"Triple" therapy in treating different efficacy of lumbar disc herniation
【Abstract】 Objective To investigate the "triple" therapy for different clinical effect of lumbar disc herniation. Method of treatment group, three-dimensional main ridge of the
instrument, small needle-knife, acupuncture and comprehensive use of three kinds of governing law (known as "triple" therapy), the 980 cases of lumbar disc herniation treated control group, three-dimensional main ridge of the treatment
alone , in accordance with lumbar intervertebral disc "bulging, prominent, extrusion" category grouping clinical efficacy, according to Macnab's waist after the evaluation criteria to assess efficacy. Results In the control group, a single instrument using three-dimensional main ridge of the
three groups of cases treated by the statistical analysis of clinical efficacy of a very significant (P <0.01), the optimal efficacy of lumbar intervertebral disc prolapse, followed by the prominent, while the extrusion of the most difference.
Using the "triple" therapy of the clinical efficacy of three groups is not very different, we can see there are outstanding and extrusion efficiency will be greatly increased. Conclusion "triple" therapy for different levels highlight the clinical
effect of lumbar disc herniation were no significant sex differences. Therefore, different lumbar disc herniation, treatment methods, the use of flexible and can improve the clinical efficiency.
Key words "triple" therapy of lumbar disc herniation
We are in the 2003 06 ~ 2006 06 by lumbar
intervertebral disc "bulging, prominent, extrusion," imaging classification methods, treatment of 980 cases of lumbar herniation between the subgroup of patients with clinical observation and analysis. These are as follows.
1 Materials and methods
1.1 Clinical data
980 cases in 500 cases of male and female 480 cases, with an average age of 42 (16 ~ 78) years of age; average weight of 68 (42 ~ 120) kg; average height of 164 (145 ~ 183) cm, the
average duration of 2.9 (1 d ~ 23 years ) year imaging examination; lumbar X-ray 326 cases, lumbar CT 451 cases of lumbar MRI 203 cases; lesion segments: L3 / 4 108 Li, L4 / 5 438 Li, L5/S1 434 cases; prominent type: Expansion out of 429 cases, 398 cases outstanding, 153 cases of prolapse; divided into treatment group of 600 cases and 380 cases of control group observations.
1.2 Methods treatment group a "triple" therapy, group therapy alone three-dimensional main ridge of the instrument.
1.2.1 Three-dimensional main ridge of the therapy
equipment: three-dimensional main ridge of the treatment instrument.
Group: Based on the lumbar spine CT or MRI examination results, select the "bulging, prominent, extrusion," three kinds of cases of varying degrees of lumbar intervertebral disc, group three-dimensional main ridge of the treatment and clinical observation.
Treatment: The treatment parameters based on patient height and weight, combined with disease severity, age and
physical development of traction situations such as distance, angle of flexion and rotation parameters of such treatment. Position: prone position in patients taking the chest cushion chest pad. According to iliac crest anatomical landmark and transformed the relationship between the corresponding intervertebral space to determine patient's position. Fixed: Using the automatic bundling equipment and support to patients with a fixed waist with a fixed and reliable. Slow pull: In order to improve patient treatment of lumbar organizations to
quickly pull ability to adapt to repeated slow-pull treatment
for 4 ~ 5 times.
Fast pull: The lesions intervertebral positioned perpendicular to the lower edge of the side of the chest plate, both sides of the symmetrical swing rapid traction
reset 4 times. Main ridge of the parameters: the distance 57 (49 ~ 66) cm, angle 22 ? (10 ~ 25 ?), rotated 24 ? (12 ~
24 ?); the average number of treatment 1.56 (1 ~ 4) times; hospital stay was 9 (5 ~ 12) d.
Bed rest: After treatment, patients with hospital bed rest arrangements for 1 week, was discharged 1 month outpatient review, or will urge bed rest at home, 1 week, 1 month after the review.
1.2.2 Small needle-knife therapy for response points to reflect the point of treatment sites, regular skin
disinfection, needle-knife with the flat edge upward mobility in the reaction-point needles, deep base reaction point, line vertical and horizontal peeling sparse 3 ~ 4 times, out of knife surgery with manipulation treatment, the 1 times / week,
1 ~ 3 times as a course of treatment.
1.2.3 acupuncture acupoints: lumbar Jiaji, ring jump, Cheng Fu, Wind City, Venezuela, Yang Ling-chuen, full three
years, bearing mountains, Afghanistan is a cave, etc..
Governing law: the waist acupuncture points, moxibustion cupping, I cave under the nerve entrapment, so as to pain-
based techniques such as use of dragon and tiger fighting strong stimulation to the acupuncture waist and legs numb-
based detection using Cang Turtle Point Method To have a sense
of direct discharge is appropriate. 1 / d, 7 times for a course of treatment.
1.2.4 Assessment according to Macnab's treatment of postoperative treatment of lumbar intervertebral disc evaluation criteria to be assessed, the pain disappeared and
no motor function is limited and resume their normal work and activities of the superior; occasional Waist-Leg pain, can do
as a good light; waist function improvement, there is still pain, and had to change the work and lifestyle can be; pain
and dysfunction, without any improvement, required further surgical treatment was poor. Reposted elsewhere in the paper for free download http://
Χ2 test statistical methods.
