A new free-hand pedicle screw placement technique with reference to the supraspinal ligament

We sought to compare the safety and accuracy of a new free-hand pedicle screw placement technique to that of the conventional technique. One hundred fifty-three consecutive adult patients with simple fracture in the tho- racic or/and lumbar spine were alternately assigned to either the new free-hand or the conventional group. In the new free-hand technique group, preoperative computerized tomography （CT） images were used to calculate the targeted medial-lateral angle of each pedicle trajectory and the pedicle screw was inserted perpendicular to the corresponding supraspinal ligament. In the conventional technique group, the medial-lateral and cranial-caudal angle of each pedicle trajectory was determined by intraoperatively under fluoroscopic guidance. The accuracy rate of pedicle screw placement, the time of intraoperative fluoroscopy, the operating time and the amount of blood loss during operation were respectively compared. All screws were analyzed by using intraoperative ra- diographs, intraoperative triggered electromyography （EMG） monitoring data, postoperative CT data and clinical outcomes. The accuracy rate of pedicle screw placement in the new free-hand technique group and the conven- tional technique group was 96.3% and 94.2% （P 〈 0.05）, respectively. The intraoperative fluoroscopy time of the new technique group was less than that of the conventional technique group （5.37 seconds vs. 8.79 seconds, P 〈 0.05）. However, there was no statistical difference in the operating time and the amount of blood loss during op- eration （P 〉 0.05）. Pedicle screw placement with the free-hand technique which keeps the screw perpendicular to the supraspinal ligament is an accurate, reliable and safe technique to treat simple fracture in the thoracic or lum- bar spine.

Observation of therapeutic effects on supraspinal ligament impairment treated with fire needling

Objective To compare the therapeutic effect of fire needling with that of medication on supraspinal ligament impairment. Methods One hundred and sixty cases were randomly divided into 2 groups. Of which, in fire needling group （80 cases）, fire needling was applied and Ashi points （choosing the spinous processes of the affected vertebras as the central points） were selected. In western medicine group （80 cases）, medication was applied with Nabumetone capsules for oral administration. Two groups were treated for 2 courses and the therapeutic effects were evaluated 4 weeks after the treat- ment. Results The total effective rate was 96.3% in the fire needling group and 67.5% in the western medicine group, indicating a significant difference in comparison of the 2 groups （P〈0.05）. Conclusion The therapeutic effect of fire needling is much superior to that of medication therapy on supraspinal ligament impairment.

Neural mechanism of acupuncture-modulated gastric motility

AIM: To investigate the acupuncture-modulated gastric motility and its underlying neural mechanism.METHODS: Intragastric pressure and/or waves of gastric contraction in rats were recorded by intrapyloric balloon and changes of gastric motility induced by acupuncture stimulation were compared with the background activity before any stimulation. Gastro-vagal or splanchnic-sympathetic nerves were recorded or cut respectively for investigating the involvement of autonomic nerve pathways. Spinalization experiment was also performed.RESULTS: Acupuncture-stimulation by exciting Aδ and/or C afferent fibers, could only modulate gastric motility. Acupuncture-stimulation on fore- and hind-limbs evoked a moderate gastric motility followed by increased vagus discharges with unchanged sympathetic activity, while the same stimulus to the acupoints in abdomen resulted in reversed effects on gastric motility and autonomic nervous activities. The inhibitory gastric response was completely abolished by splanchnic denervation, but the facilitative gastric response to stimulation of acupoints in limbs was not influenced, which was opposite to the effect when vagotomy was performed. The similar depressive effects were produced by the stimulation at the acupoints homo-segmental to the gastric innervation in the animals with or without spinalization. However, the facilitation induced by the stimulation at the acupoints hetero-segmental to the gastric innervation was not observed in the spinalized animals.CONCLUSION: Facilitative effects of stimulating hetero-segmental acupoints are involved in the intact preparation of vagal nerves and spinal cord, while the inhibitory response induced by stimulating homo-segmental acupoints is involved in the intact preparation of sympathetic nerves. Only the acupuncture-stimulation with intensity over the threshold of Aδ and/or C afferent fibers can markedly modulate gastrointestinal motility.

跌打丸外敷配合频谱仪与抗炎止痛药治疗棘上韧带损伤的对比研究

比较了跌打丸外敷配合频谱仪与抗炎止痛药治疗棘上韧带损伤的临床效果.将48例棘上韧带损伤患者随机分为两组,一组采用跌打丸外敷配合频谱仪治疗(n=28),另一组口服抗炎止痛药物治疗.结果显示跌打丸外敷配合频谱仪治疗组总有效率为96.4%%,优良率为85.7%,且没有明显副作用;而抗炎止痛组总有效率为45%,优良率仅为20%(P<0.01),表明跌打丸外敷配合频谱仪治疗棘上韧带损伤明显优于抗炎止痛药物.

铍针治疗慢性棘上韧带损伤疗效观察

目的观察铍针治疗慢性棘上韧带损伤的临床疗效。方法将128例慢性棘上韧带损伤患者随机分为治疗组88例和对照组40例。治疗组采用铍针治疗,对照组采用常规针刺治疗。比较两组临床疗效及治疗次数。结果治疗组总有效率为81.8%,对照组为62.5%,两组比较差异具有统计学意义(P<0.01)。结论铍针是一种治疗慢性棘上韧带损伤的有效方法。

运动员棘上韧带与棘间韧带损伤的诊断和治疗

目的：了解棘上韧带与棘间韧带合并损伤的诊断和治疗方法。方法：32例患者均采用曲安奈德加0.2%利多卡因2-4ml对两韧带同时作局部封闭治疗。结果：棘上韧带合并棘间韧带损伤25例为1次性治愈，另7例第1次仅作棘上韧带封闭，疗效差，后追加棘间韧带封闭，治疗效果良好。结论：这类损伤确诊后，采用封闭治疗，通过临床观察，疗效优于其他治疗方法。