BACKGROUND Scedosporium apiospermum(S.apiospermum)is a clinically rare and aggressive fungus mainly found in contaminated water,wetlands,decaying plants,stagnant water,and potted plants in hospitals.The lung,bone,join...BACKGROUND Scedosporium apiospermum(S.apiospermum)is a clinically rare and aggressive fungus mainly found in contaminated water,wetlands,decaying plants,stagnant water,and potted plants in hospitals.The lung,bone,joint,eye,brain,skin,and other sites are easily infected,and there is a marked risk of misdiagnosis.There have been few case reports of infection by S.apiospermum of the lumbar vertebrae;most reports have focused on infection of the lung.CASE SUMMARY An otherwise healthy 60-year-old man presented with a 4-mo history of lumbosacral pain,stooping,and limited walking.The symptoms were significantly aggravated 10 d prior to hospitalization,and radiating pain in the back of his left lower leg developed,which was so severe that he could not walk.Movement of the lumbar spine was significantly limited,anterior flexion was about 30°;backward extension,right and left lateral curvature,and rotational mobility were about 10°;tenderness of the spinous processes of the lumbar 3-5 vertebrae was evident,and the muscle strength of both lower limbs was gradeⅣ.Imaging suggested bony destruction of the lumbar 3,4,and 5 vertebrae and sacral 1 vertebra;in addition,the corresponding intervertebral spaces were narrowed and the lumbar 5 vertebra was posteriorly displaced and unstable.Lumbar vertebral infection was also noted,and the possibility of lumbar tuberculosis was considered.We first performed surgical intervention on the lesioned lumbar vertebrae,cleared the infected lesion,and performed stable fixation of the lesioned vertebral body using a lumbar internal fixation device,which restored the stability of the lumbar vertebrae.Cytological and pathological examination of the lesioned tissue removed during surgery confirmed S.apiospermum infection of the lumbar vertebrae;on this basis,the patient was administered voriconazole.At the 6-mo followup,efficacy was significant,no drug-related side effects were observed,and imaging examination showed no evidence of recurrence.CONCLUSION S.apiospermum infection can occur in immunocompetent individuals with no history of near drowning.Voriconazole is effective for the treatment of S.apiospermum infection of the lumbar vertebrae for which it is suitable as the first-line therapy.展开更多
Objective To investigate surgical strategy for high-grade isthmic spondylolisthesis(more thanⅡ degree)of 5th lumbar vertebrae.Methods From August 2003 to October 2008,26 patients with high-grade isthmic spondylolisth...Objective To investigate surgical strategy for high-grade isthmic spondylolisthesis(more thanⅡ degree)of 5th lumbar vertebrae.Methods From August 2003 to October 2008,26 patients with high-grade isthmic spondylolisthesis (L5) were展开更多
In the present study, 121 patients with lumbar vertebra hyperosteogeny were dividedinto following four groups for treatment and comparison: intense electro-acupuncture group (Group1), hydro-acupuncture group (Group 2)...In the present study, 121 patients with lumbar vertebra hyperosteogeny were dividedinto following four groups for treatment and comparison: intense electro-acupuncture group (Group1), hydro-acupuncture group (Group 2), electro-acupuncture plus hydro-acupuncture group (Group3) and analgesic liquid for spur group (Group 4). It is indicated that the effect of electro-acupunctureplus hydro-acupuncture is the best in the treatment of lumbar vertebra hyperosteogeny.展开更多
In the present paper, 70 cases of retrograde affection of the lumbar vertebrae are randomly and evenly divided into treatment group and control group. Shenshu (BL 23), Qihaishu (BL 24), Dachangshu (BL 25), Weizhong (B...In the present paper, 70 cases of retrograde affection of the lumbar vertebrae are randomly and evenly divided into treatment group and control group. Shenshu (BL 23), Qihaishu (BL 24), Dachangshu (BL 25), Weizhong (BL 40), Jiaji (EX B 2), etc. are used. In treatment group, acupuncture, TDP irradiation and cupping are performed, and in control group, only acupuncture is given. After 30 sessions (3 therapeutic courses) of treatment, in treatment and control groups, the total effective rates are 91.43% and 71.43% respectively. The therapeutic effect of comprehensive treatment is significantly superior to that of simple acupuncture therapy (P<0.05).展开更多
Objective Comparing different medication pro ject of continuous epidural analgesia for the patient after lumbar verte bra opera-tion,to decrease the complications and promote analgesia effects.Methods150cases with AS...Objective Comparing different medication pro ject of continuous epidural analgesia for the patient after lumbar verte bra opera-tion,to decrease the complications and promote analgesia effects.Methods150cases with ASAⅠ～Ⅱgrade,lumbar intervertebral disc e x-tirpation and /or vertebral canal decompression,were divided into 5gro ups.A group:0.0625%bupivacaine;B group:0.125%bupiva-caine;C group:0.0625%bupivacaine and 1mg morphine;D group:0.125%bupivacaine and 1mg morphine;E group:n o analgesia.Record the occurrence of RR,MAP,HR,VAS score and side effects.Results The analgesia effects of all groups were satisfying,but the oc-currence of urine retention increased in B,C,D group,and the occurrence of nausea and vomit increased obviou sly in C,D group.Conclusions The continuous epidural analgesia w ith simple 0.0625%for patients afte r lumbar vertebral operation is best.展开更多
