Isovelocity investigation of the lengthening behaviour of the erector spinae muscles

The purpose of this study was to investigate the force-velocity (F/) relationship for the erector spinae muscles in submaximal activation movements, with particular attention to their response during lengthening movements and at lower shortening contraction velocities. Dynamic models that predict lower back muscle forces require reasonable representations of the modulating effect of instantaneous velocity. Ten males were observed performing trunk flexion and extension in the sagittal plane under constant load. Contraction velocities were measured as the first derivative from a devise sensitive to changes in spine curvature, and controlled by a visual feedback system while a constant load was applied through a chest harness. The erector spinae exhibited a yielding phenomenon which causes an abrupt drop in force during constant velocity stretching under constant, submaximal, stimulation. The findings were consistent with previous isovelocity muscle lengthening experiments. Yielding appeared dependent on the level of load/activation supporting the theory of a state-variableF/ relationship. The eccentric behaviour of the lower erectors (L3) seemed independent of velocity and length, while that of the upper erectors (T9) showed a dependence on length. At lower concentric velocities, concavity in torque-velocity curves was noted after a threshold velocity. The findings of this study strongly reinforce the notion that theF/ length relationship is not a continuous hyperbolic relationship during muscle shortening and that the commonly modelled force augmentation effect of lengthening is incorrect, at least for submaximal activation of the extensors of the lower back.     

腰穿置管稳压引流治疗蛛网膜下腔出血后脑积水

目的探讨蛛网膜下腔出血(SAH)后脑积水简便、安全、有效的治疗方法。方法所收治的283例SAH病人中有90例发生了急性脑积水,在内科治疗基础上,其中46例进行了腰穿置管稳压引流治疗结果与无脑积水者对照比较。结果上法治疗后32例(32/46,70%)意识水平均有所改善;所有受治病人12d内再出血和脑缺血的发生率与无脑积水的病人组无显著性差异〔5/46(11%),24/193(12%);16/46(35%)60/193(31%)。P>0.05〕。治疗组未发生脑室炎或脑膜炎。结论腰穿置管稳压引流是一种治疗SAH后脑积水简便、安全、有效的方法。     

挑刺阳性反应点治疗腰椎骨质增生38例

试用三棱针挑刺腰部阳性反应点,治疗腰椎骨质增生38例,结果有效率100%,具有疗效好,费用低,疗程短,应用方便的特点.     

脊柱椎弓根螺钉入路及手术方法的临床应用

目的：探讨椎弓根螺钉最佳入路及手术步骤。方法：对104例胸腰椎骨折脱位患者，分两组采用不同方法、步骤钻入椎弓根螺钉，并对其进行疗效比较。结果：经过技术改进后的方法较传统方法对骨折脱位的复位效果无明显差异，而两者在X线曝光次数、手术时间、出血量及并发症等方面存在显著性差异。结论：技术改进后的椎弓根螺钉进钉方法简单、安全、创伤小、疗效优良。     

Clinical research on acute lumbar sprain by Qi-inducing acupuncture manipulation

目的:探讨针刺导气法治疗急性腰扭伤的临床价值.方法:将60例急性腰扭伤患者随机单盲分为两组,观察组30例,在针刺得气的基础上施以导气法治疗;对照组30例,在常规针刺得气后留针20 min.3 d后观察疗效.结果:观察组痊愈率为86.7%,对照组为43.3%,观察组痊愈率明显优于对照组(P＜0.01).结论:针刺导气法是治疗腰扭伤的一种较好的方法.     

Treatment of acute lumbar sprain with acupuncture and Tuina

将急性腰扭伤分为脊柱型损伤和非脊柱型损伤两种类型,分别施以针刺和推拿治疗,治疗了30例急性腰扭伤患者,结果27例痊愈,3例有效.     

腹针加腕踝针治疗腰椎间盘突出症临床观察

目的观察腹针加腕踝针对腰椎间盘突出症疼痛及腰椎功能障碍的作用。方法将符合纳入标准的78例患者随机分为治疗组和对照组。治疗组45例采用腹针加腕踝针治疗,对照组33例采用常规体针治疗,分别观察治疗前及治疗1次、3次、1个疗程结束后视觉模拟评分（VAS）和中文版Oswestry腰椎功能障碍指数（ODI）的变化。结果治疗组治疗1次后VAS明显下降（P〈0.05）,而ODI下降无统计学意义（P〉0.05）;3次治疗及疗程结束后,两组VAS和ODI均有明显改善,且治疗组优于对照组。结论腹针加腕踝针治疗腰椎间盘突出症,能迅速有效地缓解疼痛,对改善腰椎功能也有很好的作用。     

经方治疗腰椎间盘突出症临床研究

本文阐述了经方治疗腰椎间盘突出症的临床特点,针对病因病机,用辛热辛温药物,如肉桂、细辛、地龙、当归、川芎、牛膝、桃仁、红花等,以补助阳气,驱除寒邪,温通经络,养血活血,化瘀止痛,用药规律,疗效独特。     

Full-Endoscopic versus Minimally Invasive Lumbar Interbody Fusion for Lumbar Degenerative Diseases : A Systematic Review and Meta-Analysis

ObjectiveAlthough full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. MethodsWe systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. ResultsFour retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo-LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669–35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941–41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. ConclusionRelative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.