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31.
32.
手法为主综合治疗腰椎间盘突出手术后复发 总被引:2,自引:0,他引:2
腰椎间盘突出症所引起的腰腿痛,目前多主张以保守治疗为主,但经手术治疗的也有一定比率。自2000年10月-2005年12月共收治经手术后复发的腰椎间盘突出症19例,临床应用松肌法、分离神经根粘连法、骨盆旋转整脊法、后伸压腰法、纠正脊柱侧弯法为主,结合骨盆牵引中药熏蒸,药物对症治疗为辅,取得了满意的效果。为探究其疗效机制,现总结如下。1临床资料1.1一般资料19例中,男16例,女3例;年龄26~59岁。有劳损、外伤及受凉诱发者12例。发病部位据CT、MRI检查统计:L3,4椎间盘突出1例,L4,5椎间盘突出9例,L5S1椎间盘突出5例,L4,5和L5S1两节段椎间盘… 相似文献
33.
目的探讨人工髓核置换治疗腰椎间盘突出症临床应用的初步效果. 方法自2002年5月~2003年8月行单个人工髓核假体(PDN)置换术治疗腰椎间盘突出症26例. 结果所有病例均获随访,平均时间10.5(3~18)个月.临床疗效评价:优18例,良4例,尚可2例.1例发生椎间隙感染,保守治疗后好转;1例术后2月出现假体移位、症状复发,行再次手术更换假体后治愈. 结论人工髓核假体置换治疗腰椎间盘突出症能恢复椎间隙高度,操作简单,创伤小,恢复快,近期疗效满意,远期疗效仍需进一步观察. 相似文献
34.
35.
腰椎间盘突出症患者手术前后血浆内皮素及降钙素基因相关肽的变化 总被引:4,自引:0,他引:4
目的 探讨血浆内皮素 (ET)及降钙素基因相关肽 (CGRP)在腰椎间盘突出症(PLID)患者手术前后的变化及其意义。方法 采用放射免疫法检测 40例正常人及 40例患者手术前后的血浆CGRP及ET值。结果 40例PLID患者术前血浆ET值明显高于正常对照组 ,术后ET值明显低于术前 (P <0 .0 1) ,但患者术后血浆ET值与正常对照组差异无显著性 (P >0 .0 5 )。40例PLID患者术前血浆CGRP值与正常对照组比较差异无显著性 (P >0 .0 5 ) ,40例PLID患者术后疼痛明显改善 ,且其血浆CGRP值明显高于术前及正常对照组 (P <0 .0 1)。正常对照组ET与CGRP无明显相关 ,病组术前ET与CGRP呈正相关 ,而术后两者无明显相关。结论 ET与CGRP共同参与了PLID的发病过程 ,为探讨PLID保守治疗方法提供了依据。 相似文献
36.
[目的 ]评价Mackenzie治疗法对腰椎间盘突出症的疗效 .[方法 ]对照组行腰椎牵引、电脑中频电治疗及超短波治疗 ,治疗组除了采用对照组的治疗方法外 ,加用Mackenzie治疗法进行治疗 .[结果 ]治疗组治愈显效率为 93 % ,对照组治愈显效率为 70 % ,两组治愈显效率间有显著性差异 .[结论 ]Mackenzie治疗法可提高腰椎间盘突出症的疗效 相似文献
37.
A new technique for the treatment of lumbar far lateral disc herniation: technical note and preliminary results 总被引:2,自引:0,他引:2
A newly designed technique for a minimally invasive approach to the laterally herniated disc is presented. Fifteen patients suffering from far lateral disc herniation (extraforaminal) were operated according to this technique. Through a small skin incision (1.5 cm), the paraspinal muscles are spread by dilators, until a working channel of 9 mm inner diameter and 11 mm outer diameter can be placed. The next steps are done through this channel using the surgical microscope. No bone resections are necessary and the facet joints are left untouched. However, partial resection of the intertransverse ligament may be necessary. The mean follow-up period for these 15 patients was 11.5 months, and they were evaluated by using the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). The average surgical time was 43 min. The ODI improved from 30.6 (preoperative) to 14.3 (postoperative). The VAS of leg pain improved from 7 (preoperative) to 3.6 (postoperative), which represented a statistically significant improvement at the significance level of (P<0.01). No intra-operative or early postoperative complications occurred. However, one recurrence did occur, which was treated by the same technique. This technique combines the advantages of three-dimensional visual control (operating microscope) with the minimal surgical trauma of endoscopic techniques, while avoiding some of the shortcomings of both the microsurgical and endoscopic techniques. 相似文献
38.
A prospective and controlled study of training after surgery for lumbar disc herniation (LDH). The objective was to determine
the effect of early neuromuscular customized training after LDH surgery. No consensus exists on the type and timing of physical
rehabilitation after LDH surgery. Patients aged 15–50 years, disc prolapse at L4–L5 or L5–S1. Before surgery, at 6 weeks,
4, and 12 months postoperatively, the following evaluations were performed: low back pain and leg pain estimated on a visual
analog scale, disability according to the Roland–Morris questionnaire (RMQ) and disability rating index (DRI). Clinical examination,
including the SLR test, was performed using a single blind method. Consumption of analgesics was registered. Twenty-five patients
started neuromuscular customized training 2 weeks after surgery (early training group=ETG). Thirty-one patients formed a control
group (CG) and started traditional training after 6 weeks. There was no significant difference in pain and disability between
the two training groups before surgery. Median preoperative leg pain was 63 mm in ETG and 70 mm in the CG. Preoperative median
disability according to RMQ was 14 in the ETG and 14.5 in the CG. Disability according to DRI (33/56 patients) was 5.3 in
the ETG vs. 4.6 in the CG. At 6 weeks, 4 months, and 12 months, pain was significantly reduced in both groups, to the same
extent. Disability scores were lower in the ETG at all follow-ups, and after 12 months, the difference was significant (RMQ
P=.034, DRI P=.015). The results of the present study show early neuromuscular customized training to have a superior effect on disability,
with a significant difference compared to traditional training at a follow-up 12 months after surgery. No adverse effects
of the early training were seen. A prospective, randomized study with a larger patient sample is warranted to ultimately demonstrate
that early training as described is beneficial for patients undergoing LDH surgery. 相似文献
39.
视盘血管炎——关于混合型的研讨 总被引:2,自引:0,他引:2
对60例(63眼)视盘血管炎的临床分型进行了探讨,结果表明,除分为Ⅰ、Ⅱ两型外,尚存在混合型,当视盘睫状血管炎性病变波及中央静脉,或两个血管系统同时受炎症侵犯时,即可再现混合型的临床表现,视盘明显水肿,视网膜静脉迂张,散在渗出,出血,动脉狭细。眼底荧光血管造影可见视盘荧光早期充盈明显迟缓,后期渗漏面积〉2.0PD,视网膜循环时间延长,混合型兼有Ⅰ,Ⅱ两型的临床特征,应作为一个独立类型存在,同时观察 相似文献
40.
颈椎间盘突出的MRI诊断价值(附41例分析) 总被引:5,自引:1,他引:4
目的:探讨颈椎间盘突出的MRI诊断。方法:对41例椎间盘突出进行磁共振成像检查。结果:表明本病可分为中央型和侧方型突出。MRI可直接显示颈椎间盘突出的部位、类型及颈髓和神经根的受压程度。结论:MRI对本病的确诊具有重要价值 相似文献