ABSTRACT
Objective To compare the clinical effect of minimally invasive surgery transforaminal lumbar interbody fu-sion(MIS-TLIF)and posterior lumbar interbody fusion(PLIF)in the treatment of recurrent lumbar intervertebral disc hernia-tion(LIDH). Methods Twenty-nine patients with recurrent LIDP were selected from May 2014 to May 2016 in Weifang Peo-ple's Hospital and the clinical data were analyzed retrospectively. Thirteen patients were given MIS-TLIF(MIS-TLIF group) and sixteen patients were given PLIF(PLIF)group. The operative incision length,intraoperative bleeding volume,postoperative drainage volume,hospitalization time and complications were compared between the two groups. The lumbar function was evalu-ated with the Japanese Orthopaedic Association(JOA)score standard,and the clinical effect was compared between the two groups according to the modified Macnab standard one year after treatment. Results The operativeincision length,intraopera-tive bleeding volume,postoperative drainage volumeand hospitalization time in MIS-TLIF group were significantly less than tho-sein PLIF group (P < 0. 05). The preoperative JOA score of lumbar function in PLIF group and MIS-TLIF group was 7. 9 ± 1. 9 and 8. 0 ± 1. 6 respectively,it was 24. 0 ± 2. 7 and 24. 2 ± 2. 5 respectively at one year after treatment,there was no significant-difference in the JOA score between the two groups before and one year after operation (P > 0. 05). The JOA score atone year after operation was significantly higher than that before operation in the two groups (P < 0. 05). According to the modified Macnab standard one year after treatment,the fineness rate of the patients in PLIF group was 87. 50％(14 / 16),the fineness rate of the patients in the MIS-TLIF group was 84. 62％(11 / 13). There was no significant difference in the fineness rate be-tweenthe two groups (χ2 = 1. 380,P > 0. 05). The incidence of postoperative complications in the MIS-TLIF group and PLIF group was 7. 7％(1/ 13)and 6. 3％ (1/ 16)respectively,there was no significant difference in the incidence of postoperative complications between the two groups (χ2 = 0. 020,P > 0. 05). There were 8 cases (61. 5％)with gradeⅠfusion and 5 cases (38. 5％)with gradeⅡfusion in MIS-TLIF group,there were 9(56. 3％)with gradeⅠfusion and 7(43. 8％)with gradeⅡfu-sion,there was no significant difference in the constituent ratio with gradeⅠandⅡfusion between the two groups (χ2 = 0. 080, P >0. 05). Conclusion MIS-TLIF in treatment of recurrent LIDH has the advantages of less incision,less intraoperative bleed-ing,less postoperative drainage and shorter hospitalization time;and the clinical effect of MIS-TLIF is similar to that of PLIF.
ABSTRACT
Objective To investigate the effect of intervertebral finite fenestration on lubar intervertebral disc protrusion (LIDP) complicated with spinal stenosis.Methods Eighty patients with LIDP complicated with spinal stenosis were selected from May 2014 to May 2016 in the 159th Hospital of the Chinese People's Liberation Army.The patients were divided into observation group and control group according to the treatment method,40 cases in each group.The patients in the observation group were treated with intervertebral finite fenestration,lateral recess and nerve root canal decompression.The patients in the control group were treated with total laminectomy,lateral recess and nerve root canal decompression.The lumbar pain of patients was evaluated by the visual analogue scale (VAS),and the lumbar function was evaluated by using Japanese Orthopaedic Association(JOA) scoring system in the two groups before and after operation.The postoperative complications were observed in the two groups.Results There was no significant difference in VAS score of lumbar pain between the two groups before operation (t =1.638,P ＜ 0.05).The VAS score of lumbar pain after operation was significantly lower than that before operation in the two groups(t =3.182,4.303,P ＜ 0.05).The VAS score of lumbar pain in the observation group was significantly lower than that in the control group after operation(t =2.776,P ＜ 0.05).There was no significant difference in JOA score of lumbar function between the two groups before operation(t =5.170,P ＜ 0.05).The JOA score after operation was significantly higher than that before operation in the two groups (t =28.841,45.070;P ＜ 0.05).The JOA score of the lumbar function in the observation group was significantly higher than that in the control group after operation(t =52.952,P ＜ 0.05).The total effective rate in the control group and the observation group was 62.5 ％ (25/40) and 92.5 ％ (37/40),respectively;the total effective rate in the observation group was significantly higher than that in the control group(x2 =12.381,P ＜0.05).The incidence of postoperative complications in the control group and observation group was 25.0％ (10/40) and 10.0％ (4/40),respectively;the incidence of postoperative complications in the observation group was significantly lower than that in the control group(x2 =11.140,P ＜ 0.05).Conclusion Intervertebral finite fenestration can effectively reduce lumbar pain,improve the lumbar function of patients with LIDP complicated with spinal stenosis;and it has fewer postoperative complications.