Objective: To compare the influence of normal and degenerative discs on stress distribution of the thoracolumbar vertebrae under destructive load, explore the biomechanical background and clinical meaning and provide ...Objective: To compare the influence of normal and degenerative discs on stress distribution of the thoracolumbar vertebrae under destructive load, explore the biomechanical background and clinical meaning and provide theoretical basis for clinical diagnosis and treatment. Methods: A mechanical model of thoracolumbar motion segment of normal and degenerative discs was built with a three dimensional finite element method and three stresses of vertical compression, compressive flexion and distractive flexion were comparatively analyzed. Results: With vertical compression and compressive flexion loads, the thoracolumbar motion segment of the normal disc showed that the central part of the upper and lower end plates of the vertebrae and the central part of the trabecular bone adjacent to the end plate were loaded with the most intensive stresses, meanwhile, the postero lateral part of the annulus fibrosus was concentrated with stresses. Degenerative disc showed that the stress distribution of the trabecular bone was relatively averaged, the stresses of the central part adjacent to the end plate were low, while at the same time, the stresses of the peripheral part were elevated relatively. With distraction flexion load, the stresses of the cortex bone, trabecular bone, end plate and annulus fibrosus of the thoracolumbar vertebrae of degenerative discs were low, meanwhile, the stresses of the posterior structure of the vertebral body were relatively elevated compared with that of normal discs. Conclusions: There is difference in influence between normal and degenerative discs on the stress distribution of the thoracolumbar vertebrae with destructive load. The transferring way of load is changed after disc degeneration.展开更多
Objective: To observe the effect of warm needling therapy plus acupuncture on third lumbar vertebra transverse process syndrome. Methods: Sixty cases of third lumbar vertebra transverse process syndrome were randomly ...Objective: To observe the effect of warm needling therapy plus acupuncture on third lumbar vertebra transverse process syndrome. Methods: Sixty cases of third lumbar vertebra transverse process syndrome were randomly divided into a warm needling group or an acupuncture group, 30 cases in each group. Cases in the acupuncture group were treated by routine points and needle sticking manipulation, while those in the warm needling group were treated by moxibustion plus needling as same as the acupuncture group. Japanese orthopedic association scores(JOA) in the two groups were observed and compared after 2 treatment courses. Results: After treatment, the JOA score in the warm needling group was higher than that in the acupuncture group(P<0.01); subjective symptom, clinical syndromes, activity of daily living(ADL) in the warm needling group were all higher than those in the acupuncture group(all P<0.05); the score of pain in the warm needling group was significantly lower than that in the acupuncture group(P<0.01); the total effective rate in the warm needling group was 76.7%, versus 70.0% in the acupuncture group, showing a statistically significant difference(P<0.05). Conclusion: Warm needling therapy is more effective than normal acupuncture in treating third lumbar vertebra transverse process syndrome.展开更多
Protrusion of the lumbar intervertebral disc is a common disorder frequently encountered in clinic. With TCM massage and the maneuver of manual reduction, we have treated 82 cases of protrusion of the lumbar inter... Protrusion of the lumbar intervertebral disc is a common disorder frequently encountered in clinic. With TCM massage and the maneuver of manual reduction, we have treated 82 cases of protrusion of the lumbar intervertebral disc, with satisfactory therapeutic results reported in the following.……展开更多
The authors treated 62 cases of protrusion oflumbar intervertebral disc by pulling and turningmanipulations from February 1993 to February 1998.Another 50 cases were treated by traction as controls.Statistical data sh...The authors treated 62 cases of protrusion oflumbar intervertebral disc by pulling and turningmanipulations from February 1993 to February 1998.Another 50 cases were treated by traction as controls.Statistical data showed that pulling and turningmanipulations had much better therapeuticeffectiveness than traction(P<0.05).展开更多
Clinically, there is a higher incidence of protrusion of the lumbar intervertebral disc. It can cause a terrible pain. The author has treated 66 cases by massotherapy, who were confirmatively diagnosed as having protr...Clinically, there is a higher incidence of protrusion of the lumbar intervertebral disc. It can cause a terrible pain. The author has treated 66 cases by massotherapy, who were confirmatively diagnosed as having protrusion of the lumbar intervertebral disc by X-ray film and computer-aided tomography, with satisfactory results as reported in the following.
