腰痹舒治疗腰椎间盘突出症临床疗效分析

用中药腰痹舒治疗腰椎间盘突出症 3 1例 ,治愈 2 8例 ,有效 3例。治疗后随访 6～ 1 8个月 ,无 1例复发。与牵引、按摩、秋水仙碱内服对照组比较 ,中药疗效显著优于对照组 (P<0 .0 5 )。经 CT检查 ,腰痹舒治愈后椎间盘的后突压迫、粘连均有不同程度的解除。提出可根据症状、体征将腰椎间盘出症的腰腿痛分为 1 0级。作为判断病情和疗程的主要指标。其治疗宜通经、化瘀散寒为主。     

"脊柱九针疗法"治疗腰椎间盘突出症40例

目的　观察采用“脊柱九针疗法”治疗腰椎间盘突出症的疗效。方法与结果　选择 4 0例经 CT检查确诊为腰椎间盘突出症 ,并有典型临床症状的患者作为研究对象 ,选用突出椎间盘的相应椎体及上下两个节段椎体棘突下和“夹脊穴”为主进针点 ,针刺治疗腰椎间盘突出症 ,总有效率为 10 0 %。结论　“脊柱九针疗法”较常规针刺取穴方法具有针对性强 ,针感强 ,疗效明显之特点 ,且取穴简便 ,操作简单安全。     

钛钢螺纹椎体融合器治疗退行性腰椎间盘突出症的远期疗效观察

目的　观察钛钢螺纹椎体融合器 (TFC)手术治疗退行性腰椎间盘突出症的远期疗效。方法　选择 36例腰椎间盘突出症患者 ,随机分为 2组各 18例 ,治疗组采用TFC手术治疗 ,对照组采用单纯椎板开窗、髓核摘除术治疗。治疗后进行融合率、椎间隙高度、椎间孔高度观测和主、客观疗效评价。结果　治疗组椎体融合率达 94 % ,术后椎间隙高度及椎间孔高度增加 ,远期随访无明显丢失 ,临床疗效主客观评估均优于对照组。结论　TFC治疗退行性腰椎间盘突出症 ,可以有效地撑开或保持受累椎间隙 ,扩大椎间孔 ,有利于骨融合 ,可缓解疼痛 ,其远期疗效可靠。     

TREATMENT OF 247 CASES OF PROLAPSE OF LUMBAR INTERVERTEBRAL DISC WITH COMPREHENSIVE PLUM-BLOSSOM MAGNETIC NEEDLE THERAPY

Objective: To.observe the therapeutic effect of comprehensive plum-blcssom magnetic needle therapy on prolapse of lumbar intervertebral disc. Methods. 247 cases of prolapse of lumbar intervertebral disc were treated first with manual treatment and then with plum-blcssom magnetic needle therapy and effect-increasing pad therapy at specified points and reactive points. Results: After treatment for 2 therapeutic courses, 153 cases were cured accounting for 61.94%, 71 cases were markedly effective accounting for 28.75%, 22 cases were improved accounting for 8.91% and the rest one failed,acceunting for 0.45%. Conclusion. The comprehensive plum-blessom magnetic needle therapy has a better therapeutic effect on prolapse of lumbar intervertebral disc.     

腰椎间盘巨大突出手术治疗的回顾性分析

目的探讨腰椎间盘巨大突出的临床特点及治疗方法。方法回顾性分析本院1999～2002年住院手术并有随访资料的77例。结果随访6～36个月,平均17.2个月,按Nakal疗效评价,优61例,良10例,可6例。优良率92.2%。结论手术治疗腰椎间盘巨大突出疗效确切,明确诊断后,应尽早手术治疗。     

腰椎间盘突出症术中定位失误原因及处置

目的分析腰椎间盘术中定位失误的原因,并提出对策。方法结合相应文献复习,对21例术中定位失误病例的术前准备及判断、手术操作进行回顾性研究。结果21例术中定位失误的形式、原因多种。其中左侧误为右侧7例,L3,4误为L4,59例,L5,6误为L5S16例,L5S1误为L4,53例,S1S2误为L5S12例。结论充分的术前准备及准确判断、仔细的术中操作、术者较好的临床经验能有效地减少术中失误。     

