80 CASES OF PROLAPSE OF LUMBAR INTERVERTEBRAL DISC TREATED BY ROUND-SHARP NEEDLE

Objective: To observe the therapeutic effect of round-sharp needle for prolapse of lumbar intervertebral disc. Methods: A total of 80 cases of lumbar intervertebral disc prolapse were treated by puncturing Qihaishu (气海俞 BL 24), Guanyuanshu (关元俞 BL 26), etc., with round-sharp needle, once every week, continuously for 4 sessions. Results: After the treatment, of the 80 cases, 56 (70 %) were cured, 16 (20%) improved,and 8 (10)%) failed, with an effective rate of 90%. Conclusion: Round-sharp needle works well in the treatment of prolapse of lumbar intervertebral disc.

CLINICAL OBSERVATION ON TREATMENT OF 80 CASES OF PROLAPSE OF LUMBAR INTERVERTEBRAL DISC BY COMBINATION OF ACUPUNCTURE AND MEDICINE

cases of prolapse of lumbar intervetebral disc were randomly divided into treatment and control groups. 80 cases in treatment group were treated with combination of acupuncture, oral administration of Chinese medicinal herbs, traction, point injection and intravenous drip of energy dehydration mixture; 70 cases in control group were managed by combination of acupuncture, oral administration of herbal medicines, traction, acupoint injection (without energy dehydration mixture). The results showed that the curative rate and the total effective rate of the treatment group were 91.25% and 98.75% separately, while those of the control group 62.86% and 92.86% respectively. Comparison of the curative rate between the 2 groups showed a remarkable significance (P<0.01). The observation demonstrated that combined treatment of prolapse of lumbar intervertebral disc with traditional Chinese and Western medicine is an effective approach.

A rare case report:tubercular spondylodiscitis following lumbar disc surgery

Postoperative spondylodiscitis is a rare but serious complication after lumbar disc surgery.Most cases are due to more virulent organisms such as Staphylococcus aureus and Streptococcus.No case of post operative tubercular spondylodiscitis has been reported till date to our knowledge. We are reporting a case of tubercular spondylodiscitis followed by lumbar disc surgery of L2-3 level.

Therapy of auricular subcutaneous penetration needling combined with row acupuncture at the meridian sinew in 103 cases of prolapse of lumbar intervertebral disc

Objective To observe the clinical efficacy of auricular subcutaneous penetration needling combining with row acupuncture at meridian sinew on prolapse of lumbar intervertebral disc. Methods One hundred and three patients with prolapse of lumbar intervertebral disc were treated with a combined treatment of auricular subcutaneous penetration needling and row acupuncture at meridian sinew. Results Of 103 patients, 46 cases were cured, 33 were markedly effective, 21 effective and 3 ineffective. The total effective rate was 97.1% （100/103）. Conclusion The combined treatment of auricular subcutaneous penetration needling and row acupuncture at meridian sinew has a significant efficacy for the treatment of prolapse of lumbar intervertebral disc.

Observation of efficacy on prolapse of lumbar intervertebral disc treated with body acupuncture and wrist-ankle acupuncture

Objective To observe the clinical effects of body acupuncture and wrist-ankle acupuncture on prolapse of lumbar intervertebral disc, Methods One hundred and eighty cases of prolapse of lumbar intervertebral disc were randomly divided into body acupuncture and wrist-ankle acupuncture group （observation group） and simple body acupuncture group （control group）, 90 cases in each one. In observation group, body acupuncture was applied on Ahshi points of lumbar region, lumbar Jiájǐ （夹脊EX-B 2）, Dàchángshú（大肠俞 BL 25）, etc. and wrist-ankle acupuncture was applied on lower No. 4, 5 and 6 regions. In control group, simple body acupuncture was applied on the same points as observation group. Results The lumbar vertebral function and pain scale were improved in either group in comparison before and after treatment （P〈0.05）. Concerning pain improvement, the total effective rate was 95.6% in observation group, which was superior to that （86.7%） in control group （P〈0.05）. Concerning the improvement of lumbar vertebral function, the total effective rate was 90.0% in observation group and 93.3% in control group, without significant difference between two groups （P〉0.05）. Conclusion Combined therapy of body acupuncture and wrist-ankle acupuncture demonstrates apparent analgesia in prolapse of lumbar intervertebral disc.