Clinical Data
Among the 66 cases in this series, 49 were male and 17 female, ranging in age from 26 to 59 years, averaging 36.2 years. All the patients had got lumbago and unilateral ischialgia, with the left side affected in 37 cases and the right side in 29 cases. The leg pain radiating to lateral malleolus was found in 28 cases, to dorsum of the foot in 24 cases, and to the toes in 14 cases. Intermittent claudication was present in 22 cases, numbness of the affected foot in 16 cases, pain exacerbated when coughing in 35 cases, scoliosis in 21 cases, and positive Lasegue's sign in 48 cases.展开更多
Fifty-six cases of the protrusion of the lumbar intervertebral disc in the treatment group were treated by drug-penetration and oral administration of traditional Chinese decoction plus traction, and the other 35 case...Fifty-six cases of the protrusion of the lumbar intervertebral disc in the treatment group were treated by drug-penetration and oral administration of traditional Chinese decoction plus traction, and the other 35 cases in the control group by oral administration of Chinese decoction and traction. The results showed that the cure rate in the treatment group was 83.9%, and that in the control group was 57.1%, with a statistically significant difference between the two groups (P<0.01), indicating that the former is a more effective therapy for protrusion of the lumbar intervertebral disc.展开更多
To provide a new method to estimate the effectiveness of thoracolumbar vertebral finite element model. Methods: A mechanical model of human thoracolumbar vertebrae motion segment was made using three-dimensional finit...To provide a new method to estimate the effectiveness of thoracolumbar vertebral finite element model. Methods: A mechanical model of human thoracolumbar vertebrae motion segment was made using three-dimensional finite element method and the stress distribution of vertically compressed thoracolumbar vertebrae was analyzed, meanwhile, 20 patients with burst fracture of thoracolumbar vertebrae were tested by CT to calculated average CT value at ascertained different points of thoracolumbar vertebrae. The calculated results and effective stress at the same position were analyzed with straight line correlation. Results: The stress level of different position of thoracolumbar vertebrae under vertical compressive force was positively correlated with the correlative CT value, and the regressive style, Y= 214.028 + 45.268 X, r= 0.7386 , P< 0.05 (n=8) showed a statistical significance.Conclusions: To study mechanism of thoracolumbar vertebrae injuries under different forces has clinical significance.展开更多
Since 1996,the author has treated 40 cases of protrusion of lumbar intervertebral disc with ultra short wave and the point injection,and obtained good therapeutic effects.This is reported as follows.
基金Supported by Chinese People’s Liberation Army Medical Technology Youth Training Program,No. 20QNPY071
文摘BACKGROUND Scedosporium apiospermum(S.apiospermum)is a clinically rare and aggressive fungus mainly found in contaminated water,wetlands,decaying plants,stagnant water,and potted plants in hospitals.The lung,bone,joint,eye,brain,skin,and other sites are easily infected,and there is a marked risk of misdiagnosis.There have been few case reports of infection by S.apiospermum of the lumbar vertebrae;most reports have focused on infection of the lung.CASE SUMMARY An otherwise healthy 60-year-old man presented with a 4-mo history of lumbosacral pain,stooping,and limited walking.The symptoms were significantly aggravated 10 d prior to hospitalization,and radiating pain in the back of his left lower leg developed,which was so severe that he could not walk.Movement of the lumbar spine was significantly limited,anterior flexion was about 30°;backward extension,right and left lateral curvature,and rotational mobility were about 10°;tenderness of the spinous processes of the lumbar 3-5 vertebrae was evident,and the muscle strength of both lower limbs was gradeⅣ.Imaging suggested bony destruction of the lumbar 3,4,and 5 vertebrae and sacral 1 vertebra;in addition,the corresponding intervertebral spaces were narrowed and the lumbar 5 vertebra was posteriorly displaced and unstable.Lumbar vertebral infection was also noted,and the possibility of lumbar tuberculosis was considered.We first performed surgical intervention on the lesioned lumbar vertebrae,cleared the infected lesion,and performed stable fixation of the lesioned vertebral body using a lumbar internal fixation device,which restored the stability of the lumbar vertebrae.Cytological and pathological examination of the lesioned tissue removed during surgery confirmed S.apiospermum infection of the lumbar vertebrae;on this basis,the patient was administered voriconazole.At the 6-mo followup,efficacy was significant,no drug-related side effects were observed,and imaging examination showed no evidence of recurrence.CONCLUSION S.apiospermum infection can occur in immunocompetent individuals with no history of near drowning.Voriconazole is effective for the treatment of S.apiospermum infection of the lumbar vertebrae for which it is suitable as the first-line therapy.
