Comprehensive physical therapy on the nerve root type cervical spondylosis efficacy of acute phase
【Key Words】 nerve root type cervical spondylosis
Nerve root type cervical spondylosis in the cervical disease is the highest incidence
of a type, its acute symptoms of heavy, severe pain, serious impact on patient's life and work. At present the clinical cervical spondylosis of nerve root type of non-surgical
therapy a lot, but its treatment of acute dehydration is limited to conventional therapy,
that is, mannitol and dexamethasone, although can effectively alleviate the symptoms, but steroids adverse reaction caused by a series of increasing cause of clinical attention, in order to explore the nerve root type cervical spondylosis and effective physical
therapy in acute phase, we are in July 2000 ~ January 2005 using electro-acupuncture
plus infrared, traction and ultrashort comprehensive physical therapy joint nerve root of cervical spondylosis in 32 patients with acute stage and with the conventional
treatment group in contrast to studies now report the results as follows.
1 Data and methods
1.1 General information on 64 cases in this group were hospital out-patients, male
30, female 34 cases, aged 37 to 55 years, with an average 43-year-old. In 14 cases of
acute onset, prior to the onset without neck discomfort and arm numbness, chronic disease with acute onset of 50 cases, the patient is not the original neck and hands, numbness acute exacerbation within a short time. All patients had severe neck,
shoulder, upper arm pain or showed Fangshe Tong; 16 cases with a finger Ma; 21 cases with faint; All patients had cervical spine X-ray film shoot, all see the vertebral body
showed varying degrees of hyperplasia-like change or intervertebral relative narrow
intervertebral foramen smaller. X-ray films and CT, ESR investigation, anti-chain
"O", rheumatoid factor and other tests, the exclusion of other diseases, and those who did not complete the treatment course of treatment pilot project in accordance with
those. All cases are selected coin when 32 cases were randomly divided into treatment group and control group 32 cases, clinical data of the two groups was no significant difference.
1.2 Treatment day 1 treatment group, application of an integrated physical therapy,
the first application of the control group 20% mannitol 250ml rapid infusion, dexamethasone 5mg join the mannitol, the 2 times / d, 5 days after the application of an integrated physical therapy. Comprehensive physical therapy include: (1) electro-
acupuncture plus infrared: acupoints according to the diagnostic imaging options on both sides of its upper and lower vertebral body lesions and one each in the ipsilateral vertebral Jiaji, pain, numbness along the Meridian plus radiation by Qu pool, Hoku;
pain and numbness along the Shaoyang the exception of those closed by the radiation, the islet-hole; pain and numbness along the solar radiation were added later by the river cave. Select 30-inch 1.5 to 3 milli-pin, neck Jiaji points to the direction of the spine
diagonal stabbing, twisting around the points go to re-create a sense of Suanma
inflation in order to transfer to the upper extremity and hand pain location is better I have regular acupuncture points, required by the gas to the disease, and then take the
needle handle G6805 electroacupuncture instrument wire, use a continuous wave, frequency 20Hz, electric current as the degree of patient comfort, while plus infrared light, which left needle 20min; (2) traction: The ride jaw-type pillow with a continuous
traction, traction weight generally from 3 ~ 5kg start gradually increased to 8 ~ 10kg, patient comfort and can alleviate the symptoms prevail, but not more than 20% of body weight is appropriate; traction depending on the angle disease and X-ray changes
may be, after the upper cervical spine extension 5 ? ~ 20 ?, C4 ~ 5 to 0 ?, C5 ~ 6 for the flexion 5 ? ~ 15 ?, C6 ~ 7 for flexion 15 ?, C7 ~ T1 for flexion 20 ?, each traction 20min; (3) FM: The patient supine, with Shanghai-based ultrashort wave therapy machine
produced 80, the frequency 40.68Hz, electrodes 22cm × 15cm × 2, shoulder and neck on the purchase method and no calories, every 20min , the above treatment are 1 / d. During the treatment, both groups with envelope neck neck brake, because the neck
and braking to maintain cervical stability is the prerequisite for treatment.
Healing efficacy of the standard 1.3: The main symptoms and signs disappeared, to resume normal work; markedly: most of the main symptoms and signs disappeared
basically be able to persist in their work; improved: symptoms and signs to reduce the working part of the impact; invalid: no improvement of symptoms and signs. The two groups were selected, the treatment of 1 week and after the end of treatment,
respectively, using Visual Analogue Scale (VAS) for clinical pain measurement . Patient groups the number of days symptoms were concluded, if the symptoms have not disappeared, no more than 15 days.
1.4 statistical analysis software used SPSS.V.12.0 statistical χ2 test and t test analysis and processing, P <0.05 for the difference was significant. P <0.01 for the difference was significant. Reposted elsewhere in the paper for free download http://
After a course of treatment, the clinical efficacy of the two groups was no significant difference (P> 0.05, Table 1). The average number of days the treatment was no difference between the two groups was significant (12.49 ? 3.67 Tian, 11.67 ? 3.79 days).
VAS two groups before treatment and 1 week after treatment no significant difference between the margin (see Table 2), P> 0.05. Follow-up one year, two groups the relapse
rate in Table 3, treatment group significantly better than the control group (P <0.05).
Table 1 Comparison of clinical efficacy in patients with two groups in Table 2 two groups before and after treatment VAS score index
Nerve root type cervical spondylosis with acute radicular pain is essentially generated in the nerve root canal stenosis, based on secondary injury in the physical, biochemical changes occur metabolic disorders, metabolic products of siltation, mediated by inflammatory factors, nerve root occurred congestion, edema, inflammatory reaction and conductive characteristics of the damage [2,3]. Electro-
acupuncture plus infrared can improve the microcirculation around the nerve root to remove inflammatory media; inhibit the conduction of nociceptive information to ease
muscle spasm, reduce or eliminate the nerve root inflammation, edema . Traction
can be lifted and neck muscle spasms, so that widened intervertebral space, nerve roots and loosen the adhesion of the joint capsule, so that suffered nerve root compression can be alleviated, and improve or restore Luschka joint and nerve roots and posterior
joints and other anatomical location of the nerve root decompression starting role for therapeutic purposes . FM local organizations can promote blood circulation and lymphatic flow, enhance reticuloendothelial system and phagocytic cell function is
conducive to nerve root inflammation, edema control and dissipation . The acknowledged clinical, nerve root type cervical spondylosis with acute nerve root traction injury prone, does not advocate traction therapy, our clinical observation, as
long as the precise angle of traction, traction weight gradually rose gradually decreased during traction to ensure that patients feel comfortable and can alleviate the symptoms, not will be injured nerves. Experience: Comprehensive physical therapy and
conventional dehydration therapy are treatment of acute nerve root type cervical spondylosis for the effective and reliable method; comprehensive physical therapy and conventional dehydration therapy compared with no side effects, efficacy and stability
of the advantages of easy to relapse. In the treatment of attention should be paid: Acupuncture techniques should be reinforcing-reducing, not strong stimulation to
avoid nerve damage. In summary, using electro-acupuncture plus infrared, traction
and ultrashort comprehensive physical therapy joint nerve root type cervical spondylosis in patients with acute stage, with synergy to effectively discharge in patients with pain, it is worth to further promote the clinical application of a
comprehensive physical therapy post-effective superior to conventional treatment for
dehydration mechanism remains to be further explored.
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