TREATMENT OF 247 CASES OF PROLAPSE OF LUMBAR INTERVERTEBRAL DISC WITH COMPREHENSIVE PLUM-BLOSSOM MAGNETIC NEEDLE THERAPY

Objective: To observe the therapeutic effect of comprehensive plum-blossom magnetic needle therapy on prolapse of lumbar intervertebral disc. Methods: 247 cases of prolapse of lumbar intervertebral disc were treated first with manual treatment and then with plum-blossom magnetic needle therapy and effect-increasing pad therapy at specified points and reactive points. Results: After treatment for 2 therapeutic courses,153 cases were cured accounting for 61.94%, 71 cases were markedly effective accounting for 28.75%, 22 cases were improved accounting for 8.91% and the rest one failed,accounting for 0.45%. Conclusion: The comprehensive plum-blossom magnetic needle therapy has a better therapeutic effect on prolapse of lumbar intervertebral disc.

Conservative Treatment of Lumbar Intervertebral Disc Prolapse by Epidural Injection Combined with Massage under Traction

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EFFECT OF ACUPUNCTURE ON POST-OPERATIVE FUNCTIONAL RECOV-ERY IN PATIENTS WITH LUMBAR INTERVERTEBRAL DISC PROTRUSION

Objective To observe the influence of acupuncture on the post-operative rehabilitation in patients undergoing vertebral pulp extraction due to lumbar intervertebral disc protrusion （LIDP） so as to evaluate its efficacy in the treatment of lumbago induced by LIDP. Methods A total of 69 patients undergoing vertebral pulp extraction were randomized into acupuncture group （ n = 35） and control group （ n = 34）. Patients of acupuncture group were treated with routine rehabilitation method and electroacupuncture （EA） stimulation on Zhìbiān （秩边 BL54） and Wěizhōng （委中 BL40）, acupuncture on Shènshū （ 肾俞 BL23）, Dàchángshū （大肠俞 BL25）, BL54, BL40, Jiájǐ （夹脊 EX-B 2）, Shàngliáo （上髎 BL31）, etc., and cupping on BL40, with 15 days being a therapeutic course and for average 7. 36 courses. Patients of control group were treated with simple rehabilitation method. Functional recovery state was judged before and after surgery by using the standards of Japanese Orthopedic Association （JOA）. Results The average recovery rates of 3 months, 6 months and one year after surgery were 49.93% ,90.31% and 95.08% separately in acupuncture group, and 26.24% ,63.42% and 71.36% successively in control group. The recovery rates of acupuncture group were significantly higher than those of control group at the same time-points （P〈0. 05）. Conclusion Acupuncture has a definite effect on promoting post-operative functional recovery in LIDP patients undergoing vertebral pulp extraction and spinal fusion.

Apparent diffusion coefficient in normal and abnormal pattern of intervertebral lumbar discs: initial experience

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.

Percutaneous Endoscopic Lumbar Spine Surgery for Lumbar Disc Herniation and Lumbar Spine Stenosis: Emphasizing on Clinical Outcomes of Transforaminal Technique

Lumbar Disc Herniation and Lumbar Spine Stenosis are the most common spine diseases which are mainly due to age related Spine degeneration. Diagnosis of both Lumbar Disc Herniation and Lumbar Spine Stenosis depends on clinical findings as well as radiological investigations. Treatment of choice of these conditions is on the basis of the patient conditions. Surgical treatment is the option only when the conservative treatment does not improve the patient’s clinical condition. Advancement and improvement of the technology have resulted in the traditional open surgical treatment into minimal invasive surgery. Intervention of the different surgical instruments with expert spinal surgeons had made percutaneous endoscopic lumbar Spine surgery as one of the preferred choices of surgery for treating Lumbar Disc Herniation and Lumbar Spine Stenosis. The concept of percutaneous endoscopic surgery for lumbar region is to provide surgical options without producing iatrogenic morbidity associated with the open surgical procedures. Conventionally, there are different approaches/techniques for Percutaneous Endoscopic Lumbar Spine Surgery, but in this review we are mainly focusing on the Transforaminal Technique. Regarding the Lumbar Disc Herniation treatment with transforaminal approach, a number of articles have been published due to which we mainly focused on those articles which were published after 2009 onwards. While fewer articles related to Lumbar Spine Stenosis treatment with Transforaminal approach were found, we tried to brief out all those articles. On the basis of comparative study of different surgeries done for Lumbar Disc Herniation and Lumbar Spine Stenosis, Percutaneous Transforaminal endoscopic Lumbar Surgery provides a substantial benefit. Transforaminal approach for treating Lumbar Disc Herniation and Lumbar Spine Stenosis is safe and effective. The Percutaneous Transforaminal Endoscopic Lumbar Surgery has advantage as it is performed under local anesthesia with shorter length of hospitalization and early return to normal life. The clinical outcome of the patient that underwent Percutaneous Transforaminal Endoscopic Lumbar Surgery for Lumbar Disc Herniation and Lumbar Spine Stenosis is quite good in regard of its fewer complication and more benefits.