文摘Objective To investigate surgical strategy for high-grade isthmic spondylolisthesis(more thanⅡ degree)of 5th lumbar vertebrae.Methods From August 2003 to October 2008,26 patients with high-grade isthmic spondylolisthesis (L5) were
文摘In the present study, 121 patients with lumbar vertebra hyperosteogeny were dividedinto following four groups for treatment and comparison: intense electro-acupuncture group (Group1), hydro-acupuncture group (Group 2), electro-acupuncture plus hydro-acupuncture group (Group3) and analgesic liquid for spur group (Group 4). It is indicated that the effect of electro-acupunctureplus hydro-acupuncture is the best in the treatment of lumbar vertebra hyperosteogeny.
文摘In the present paper, 70 cases of retrograde affection of the lumbar vertebrae are randomly and evenly divided into treatment group and control group. Shenshu (BL 23), Qihaishu (BL 24), Dachangshu (BL 25), Weizhong (BL 40), Jiaji (EX B 2), etc. are used. In treatment group, acupuncture, TDP irradiation and cupping are performed, and in control group, only acupuncture is given. After 30 sessions (3 therapeutic courses) of treatment, in treatment and control groups, the total effective rates are 91.43% and 71.43% respectively. The therapeutic effect of comprehensive treatment is significantly superior to that of simple acupuncture therapy (P<0.05).
文摘Objective Comparing different medication pro ject of continuous epidural analgesia for the patient after lumbar verte bra opera-tion,to decrease the complications and promote analgesia effects.Methods150cases with ASAⅠ～Ⅱgrade,lumbar intervertebral disc e x-tirpation and /or vertebral canal decompression,were divided into 5gro ups.A group:0.0625%bupivacaine;B group:0.125%bupiva-caine;C group:0.0625%bupivacaine and 1mg morphine;D group:0.125%bupivacaine and 1mg morphine;E group:n o analgesia.Record the occurrence of RR,MAP,HR,VAS score and side effects.Results The analgesia effects of all groups were satisfying,but the oc-currence of urine retention increased in B,C,D group,and the occurrence of nausea and vomit increased obviou sly in C,D group.Conclusions The continuous epidural analgesia w ith simple 0.0625%for patients afte r lumbar vertebral operation is best.
文摘Objective: To compare the influence of normal and degenerative discs on stress distribution of the thoracolumbar vertebrae under destructive load, explore the biomechanical background and clinical meaning and provide theoretical basis for clinical diagnosis and treatment. Methods: A mechanical model of thoracolumbar motion segment of normal and degenerative discs was built with a three dimensional finite element method and three stresses of vertical compression, compressive flexion and distractive flexion were comparatively analyzed. Results: With vertical compression and compressive flexion loads, the thoracolumbar motion segment of the normal disc showed that the central part of the upper and lower end plates of the vertebrae and the central part of the trabecular bone adjacent to the end plate were loaded with the most intensive stresses, meanwhile, the postero lateral part of the annulus fibrosus was concentrated with stresses. Degenerative disc showed that the stress distribution of the trabecular bone was relatively averaged, the stresses of the central part adjacent to the end plate were low, while at the same time, the stresses of the peripheral part were elevated relatively. With distraction flexion load, the stresses of the cortex bone, trabecular bone, end plate and annulus fibrosus of the thoracolumbar vertebrae of degenerative discs were low, meanwhile, the stresses of the posterior structure of the vertebral body were relatively elevated compared with that of normal discs. Conclusions: There is difference in influence between normal and degenerative discs on the stress distribution of the thoracolumbar vertebrae with destructive load. The transferring way of load is changed after disc degeneration.
