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71.
Background:
Posterior endoscopic discectomy is an established method for treatment of lumbar disc herniation. Many studies have not been reported in literature for lumbar discectomy by Destandau Endospine System. We report a series of 300 patients operated for lumbar dissectomy by Destandau Endospine system.Materials and Methods:
A total of 300 patients suffering from lumbar disc herniations were operated between January 2002 and December 2008. All patients were operated as day care procedure. Technique comprised localization of symptomatic level followed by insertion of an endospine system devise through a 15 mm skin and fascial incision. Endoscopic discectomy is then carried out by conventional micro disc surgery instruments by minimal invasive route. The results were evaluated by Macnab''s criteria after a minimum followup of 12 months and maximum up to 24 months.Results:
Based on modified Macnab''s criteria, 90% patients had excellent to good, 8% had fair, and 2% had poor results. The complications observed were discitis and dural tear in five patients each and nerve root injury in two patients. 90% patients were able to return to light and sedentary work with an average delay of 3 weeks and normal physical activities after 2 months.Conclusion:
Edoscopic discectomy provides a safe and minimal access corridor for lumbar discectomy. The technique also allows early postoperative mobilization and faster return to work. 相似文献72.
ABSTRACTThe Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online (http://www.thecochranelibrary.com). The April 2013 issue (2nd DVD for 2013) contains 5484 complete reviews, 2341 protocols for reviews in production, and 22,600 short summaries of systematic reviews published in the general medical literature. In addition, there are citations of 692,000 randomized controlled trials, and 15,700 cited papers in the Cochrane methodology register. The health technology assessment database contains some 12,000 citations. Ninety-four new reviews have been published in the previous 3 months, of which four have potential relevance for practitioners in pain and palliative medicine. The impact factor of the Cochrane Library stands at 5.715. Readers are encouraged to access the full report for any articles of interest, as only a brief commentary is provided. 相似文献
73.
ABSTRACTThe Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online (http://www.thecochranelibrary.com). The April 2013 issue (2nd DVD for 2013) contains 5484 complete reviews, 2341 protocols for reviews in production, and 22,600 short summaries of systematic reviews published in the general medical literature. In addition, there are citations of 692,000 randomized controlled trials, and 15,700 cited papers in the Cochrane methodology register. The health technology assessment database contains some 12,000 citations. Ninety-four new reviews have been published in the previous 3 months, of which four have potential relevance for practitioners in pain and palliative medicine. The impact factor of the Cochrane Library stands at 5.715. Readers are encouraged to access the full report for any articles of interest, as only a brief commentary is provided. 相似文献
74.
神经根型颈椎病是临床上最为常见的颈椎病类型,多发于中老年人,是由于颈椎间盘退行性改变、颈椎骨质增生及颈部损伤等原因引起脊柱内、外平衡失调,刺激或压迫神经根而引起。推拿治疗时患者一般都采用坐位接受手法治疗。近年来,我院以侧卧体位下利用手法治疗神经根型颈椎病95例, 相似文献
75.
Background Context
Epidural steroid injection is commonly used in patients with chronic low back pain. Applying a mixture of a local anesthetic (LA) and steroid using the interlaminar (IL), transforaminal, and caudal techniques is a preferred approach.Purpose
The present study aims to investigate the efficacy of interlaminar epidural steroid administration in patients with multilevel lumbar disc pathology (LDP) and to assess the possible correlation of the procedure's success with age and body mass index (BMI).Study Design
A randomized controlled trial was performed.Patient Sample
We administered interlaminar epidural steroid to a total of 98 patients with multilevel LDP.Outcome Measures
The visual analog scale (VAS) and Oswestry Disability Index (ODI) scoring were performed on the study population at pretreatment (PRT), posttreatment, and 1, 3, 6, and 12 PRT months. A possible correlation of BMI and age with the procedure success was evaluated.Methods
The LA group (Group L, n=50) received 10?mL 0.25% bupivacaine, whereas the steroid+LA group (Group S, n=48) received 10?mL 0.25% bupivacaine+40?mg methylprednisolone at L4–L5 intervertebral space in prone position under the guidance of C-arm fluoroscopy.Results
There was no statistical difference in the PRT VAS and ODI scores between the groups (p<.05), whereas the VAS and ODI scores at 1, 3, 6, and 12 posttreatment months were higher in Group L, compared with Group S (p<.05). Age and BMI were not found to be related with the success of the procedure.Conclusions
Our study results showed that the VAS and ODI scores were lower in patients with multilevel LDP receiving steroid, following the administration of IL epidural injection. However, further studies are required to establish a robust conclusion on the dispersion of IL epidural injections in the epidural area and the dose of steroid. 相似文献76.
