推拿加点穴疗法治疗第三腰椎横突综合症

目的探讨传统方法治疗第三腰椎横突综合症在中、小型医院的应用。方法总结76例第三腰椎横突综合症患者采用推拿手法点穴疗法治疗的效果。结果第三腰椎横突综合症患者临床治愈54例,占71%,显效22例,占29%,无效0例。结论推拿手法加点穴疗法治疗第三腰椎横突综合症疗效好、安全,值得在中、小型医院推广。     

小针刀加手法治疗第三腰椎横突综合症60例

笔者运用小针刀加手法治疗第三腰椎横突综合症60例,现总结报告如下。1　临床资料本组60例中,男42例(其中青年战士38例),女18例;年龄19～50岁;病程15月～10年;发病部位:左侧23例,右侧17例,双侧20例。全部病例均按邵氏第三腰椎横突综合症标准诊断[1]。2　治疗方法①针刀治疗:患者俯卧,在第三腰椎横突尖部找准压痛点,用龙胆紫作标记,常规消毒,铺洞巾。术者戴无菌手套,左手拇指按压在标记处,右手持针刀,使刀刃和骶棘肌平行,垂直快速进入,直达第三腰椎横突骨面。再将刀锋移至横突尖端,先纵行切割2～3刀,然后横行铲剥,感觉刀下组织已松动即可出针,…     

四联疗法治疗第三腰椎横突综合症附78例临床观察

第三腰椎横突综合症是临床常见疾病,在腰腿痛患者中占有相当比例,尤以青壮年体力劳动者多见,严重影响其劳动能力和生活质量。笔者近年来采用小针刀、正骨推拿、局部神经阻滞、腰背肌功能锻炼四联疗法治疗本病78例,疗效满意,今总结报道如下：     

第三腰椎横突综合征

第三腰椎横突综合征秦学敏，王铁林，桑建美，李俊第三腰椎横突综合征是椎管外软组织所致腰痛和腰臀痛的常见疾患。许多学者近年来从解剖、病理及临床方面做了研究。我们从１９７８～１９９０年共治疗４２６例，手术５２例，本文就其诊断、病因、病理及手术治疗予以分析探...     

针刀结合局部封闭治疗第三腰椎横突综合征的病例对照研究

第三腰椎横突综合征是临床常见病,是由于第三腰椎横突周围组织损伤造成的慢性腰痛,临床以第三腰椎横突处明显压痛为主要特征。目前针对该病的治疗方法较多,临床疗效不一。     

腰三横突综合症与腰椎间盘突出症关系初探

腰椎间盘突出症为临床常见病多发病,在临床查体中我们发现,腰椎间盘突出症的患者往往伴随着患侧或健侧腰三横突的压痛,局部可扪及条索状硬结,并且我们用手法或小针刀治疗松解局部组织后,患者的症状体征都可有不同程度的改善.     

第三腰椎横突综合征的基础与临床研究

本文从解剖、病理和临床等方面对第三腰椎横突综合征的发病机理和防治方法进行了研究。结果表明，由于腰三横突在腰椎中的特殊地位和作用，其末端所承受的拉应力较其它腰椎横突大，当腰部受力过大或长期不良工作体位，易引起腰三横突末端组织的急慢性损伤，腰三横突末端血管受累有碍于局部组织的供养，可引起或加重腰三横突末端组织的病理变化。非手术治疗是本病的首选疗法，保持良好的体位，加强腰背肌功能锻炼，有助于稳定和预防下腰痛的复发。     

针刀配合手法治疗第3腰椎横突综合症224例

第3腰椎横突综合症为腰部常见的软组织慢性损伤性疾病之一。其发病率较高,严重影响着人们的工作和生活。以往该病多笼统的归于腰肌劳损,缺乏针对性的治疗,治疗效果较差,造成病人腰痛,医生头痛。笔者近3年来,应用针刀配合手法治疗224例腰3横突综合症,取得了满意的疗效,现报告如下：     

第三腰椎横突综合征的诊治体会

L3横突综合征,是以L3横突尖部明显压痛为特征的腰腿痛性疾患,是颈腰痛门诊的常见病。此病不仅多见于青壮年,老年人也有发病,若诊断不明或治疗不当,容易造成误诊误治。我科近几年来应用小针刀疗法治疗患者1100例,取得了满意的疗效,现报告如下。     

Chronic Osteomyelitis of the Lumbar Transverse Process

Pyogenic spondylitis involving only the posterior element of a vertebra is rare. To the best of our knowledge, there have been no reports of osteomyelitis of the transverse process. We report here on a 45-year-old male with a one month history of swelling associated with lower back pain. The magnetic resonance imaging showed a paraspinal soft tissue mass, and computed tomography revealed a fine osteolytic lesion in the right transverse process of the 5th lumbar spine, and this was all consistent with chronic osteomyelitis. A mixed staphylococcal infection was identified. Open drainage, resection of the transverse process and intravenous injection of anti-staphylococcal antibiotics resolved the back pain and reduced the erythrocyte sedimentation rate to normal. Pyogenic osteomyelitis of the transverse process is extremely rare, which can cause a misdiagnosis or a delayed diagnosis. Careful consideration of this disease is needed when evaluating patients who complain of back pain.     

