nt (both P<0.05);the JOA score of the observation group was significantly higher than that of the control group (P<0.05). Conclusion: Acupuncture at abdomen acupoints plus tuina has a better therapeutic effect than tuina alone in the treatment of LIDH.

Therapeutic observation of tuina manipulation for lumbar intervertebral disc herniation

Objective: To observe the clinical efficacy of balance-impact tuina therapy for lumbar intervertebral disc herniation (LIDH). Methods: A total of 118 eligible LIDH patients were randomized into an observation group and a control group by the random number table method, with 59 cases in each group. The observation group was intervened by balance-impact tuina therapy, while the control group was intervened by conventional tuina therapy, both for consecutive two weeks. The scores of visual analog scale (VAS), Oswestry disability index (ODI)Z quality of life questionnaire-core 30 (QOL-C30) were observed before and after treatment;the relapse rate was estimated at the sixth month and twelfth month following the treatment. The data were statistically an a lyzed. Results: After intervention, the total effective rate was 96.6% in the observation group versus 91.5% in the control group, and the between-group differenee was statistically significant (P<0.05). The VAS and ODI scores declined significantly after treatment in both groups (all Pv0.05), and the observation group was markedly lower than the control group (P<0.05, P<0.01). The QOL-C30 score in creased significantly after treatme nt in both groups (both P<0.05), and the observatio n group was markedly higher than the control group (P<0.05). The relapse rates at the post-treatment sixth month and twelfth month in the observation group were lower than those in the control group (P<0.05, P<0.01). Conclusion: Compared with the conventional tuina therapy, the balance-impact tuina therapy shows advantage in lessening pain, improving the function and enhancing the quality of life in the treatment of LIDH, and it has a lower relapse rate. Thus, this therapy is worth promoting in clinic.

Observation of the Therapeutic Effect of Treating Lumbar Intervertebral Disc Protrusion by Acupuncture Therapy

Objective： To observe the clinical effect of treating lumbar intervertebral disc protrusion by needling the points on both sides of the impaired lumbar vertebrae. Methods： One hundred and eighty cases of lumbar intervertebral disc protrusion were randomly divided into three groups, treatment group, control group of acupuncture and control group of western medicine, with 60 cases in each group. The therapeutic effects were compared after 20-day treatments. Result： The effective rate was 96.7% in the treatment group, 80.0% in the acupuncture group, and 81.7% in the Western medicine group. There was a statistically significant difference between the treatment group and two control groups （P〈0.05）. Conclusion： It is an effective therapy to treat lumbar intervertebral disc protrusion by puncturing the acupuncture points on both sides of the impaired lumbar vertebrae.

Influence of Acupuncture plus LONG＇s Manual Manipulations on Functional Improvement in Lumbar Intervertebral Disc Protrusion

Objective： To observe the effect of acupuncture plus LONG＇s manual manipulations on the functional improvement of the patients with lumbar intervertebral disc protrusion. Methods： 60 cases of the patients were randomly divided into a observation group and a control group, 30 cases in each group. The observation group was treated with acupuncture plus LONG＇s manual manipulations, and the control group was treated with single acupuncture. The functions of the lumber vertebrae were processed in accordance with the assessment system of Japanese Orthopedic Association （JOA）, and the therapeutic effects were assessed by Visual Analog Scale （VAS）. Results： After the treatments, the differences in JOA and improvement indexes were statistically significant （P〈0.05） between the two groups. VAS was decreased much remarkably in the observation group （P〈0.01） than before the treatments and decreased remarkably in the control group （P〈0.05） than before the treatments. There was a remarkable difference in VAS between the two groups after the treatments （P〈0.05）. Conclusion： Acupuncture plus LONG＇s manual manipulations are better than single acupuncture in improving the functions of the patients with lumbar intervertebral disc protrusion.

Comparison of biomechanical effect between oblique Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position for lumbar intervertebral disc herniation

Objective： To compare the biomechanical effects between oblique Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position in treating lumbar intervertebral disc herniation （LIDH）. Methods： A three-dimensional finite element model of L3-S1 was developed to carry out a comparative study between oblique Ban-pulling manipulation and lumbar erection and rotation manipulation in sitting position. The disc protrusion was assumed to be on the rear left of L4 disc, and the manipulations were performed on the right side. The loading process was simulated by two steps, in the first step, only the compression loading was imposed, and in the second step, both the compression loading and axial rotation moment were imposed. The displacement and stress distribution in L4 disc were investigated. Results： The values of stress and displacement in the second step were lower than those in the first step in each manipulation. The stress and displacement differences between the two steps were respectively 1.79 times and 3.03 times larger in oblique Ban-pulling manipulation than those in lumbar erection-rotation manipulation in sitting position. Conclusion： Oblique Ban-pulling manipulation may result in a better biomechanical effect than lumbar erection-rotation manipulation in sitting position for LIDH.