基金supported by the Community Health Service Centre, Sandun Town, Xihu District, Hangzhou
文摘Objective: To observe the effect of warm needling therapy plus acupuncture on third lumbar vertebra transverse process syndrome. Methods: Sixty cases of third lumbar vertebra transverse process syndrome were randomly divided into a warm needling group or an acupuncture group, 30 cases in each group. Cases in the acupuncture group were treated by routine points and needle sticking manipulation, while those in the warm needling group were treated by moxibustion plus needling as same as the acupuncture group. Japanese orthopedic association scores(JOA) in the two groups were observed and compared after 2 treatment courses. Results: After treatment, the JOA score in the warm needling group was higher than that in the acupuncture group(P<0.01); subjective symptom, clinical syndromes, activity of daily living(ADL) in the warm needling group were all higher than those in the acupuncture group(all P<0.05); the score of pain in the warm needling group was significantly lower than that in the acupuncture group(P<0.01); the total effective rate in the warm needling group was 76.7%, versus 70.0% in the acupuncture group, showing a statistically significant difference(P<0.05). Conclusion: Warm needling therapy is more effective than normal acupuncture in treating third lumbar vertebra transverse process syndrome.
文摘 Protrusion of the lumbar intervertebral disc is a common disorder frequently encountered in clinic. With TCM massage and the maneuver of manual reduction, we have treated 82 cases of protrusion of the lumbar intervertebral disc, with satisfactory therapeutic results reported in the following.……
文摘The authors treated 62 cases of protrusion oflumbar intervertebral disc by pulling and turningmanipulations from February 1993 to February 1998.Another 50 cases were treated by traction as controls.Statistical data showed that pulling and turningmanipulations had much better therapeuticeffectiveness than traction(P<0.05).
文摘Clinically, there is a higher incidence of protrusion of the lumbar intervertebral disc. It can cause a terrible pain. The author has treated 66 cases by massotherapy, who were confirmatively diagnosed as having protrusion of the lumbar intervertebral disc by X-ray film and computer-aided tomography, with satisfactory results as reported in the following.
Clinical Data
Among the 66 cases in this series, 49 were male and 17 female, ranging in age from 26 to 59 years, averaging 36.2 years. All the patients had got lumbago and unilateral ischialgia, with the left side affected in 37 cases and the right side in 29 cases. The leg pain radiating to lateral malleolus was found in 28 cases, to dorsum of the foot in 24 cases, and to the toes in 14 cases. Intermittent claudication was present in 22 cases, numbness of the affected foot in 16 cases, pain exacerbated when coughing in 35 cases, scoliosis in 21 cases, and positive Lasegue's sign in 48 cases.
文摘Fifty-six cases of the protrusion of the lumbar intervertebral disc in the treatment group were treated by drug-penetration and oral administration of traditional Chinese decoction plus traction, and the other 35 cases in the control group by oral administration of Chinese decoction and traction. The results showed that the cure rate in the treatment group was 83.9%, and that in the control group was 57.1%, with a statistically significant difference between the two groups (P<0.01), indicating that the former is a more effective therapy for protrusion of the lumbar intervertebral disc.
文摘To provide a new method to estimate the effectiveness of thoracolumbar vertebral finite element model. Methods: A mechanical model of human thoracolumbar vertebrae motion segment was made using three-dimensional finite element method and the stress distribution of vertically compressed thoracolumbar vertebrae was analyzed, meanwhile, 20 patients with burst fracture of thoracolumbar vertebrae were tested by CT to calculated average CT value at ascertained different points of thoracolumbar vertebrae. The calculated results and effective stress at the same position were analyzed with straight line correlation. Results: The stress level of different position of thoracolumbar vertebrae under vertical compressive force was positively correlated with the correlative CT value, and the regressive style, Y= 214.028 + 45.268 X, r= 0.7386 , P< 0.05 (n=8) showed a statistical significance.Conclusions: To study mechanism of thoracolumbar vertebrae injuries under different forces has clinical significance.
文摘Since 1996,the author has treated 40 cases of protrusion of lumbar intervertebral disc with ultra short wave and the point injection,and obtained good therapeutic effects.This is reported as follows.