腰脊柱构型与椎间盘突出症的关系

本文复习了２０５例已手术治疗的腰椎间盘突出的症病人的术前Ｘ线表现，结果提示深 Ｌ５发生Ｌ４－５椎间盘突出的可能性增高，而高骑Ｌ５则与Ｌ５－Ｓ１椎间盘出有关，腰骶移行椎的发生率较正常人显著增高，而腰骶角的病理意义尚难确定。     

A Vascular Cause of Painful Lumbar Transverse Syndrome

Background:

Despite typical signs of Leriche syndrome, this patient was misdiagnosed with disk prolapse. Vascular insufficiency, such as aortic occlusion, may underlie a motor-sensory deficit in the lower extremities.

Method:

Case report.

Findings:

A 67-year-old woman was admitted for cramping pain in the lumbar spine, hips, and legs; diffuse weakness and sensory disturbances of both legs for weeks; and a cold feeling and livid colorization of the legs. Her complaints were attributed to a disk prolapse L5/S1, for which she underwent immediate laminectomy. Postoperatively, symptoms and signs were aggravated, abdominal pain developed, and C-reactive protein and creatinine were elevated. On the fourth postoperative day, femoral pulses were no longer palpable, anuria developed, and computed tomographry angiography showed occlusion of the abdominal aorta distal to the superior mesenteric artery and absent kidney perfusion. The patient died one day later. Postmortem review showed a visible intra-aortic mass on the previous lumbar magnetic resonance image.

Conclusions:

The differential diagnosis of painful lumbar transverse syndrome should include vascular disease. Misinterpretation of a Leriche syndrome as a disk prolapse has not been reported.     

ATP注射治疗第三腰椎横突综合征

目的：探索第三腰椎横突综合征的临床治疗。方法：采用三磷酸腺苷二钠注射液２０ｍｇ，５％碳酸氢钠注射液５－１０ｍｌ和２％盐酸利多卡因２－５ｍｌ混合液注射于第三椎横突末端。每３天注射１次，平均注射４．０５次，治疗后１年随访。结果：治疗６０例，治愈５２例，好转８例。结论：明确诊断，合理的药物组合，准确的注射方法是提高疗效的关键。     

A Vascular Cause of Painful Lumbar Transverse Syndrome

Abstract

Background: Despite typical signs of Leriche syndrome, this patient was misdiagnosed with disk prolapse. Vascular insufficiency, such as aortic occlusion, may underlie a motor-sensory deficit in the lower extremities.

Method: Case report.

Findings: A 67-year-old woman was admitted for cramping pain in the lumbar spine, hips, and legs; diffuse weakness and sensory disturbances of both legs for weeks; and a cold feeling and livid colorization of the legs. Her complaints were attributed to a disk prolapse L5/S1, for which she underwent immediate laminectomy. Postoperatively, symptoms and signs were aggravated, abdominal pain developed, and C- reactive protein and creatinine were elevated. On the fourth postoperative day, femoral pulses were no longer palpable, anuria developed, and computed tomographry angiography showed occlusion of the abdominal aorta distal to the superior mesenteric artery and absent kidney perfusion. The patient died one day later. Postmortem review showed a visible intra-aortic mass on the previous lumbar magnetic resonance image.

Conclusions: The differential diagnosis of painful lumbar transverse syndrome should include vascular disease. Misinterpretation of a Leriche syndrome as a disk prolapse has not been reported.     

不典型腰椎间盘突出马尾综合征的误诊分析

目的:对继发于腰椎间盘突出的马尾综合征的误诊原因进行分析。方法:对本院收治的4例继发于腰椎间盘突出的马尾综合征的误诊病例的症状、体征、影像学表现、手术、随访结果进行研究分析。结果:本组手术无手术并发症,但术后患者的症状恢复较慢,甚至随访时仍有部分症状残留。结论:造成腰椎问盘突出马尾综合征误诊的主要原因为发病时缺少典型的腰腿痛症状以及缺少对会阴部感觉的详细检查,对于继发椎间盘突出的马尾综合征,只要通过详细的询问病史和体格检查,结合CT、MRI等影像学检查,早期诊断是不困难的。一旦诊断,就应立即手术。延迟手术明显影响疗效,甚至残留永久性的神经损害。     

腰椎间盘突出症致马尾神经综合征的外科治疗

目的：根据马尾神经综合征发病机制的临床研究和临床治疗现状,提出外科干预的术式,提高其手术疗效。方法：致压物摘除、神经根节部的无创减压是治疗马尾神经综合征主要的外科技术。结果：马尾神经综合征改良术可在到神经根节内的即刻减压,时机得当,能迅速缓解主要病理变化。结论：马尾神经综合征的改良术式将是提高马尾神经综合征治疗效果的重要方法。     

腰椎间盘突出症合并马尾综合征诊断与手术治疗的再认识

本文报告28例腰椎间盘突出症并发马尾综合征病人。作者就该病的发病机制、诱因、诊断及手术等有关的问题进行了探讨。认为该病处理的关键是早期诊断和及早手术。诊断主要依靠临床表现和CT检查；腰椎管造影术可加重马尾损伤，因此要慎重选择。手术应采用单处开窗或多处开窗，既能进行椎管减压和髓核摘除，又能保护脊柱稳定性。手术应尽量避免马尾神经的继发损伤。术后随访0．5～3．5年（平均1．5年），优良率为85．7％。