Clinical Observation on Treatment of 67 Cases with Lumbar Intervertebral Disc Herniation with Abdomen Acupuncture

Objective： To compare the clinical efficacy of abdomen acupuncture with body acupuncture for treating lumbar intervertebral disc protrusion. Methods： One hundred and thirty three patients were randomly allocated to a treatment group of 67 cases and a control group of 66 cases. The patients in the treatment group received abdomen acupuncture and those in the control group, body acupuncture. The improvements in the symptoms were compared after treatment. Results： The efficacy rate was 95.5% in the treatment group and 86.4% in the control group; there was a statistically significant difference between the two groups （P〈0.05）. The cure rate after one course of treatment was significantly higher in the treatment group than in the control group （P〈0.05）. Conclusion： Abdomen acupuncture has a good effect on lumbar intervertebral disc protrusion with a short course of treatment.

Clinical Observation on Acupoint Sticking Therapy for Lumbar Intervertebral Disc Hernination

Objective： To observe the clinical effects of acupoint sticking therapy for umbar intervertebral disc herniation. Methods： Seventy patients with lumbar intervertebral disc herniation were randomly divided into two groups by the visit order, 35 cases in each group. The treatment group was treated with acupoint sticking therapy and the control group was treated with tuina. After treatment, the clinical effects, pain integral and Japanese Orthopedic Association （JOA） scores were compared between the two groups. Results： The total effective rate, pain integral and improvement of JOA scores were better in the treatment group than in the control group （P〈O.O5）. Conclusion： Acupoint sticking therapy is affirmative in the therapeutic effects and better than tuina treatment for lumbar intervertebral disc herniation.

Intensive stimulation tuina at tender points plus medication for cervical intervertebral disc herniation

Objective： To observe the clinical efficacy of tuina with intensive stimulation at tender points plus medication in treating cervical intervertebral disc herniation（CIDH）.Methods： Totally 158 CIDH patients were randomized into an observation group and a control group by their visit sequence, 79 cases in each group. The control group was intervened by oral administration of Meloxicam tablets, 7.5 mg for each dose, once each day. The observation group was additionally intervened by tuina with intensive stimulation at tender points based on the treatment given to the control group, once each day. The therapeutic efficacy was evaluated after successive 14-day treatment for the two groups. Results： The total effective rate was 92.4% in the observation group, significantly higher than 81.0% in the control group（P〈0.05）. The visual analogue scale（VAS） scores dropped significantly after the treatment in both groups（both P〈0.01）, and the VAS score of the observation group was significantly lower than that of the control group（P〈0.01）. Conclusion： Tuina with intensive stimulation at tender points plus oral administration of Meloxicam tablets can produce a more significant efficacy in treating CIDH than taking Meloxicam alone, thus worth promoting in clinic.

Observation on therapeutic effect of aligned acupuncture for lumbar intervertebral disc herniation

Objective： To observe the clinical effects of aligned needling therapy for lumbar intervertebral disc herniation （LIDH）. Methods： A total of 80 cases with LIDH in conformity with the inclusion criteria were randomly divided into a treatment group or a control group by their visit order, 40 cases in each group. The points from the Governor Vessel, L1-L5 Jiaji （EX-B 2） points, from the first lateral line of the Bladder Meridian, Huantiao （GB 30）, Weizhong （BL 40） and Yanglingquan （GB 34） were selected for acupuncture in the treatment group. Shenshu （BL 23）, Dachangshu （BL 25）, Ashi （Extra） points and Weizhong （BL 40） were used for routine acupuncture in the control group. The clinical effects of the two groups after 2-course treatments and recurrence rates three months later were observed. The pain severity before and after treatments was assessed by visual analog scale （VAS）. The improvement of the patient＇s pathological situation was evaluated by the performance assessment of lumbar disease treatment from Japanese Orthopedic Association （JOA）. Results： After the treatment for two courses, there was no dropped-out case in the two groups. The curative rates and total effective rates were respectively 32.5% and 92.5% in the treatment group versus respectively 12.5% and 82.5% in the control group. The differences in the curative rates and total effective rates between the two groups were statistically significant （both P〈0.01）. After the treatment, VAS and JOA scores remarkably declined in the patients of the two groups, with statistical differences in comparison with those of the same group before treatment （both P〈0.05）. In follow-up check of three months, the recurrence rate was 10.7% in the cured and remarkably effective cases in the treatment group and was 29.4% in the control group. The recurrence rates of the two groups were statistically different （P〈0.05）. Conclusion： The aligned needling technique is remarkable in the clinical effects, obvious in the analgesic effects and low in the recurrence rate in the treatment of LIDH.