目的:观察穴位注射配合整脊手法治疗神经根型颈椎病的,临床疗效。方法:60例神经根型颈椎病病人接受穴位注射配合整脊手法治疗,观察周期为2个疗程,观察指标包括临床疗效的观察、McGill量表测评等。结果:60例神经根型颈椎病患者中,34例获得临床痊愈,22例获得好转,总有效率为95.88%。治疗后的PRI感觉分、PRI情绪分、PRI总分、VAS和PPI治疗前后的积分差值,与治疗前比较均有显著性差异(P〈0.01~0.05)。结论:穴位注射配合整脊手法治疗能够有效地干预神经根型颈椎病患者的临床症状、改善疼痛,促进其临床痊愈。 相似文献
77.
78.
Laminoforaminotomy is an effective treatment for cervical radiculopathy. We present our technique in conjunctionwith analysis of our long-term clinical results. The posterior approach in the surgical management of cervical radiculopathy is not only acceptable, but in certain cases is preferable to the anterior approach. When pathology is central, broad-based, and anterior, posterior procedures are unlikely to achieve decompression. However, with lateral or foraminal nerve root compression, the simpler posterior keyhole laminoforaminotomy is both safe and effective. Physicians advocating either the anterior or the posterior procedure exclusively are not providing, in our opinion, optimal care. 相似文献
79.
探索理想的诊断腰骶神经根病的神经电生理技术。采用高压短脉冲电刺激技术直接刺激神经根,在比目鱼肌及半腱肌记录H反射,共检测正常人30例,S1及L5神经根病20例。(1)测定了比目鱼肌及半腱肌神经根刺激H反射正常值。(2)半腱肌和经目鱼肌NRSH在正常人可100%记录到。93)L5S1椎间隙及S1神经孔刺激,比目鱼肌及 半腱肌NRSH各参数相差均不显著。(4)单纯S1神经根病仅比目鱼肌NRSH异常,而 相似文献
80.
Lee JY Löhr M Impekoven P Koebke J Ernestus RI Ebel H Klug N 《Acta neurochirurgica》2006,148(9):951-958
Summary Interbody fusion after anterior discectomy may lead to acceleration of degenerative changes at adjacent levels. Although the
posterior approach preserves the motion segment, decompression of the nerve root is indirect if “hard disc prolaps” is the
main cause. Recently, a technique of microsurgical anterior cervical foraminotomy for the treatment of radiculopathy with
preservation of the segment mobility was published. In this study, we present this technique with several modifications.
Thirteen patients – 5 men and 8 women with an average age of 49 years – with unilateral radiculopathy resistant to conservative
treatment underwent microsurgical anterior foraminotomy via a small keyhole transuncal approach. The base of the uncinate
process (UP) was directly drilled in the trajectory to the intervertebral foramen without destroying the disc tissue. The
vertebral artery between the transverse process was not exposed. Furthermore, the functional anatomy of the uncovertebral
joint remained largely intact. All patients experienced complete relief of radiating pain. A cervical collar was not used.
Mean follow-up time was 19 months. The mobility of the operated segment was preserved in each patient. No instability of the
cervical spine was seen.
The microsurgical anterior foraminotomy via a small keyhole transuncal approach is safe, minimally invasive, and represents
an effective method to treat unilateral cervical radiculopathy caused by disc prolaps and/or uncovertebral osteophytes. Additionally,
the segment mobility is preserved and prevents the acceleration of degenerative changes at adjacent levels. 相似文献