2.1 treatment group, 600 cases, 266 cases of lumbar intervertebral disc prolapse, highlighting 239 cases, 95 cases of prolapse. 3 groups by chi-square test cases compared to
three patients between excellent, good, and the percentage
difference between the relapse rate is not statistically significant (P> 0.05). The results in Table 1. Table 1 Comparison of clinical treatment of patients Group 3 (omitted)
2.2 The control group, 380 cases, 163 cases of lumbar
intervertebral disc prolapse, highlighting 159 cases, 58 cases of prolapse. 3 groups by chi-square test cases compared to
three patients between excellent, good, and recurrence rates compare to the percentage difference was significant (P
<0.01). The results in Table 2. Among them, cases of lumbar intervertebral disc bulging clinical best, the recurrence rate the lowest, the worst effects of prolapse cases, the recurrence rate is highest, and empty out the cases in between.
From Table 1 and Table 2 shows that, to highlight and prolapse of lumbar intervertebral disc herniation in clinical treatment, albeit difficult, but as long as a comprehensive and flexible use of various methods, three-pronged approach,
to loosen the soft tissue adhesions to relieve nerve
compression to eliminate edema and local inflammatory response, can greatly improve the clinical cure rate and overall efficiency. Table 2 Comparison of clinical treatment of patients Group 3 (omitted)
Surgery of lumbar disc herniation is a common disease, varying degrees of pathological changes of lumbar disc herniation local differences caused by the severity of the clinical characteristics and prognosis of the circumstances, there are some differences. In the lumbar spine such as CT or MRI imaging diagnosis, according to different characteristics of lumbar disc herniation were divided into 4 types, namely: lumbar disc prolapse: fibrous ring integrity, and intervertebral disc tissue diffuse outward bulge. Lumbar disc
herniation: the inner annulus fibrosus is damaged, the outer layer is still complete, focal prominent intervertebral disc tissue. Lumbar intervertebral disc prolapse (extrusion): fibrous ring the whole floor or the posterior longitudinal ligament rupture, broke into the nucleus pulposus, or to squeeze into the spinal canal. Free lumbar intervertebral disc: nucleus pulposus to squeeze into the spinal canal, and intervertebral disc of the main separation, the formation of free blocks. This classification approach is consistent with the basic pathological changes of lumbar intervertebral disc features, but also with the severity of the majority of the patients, clinical characteristics and prognosis of recovery, etc. consistent.
Three-dimensional main ridge of the technology uses mechanical "fast flexion traction and rotation reduction" methods of treatment for an instant in the intervertebral disc high-intensity negative pressure within the formation of
gravity, with annulus fibrosus and posterior longitudinal
ligament recoil, prompting prominent lumbar intervertebral disc tissue retraction or if it is satisfied, thereby ease or lift the nerve root of the oppression, to restore the conduction of nerve root function, for varying degrees of
lumbar retraction or if it is satisfied, intergovernmental organizations, thereby ease or lift the nerve root of the oppression, to restore the conduction of nerve root function. For varying degrees of localized pathological changes in lumbar intervertebral disc and three-dimensional main ridge of
the technical characteristics of the treatment principle, we have chosen to "bulging, prominent, extrusion," three different types of lumbar disc levels as a clinical treatment and observation of objects, from which three-dimensional
observations are summarized Ridge technology to varying degrees of lumbar disc herniation in patients with clinical treatment. As the "free" of lumbar disc herniation is rare in the clinical, pathological changes of its characteristics do
not meet the main ridge of the treatment of three-dimensional
theory, so not as a treatment target.
Small needle-knife therapy is a new therapeutic system, this new treatment system is based on Chinese philosophy and Western macro-anatomy, biomechanics, and micro-pathology,
based on traditional acupuncture "needles" and the Modern closed surgical "tools" are a new combination therapy. Needle-
knife for treatment of disc herniation is not a prominent disc, than discectomy, but loosen the soft tissue adhesion
outside the spinal canal and nerve roots, the intervertebral disc scar tissue away from the nerve root and spinal cord, relieving the pressure on the nerve root and lysis of the nerve root to stimulate local adhesion, adjusting the protrusion of the nerve root and the location, so that edema and nerve root lesions or disappearance of local inflammatory response and thus lift the symptoms of decompression.
Acupuncture applied to lumbar disc herniation, is based on Chinese medicine for lumbar disc herniation caused by the
knowledge of low back pain, followed by the acupoints syndrome differentiation, in particular by adjusting the Governor Vessel and Bladder full sun, these two cross-cutting back the
Department of yin and yang meridians of the blood, for
therapeutic purposes. According to the anatomical
physiological characteristics of nerve roots that produce nerve root pain and nerve root nutrition obstacles, the involvement of inflammatory mediators related to nerve root from the improvement of the microcirculation, the neural pathways of acupuncture analgesia and neurotransmitters,
acupuncture can affect the biological and other aspects of the spine out the principles of treatment of lumbar disc herniation.
"Triple" therapy is by no means the superposition of three methods, the clinical findings in patients, age, height, weight, physical fitness, disease symptoms are different, it shall be applied flexibly, with reasonable, so as to achieve the best effect. Reposted elsewhere in the paper for free download http://