Tuina Treatment of 150 Cases with Lumbar Intervertebral Disc Herniation

Objective： To observe the clinical efficacy of tuina treatment for lumbar intervertebral disc herniation. Methods： 150 cases with lumbar intervertebral disc herniation were treated with tuina, followed by a retrospective analysis and summarization on the clinical efficacy. Results： 43 cases obtained clinical recovery, 67 cases had a marked effect, 34 cases had improvement and 6 cases failed. The total effective rate was 96.0%. Conclusion： Tuina is effective for lumbar intervertebral disc herniation.

Electroacupuncture combined with traction and tuina for lumber intervertebral disc herniation

Objective： To observe the effect of electroacupuncture （EA） combined with traction and modified oblique Ban-pulling manipulation on lumber intervertebral disc herniation （LIDH）. 〈br〉 Methods：A total of 90 eligible cases were randomly allocated into three groups, 30 in each group. Cases in group A were treated with EA, traction and tuina of modified oblique Ban-pulling manipulation; cases in group B were treated with traction and tuina （same as group A）;and cases in group C were treated with traction alone （same as the other two groups）. Then the therapeutic efficacies in the three groups were evaluated using the Japanese Orthopedic Association （JOA） score rating system. 〈br〉 Results：The results after treatment and 1-month follow up showed that JOA scores in all three groups were improved （P〈0.01）; the total effective rate in Group A was 96.7%, versus 90.0% in group B and 70.0% in group C, showing a significantly better effect than the other two groups （P〈0.01）. 〈br〉 Conclusion： EA combined with traction and modified oblique Ban-pulling manipulation can obtain better effect than traction alone and traction combined with modified oblique Ban-pulling manipulation for LIDH.

Acupuncture-moxibustion at Jiaji(EX-B 2) points for intervertebral disc herniation: a systematic review

By organizing and classifying the literatures related to acupuncture-moxibustion at Jiaji （EX-B 2） points in treating intervertebral disc herniation （IDH） published before December 32, 2013, to summarize the application status and features of Jiaji （EX-B 2） points. It＇s found that its most favorable indication is IDH. It also further analyzed the action mechanism of acupuncture-moxibustion at Jiaji （EX-B 2） points in treating IDH, and brought up some ideas to highlight the further study.

Electroacupuncture combined with iontophoresis of Chinese medicine for lumbar intervertebral disc herniation

Objective：To observe the clinical efficacy of electroacupuncture （EA） combined with iontophoresis of Chinese medicine for lumbar intervertebral disc herniation （LIDH）. Methods： A total of 80 LIDH cases were randomly allocated into a treatment group and a control group by the random number table, 40 in each group. Cases in the treatment group were treated with EA combined with iontophoresis of Chinese medicine, whereas cases in the control group were treated with EA alone. Cases in both groups were treated once a day, 10 times for one course and there was a 3-day interval between two courses. The therapeutic efficacies in two groups were assessed after two courses of treatment. The short-form McGill pain questionnaire （SF-MPQ） and Japanese Orthopedic Association （JOA） low back pain evaluation questionnaire were used for the scoring system before treatment, after the first treatment and 2 courses of treatment. Results： After two courses of treatment, the total effective rate was 95.0% in the treatment group, versus 87.5% in the control group, showing a statistical difference （P〈0.05）. The therapeutic efficacy in the treatment group was significantly better than that in the control group after the first treatment and 2 courses of treatment. The score of SF-MPQ in the treatment group was more significantly decreased and the JOA score in the treatment group was more significantly increased, showing statistical differences （P〈0.01）. Conclusion： EA at Jiaji （EX-B2） points combined with iontophoresis of Chinese medicine is better than EA alone in alleviating low back and leg pain and improving functions of the low back and leg as well as the quality of life of LIDH patients .