Clinical Outcome of Percutaneous Endoscopic Lumbar Surgery (PELS) in Treatment of Lumbar Disc Herniation

Lumbar disc herniation is a spinal problem seen in both young and old people causing pain in the back with pain and numbness in lower extremity leading to disability limiting daily activities. When conservative treatments are ineffective, then it is treated by surgeries, more recently with minimal invasive percutaneous endoscopic lumbar surgery (PELS). One of the mostly accepted PELS by spinal surgeons is percutaneous transforaminal endoscopic lumbar discectomy, which can be performed for any age. The main aim of this review was to evaluate clinical outcome and safety based on the Oswestry Disable Index (ODI), Visual Analog Scale (VAS) and MacNab criteria and complications of PELS surgery and its advantages in clinical basis.

Tuina Therapy of Lumbar Intervertebral Disc Protrusion

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Comparison of pain media and inflammatory factors after percutaneous transforaminal endoscopic discectomy and traditional fenestration operation treatment of protrusion of lumbar intervertebral disc

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.

CLINICAL OBSERVATION ON ELECTRO-ACUPUNCTURE TREATMENT OF 51 CASES OF PROTRUSION OF LUMBAR INTERVERTEBRAL DISC

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.

Clinical Effect of Transforaminal Endoscopic Surgery in the Treatment of Lumbar Disc Herniation

Objective:Objective to explore the curative effect of transforaminal endoscopic surgery in the treatment of lumbar disc herniation.Methods:From October 2018 to October 2020,36 patients with lumbar disc herniation were randomly divided into group A and group B.the curative effect,pain,lumbar function and quality of life were analyzed.Results:The curative effect of group A was 94.44%,better than that of group B 61.11%,P<0.05;The visual analogue scale(VAS)of group A was lower than that of group B on 3D,5D and 7d after operation(P<0.05);The KSS of group A was higher than that of group B(P<0.05);The score of quality of life in group A was better than that in group B(P<0.05).Conclusion:Lumbar disc herniation patients underwent transforaminal endoscopic surgery,the effect is good,can improve lumbar function,relieve pain,improve the quality of life of patients.

Clinical Effect of Lateral Transforaminal Endoscopic Surgery in the Treatment of Lumbar Disc Herniation

Objective:To analyze the efficacy of lateral transforaminal endoscopic surgery in the treatment of lumbar disc herniation.Methods:A total of 44 patients with lumbar disc herniation,treated in Yancheng No.l People's Hospital from January 2019 to June 2020,were randomly divided into two groups;the 24 patients in group A were treated by lateral transforaminal endoscopic surgery,while the 20 patients in group B were treated by routine lamina fenestration and nucleus pulposus surgery.Results:The curative effect of group A(91.67%)was higher than that of group B(85.0%),P>0.05;there was no significant difference in the angle from straight leg raise between group A and group B(P>0.05);the Oswestry Disability Index(ODI)and the visual analogue scale(VAS)of group A were lower than those of group B(P<0.05);the incision length,intraoperative blood loss,and hospital stay of the patients in group A were better than those in group B,P<0.05.Conclusion:Lateral transforaminal endoscopic surgery can significantly reduce pain,improve symptoms,and help to restore normal function in the early stage for patients with lumbar disc herniation.

Isolation of <i>Gemella morbillorum</i>in Herniated Intervertebral Disc Tissue in a Lumbar Discectomy Patient: A Case Report

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.

Assessment of Glycosaminoglycan Content of Lumbar Intervertebral Discs in Patients with Radiculopathy

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% &plusmn;3.12% vs. 4.09% &plusmn;2.25%, P = 0.017). The GAG content of AF showed no significant difference between volunteers and patients (2.66% &plusmn;2.01% vs. 1.92% &plusmn;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.

Effects of percutaneous intervertebral foraminal BEIS technique on patients with lumbar disc herniation

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.

Meta-analysis of Huoxue huayu Chinese medicine compound combined with Intervertebral Pore Lens in the treatment of Lumbar Intervertebral Disc Herniation

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.