ABSTRACT
Objective To explore the relationship between apoptosis promoting effector molecules caspase-3,caspase-9 and lubar intcrvertebral disc protrusion.Methods 99 of operation patients with lubar intervertebral disc protrusion in their mater nity ward were recruited.Among them,single segment of lubar intervertehral disc protrusion were 70 (Group A),more than one segments of lubar intervertebral disc protrusion were 29(Group B).In addition,40 unrelated healthy people from physi cal examination center were enrolled as controls.Enzyme linked immunosorbent assay (ELISA) was used to examine serum caspase-3 and caspase-9 levels in lubar intervertebral disc protrusion patients.Results The level of caspase-3 in control group,group A and group B,respectively were 11.24±0.41,14.31±0.67 and 17.43±1.86 pmol/L.The caspase-3 activity in each group was statistically significant difference (F=8.47,P＜0.01).The level of caspase-9 in control group,group A and group B respectively were 18.54±2.19,30.57±3.63 and 43.68±5.15 pmol/L.The caspase-9 activity in each group was statistically significant difference (F=7.85,P=0.001).Compared with control group,the caspasc 3 and caspase-9 ac tivity in group A (q=3.08.3.29,all P＜0.05),group B (q=5.78,4.50,all P=0.014) was statistically significant differ ence.The caspase-3 and caspase-9 activity in group A,group B was statistically significant difference (q=3.21,3.22,all P＜0.05).Conclusion The augment of caspase-3 and caspase-9 promoted apoptosis of lubar intervertebral disc protrusion.It was connected with quantity of protrusive segments.The more segments of protrusion,the higher caspase-3 and caspase-9 levels of examination would be.
ABSTRACT
Objective To explore the relationship between apoptosis promoting effector molecules TFAR19,Apaf-1 and lubar intervertebral disc protrusion.Methods 99 of operation patients with lubar intervertebral disc protrusion in the First Affiliated Hospital of Guangxi Medical University Department of Spine and Osteoputhy were recruited.Among them,single segment of lubar intervertebral disc protrusion were 70 (Group A),more than one segments of lubar intervertebral disc protrusion were 29 (Group B).In addition,40 unrelated healthy people from physical examination center were enrolled as controls (Group C).Enzyme-linked immunosorbent assay (ELISA) was used to examine serum TFAR19,Apaf-1 levels in lubar intervertebral disc protrusion patients.Results The level of TFAR19 in Group A,Group B and Group C respectively were 1.85±0.14,2.33±0.25 and 1.30±0.09 ng/ml.The TFAR19 activity in each group was statistically significant difference (F=7.979,P＜0.01).Compared with Group C,the TFAR19 activity in Group B (q=5.59,P＜0.01),Group A (q=3.60,P=0.012) was statistically significant difference.The TFAR19 activity in lubar intervertebral disc protrusion patients subgroups (Group A,Group B) was statistically significant difference (q =2.93,P =0.012).The level of Apaf-1 in Group A,Group B and Group C respectively were 159.22±11.87,203.20±20.21 and 107.52±11.58 pg/ml.The Apaf-1 activity in each group was statistically significant difference (F=8.828,P＜0.01).Compared with Group C,the Apaf-1 activity in Group B (q=5.86,P＜0.01),Group A (q=3.89,P=0.007) was statistically significant difference.The Apaf-1 activity in lubar intervertebral disc protrusion patients subgroups (Group A,Group B) was statistically significant difference (q =2.97,P=0.037).Male/female ratio between each groups was not statistically significant difference (x2=0.229,P =0.892).Age between each groups was not statistically significant difference (F=0.091,P =0.91).Conclusion The augment of TFAR19 and Apaf-1 promotes apoptosis of lubar intervertebral disc protrusion.It is connected with quantity of protrusive segments.The more segments of protrusion,the higher TFAR19 and Apaf-1 level of examination will be.
ABSTRACT
Objective To explore the effect of double cypress powder (DCP) combined with TDP irradiation on lumbar intervertebral disc protrusion and summarize nursing experience.Methods One hundred and twenty-five patients with lumbar intervertebral disc protrusion were randomized into the observation group and control group.The control group was treated with massage and electro-acupuncture and the observation group received DCP fumigation combined with TDP irradiation besides treatments the controls received.The two groups were compared in terms of pain level and curative effect after two courses of treatment.Result The score on pains by VAS in the treatment group was significantly lower than that in the control group and the curative effect was better than that in the control group (P<0.05).Conclusion On the basis of the massage,electro-acupuncture and moxibustion therapy,DCP combined with TDP irradiation is therapeutically effective in the reduction of the pains from lumbar disc protrusion.
ABSTRACT
Objective To observe the changes of combined therapy on disci intervertebrales and their surrounding tissues and thus to determine its therapeutic effects on lubar intervertebral disc protrusion with magnafic resonance imaging. Methods After combined therapy including physical agents, drugs, traction, manipulation and remedial exercises had been adopted to treat 40 iubax intervertebral disc protrusion patients for 30 days, morphologic changes of disci intervertebrales and their surrounding tissues of these patients were observed by magnetic resonance imaging. Results The effective rate of combined therapy on lubar intervertebral disc protrusion was 82.5%, there were no obvious changes of thickness, salient degree of disci intervertebrales, anteroposterior diameter, transverse diameter and latero-cryptae extent of vertebral canal after the treatment. Conclusion Though the combined therapy can not change the morphous of lobar intervertebral disc protrusion, it may efficiently relief the clinical symptoms of patients with lobar intervertebral disc protrusion.
ABSTRACT
Objective:To evaluate the therapeutic effects of capsule of Biqi Capsule and VitB on lubar intervertebral disc protrusion(LIDP).Methods:78 Patients with LIDP were divided randomly into 2 groups:treatment and control group.39 Patients in treatment group were treated with Biqi Capsule and FENG's bone-setting manipulation,39 patients in control group were treated with vitamine B and FENG's bone-setting manipulation.All patients were followed up for 1 month after treatment for 2 weeks and therapeutic effects were evaluated.Results:In treatment group,24 patients were cured,6 patients had remarkable effects,5 effective,4 ineffective.In control group,the data were 16,8,8,7 correspondly.The therapeutic effects in treatment group were obviously better than those of control group(P