Clinical Observation on Tuina Treatment for Cervical Intervertebral Disc Herniation

Objective： To observe the clinical effect of tuina for cervical intervertebral disc herniation. Methods： Eighty seven cases were randomized into a treatment and a control group. 39 cases in the treatment group were treated with tuina manipulation, while 48 cases in the control group were treated with combined cervical traction and medium-frequency impulse. Cases in both groups were treated 3 times a week, and 10 times constitute a course of treatment. Results： Of 39 cases in the treatment group, 22 obtained recovery, 13 obtained marked effects and 4 obtained improvement, manifesting a marked effect rate of 89.7% and an effective rate of 100.0%. Of 48 cases in the control group, 23 obtained recoveries, 17 obtained marked effects, 7 obtained improvements and 1 saw no improvement, manifesting a marked effect rate of 83.3% and an effective rate of 97.9%. There were no statistical differences in the marked effect rate and total effective rate. Cases in the treatment group were treated 17.8 times on average, while cases in the control group were treated 26.6 times on average. Conclusion： Despite the equivalent effects in the treatment of cervical intervertebral disc herniation, tuina is superior to combined traction and medium-frequency impulse in terms of a faster effect and shorter course of treatment.

Clinical Study on Electroacupuncture for Cervical Intervertebral Disc Herniation

Objective:To compare the therapeutic efficacies between electroacupuncture(EA)and medication for cervical intervertebral disc herniation(CIDH).Methods:Totally 420 patients with CIDH were randomized into two groups by random number table.210 patients in the EA group were intervened by EA at Dazhui(GV 14),Dazhu(BL 11),and Houxi(SI 3);210patients in the medication group were treated by oral administration of Meloxicam tablets.Results:The average ranks of both short and long term efficacies in the EA group were significantly lower than that in the medication group(both P<0.01);there were significant differences in comparing the total effective rates of both short and long terms between the two groups(both P<0.01).It shows that EA group has better therapeutic efficacy than the medication group.Conclusion:EA is better than medication in comparing both short-term and long-term therapeutic efficacies in treating CIDH.

Clinical Study of Acupoint Injection in Treating Lumbar Intervertebral Disc Protrusion

Objective： To investigate the clinical efficacy of point injection in treating lumbar intervertebral disc protrusion. Methods： One hundred and fifty-six patients with lumbar intervertebral disc protrusion were randomly allocated to an observation group of 80 cases （mecobalamin injection） and a control group of 76 cases （vitamin B12 injection）. Injection at Jiaji （Ex-B 2） points corresponding to the spinal segments of the pressed nerve roots was performed. Results： The efficacy rate was 86.3% in the observation group and 78.9% in the control group. There was a statistically significant difference in curative effect between the two groups （P〈0.01）. Conclusion： The results indicate that the clinical curative effect of acupoint injection of mecobalamin is significantly better than that of point injection of vitamin B12 in treating lumbar intervertebral disc protrusion.

Comparison of Therapeutic Effects Between Acupuncture plus Sacral Injection and Simple Acupuncture for Lumbar Intervertebral Disc Herniation

Purpose： To compare the therapeutic injection and simple acupuncture for intervertebral effects between acupuncture plus sacral disc hernia. Methods： The patients with lumbar intervertebral disc hernia at the age of 30-45 years old were divided into No. 1 - 80 upon their visiting order, with odd number as Group A and even number as Group B. Group A was treated by acupuncture plus sacral injection, and Group B was treated by simple acupuncture. Results： The clinical effective rate was higher in Group A than in Group B, with significant difference （P〈0.05）. Conclusion： Acupuncture plus sacral injection had the better therapeutic effect than simple acupuncture in treating lumbar intervertebral disc hernia.

Therapeutic Evaluation of Tuina and Hyperbaric Oxygen for Prolapse of Lumbar Intervertebral Disc

Objective： To evaluate the therapeutic effects of Tuina and hyperbaric oxygen on prolapse of lumbar intervertebral disc. Methods： The included 160 cases of prolapse of lumbar intervertebral disc were allocated into a treatment group and a control group. The 100 cases in the treatment group were treated with tuina manipulation and hyperbaric oxygen. The 60 cases in the control group were treated with tuina manipulation. The total effect and scores of symptoms and signs were compared before and after treatment. Results： The total effective rate in the treatment group was 100.0%, and 83.0% in the control group. Conclusion： Tuina and hyperbaric oxygen had excellent effects on the prolapse of lumbar intervertebral disc, by improving the clinical symptoms and signs of ache and movement restriction of lower back and leg, and recovering the ability of work and daily life.