椎弓根内固定加椎体间植骨融合治疗腰椎间盘突出症伴腰椎不稳

目的 评价椎弓根内固定、椎体间植骨融合术在治疗腰椎间盘突出症伴腰椎不稳中的应用及其临床效果。方法 对75例腰椎间盘突出症伴腰椎不稳的患者行髓核摘除、椎弓根内固定加椎体间植骨融合术，病变节段分别为L3～4、L4～5和L5S1。结果 75例患者随访8～50个月，平均14．5个月。本组4例患者术后出现暂时性神经根牵拉症状，2例术后感染，椎体间植骨融合72例，不融合3例。所有病情均获不同程度缓解，无其他远期并发症出现。结论 椎弓根内固定加后路椎体间植骨融合治疗腰椎间盘突出症伴腰椎不稳，除解除椎间盘源性疼痛外，尚能提供椎间的牢固性，促进椎体间植骨融合，恢复椎体永久稳定性。     

Up-regulation of Niacinamide in Intervertebral Disc Aggrecan in vitro

The regulatory effects of niacinamide （Nia） on intervertebral disc （IVD） aggrecan in vitro was investigated. Chiba＇s 10 ng/mL interleukin-1 （IL-1）-induced rabbit IVD degeneration model in vitro was established. 0.5, 0. 25 and 0.05 mg/mL Nia was added to normal and degenerated IVDs for intervention. On the first and second week after intervention, safranin O-fast green staining intensity and glycosaminoglycan （GS） content were measured. The expression of aggrecan core protein was detected by RT-PCR. The results showed： （1） After treatment with 0. 5 mg/mL Nia for one week, the GS content in nucleus pulposus （NP） was increased by 44.80% as compared with control group （P〈0. 01） ; The GS content in IL-1 induction groups was increased with the increase of Nia concentrations： After treatment with 0. 5 mg/mL for one week, the GS content in NP was increased by 68.30% as compared with control group （P〈0. 01）. After two weeks, GS content in NP and fibrous rings was still higher than in control group at the same period （P〈0. 01） and untreated group （P〈0.01）. （2） Safranin O-fast green staining revealed that with the increase of Nia concentrations, staining density in NP and fibrous rings was increased and histological structure damage to IVDs by IL-1β was alleviated. （3） RT-PCR showed that the expression of core protein gene in IL-1β-induced degenerated IVDS was increased with the increase of Nia concentrations. It was concluded that under conditions in vitro, Nia could up-regulate the expression of aggrecan in IVDs and protect IVDs from IL-1β-induced degeneration at least partially, which offers a potential choice for IVD degeneration clinical therapy.     

腰椎间盘退变危险因素的病例-对照研究

[目的]探索腰椎间盘退变的危险因素。[方法]采用病例-对照研究方法,以CT确诊有腰椎间盘退变者114人为病例组;随机选择体检人员中无腰背痛史且腰椎功能正常者211人为对照。问卷调查腰椎疾患家族史、腰背部受伤史和5种职业危险因素的暴露情况,包括坐位、全身振动、弯腰扭腰、提举重物和重体力作业,对各因素暴露以工龄权重求得暴露指数。[结果]非条件Logistic回归分析显示腰椎疾患家族史危险性最高(OR=89.12),其次是腰背部受伤史(OR=78.60)、职业危险因素中全身振动(OR=8.58)、弯腰扭腰(OR=4.62)和重体力作业(OR=9.05)进入模型。业余运动OR为0.47。[结论]腰椎疾患家族史和腰背部受伤史是腰椎间盘退变的主要危险因素,而业余运动可能有一定保护作用。     

中药配合牵引综合治疗腰椎间盘突出症疗效观察及其对血清SOD活性的影响

为评价中医药综合治疗腰椎间盘突出症的疗效及探讨其可能的疗效机理.对36例腰椎间盘突出症患者进行治疗前后JOA评分与测定血清中SOD活性.结果治疗后JOA评分明显下降,SOD活性明显升高,但腰椎间盘突出症疗效与SOD活性无关.认为本疗法是治疗腰椎间盘突出症的有效方法之一,但不是通过提高SOD活性而改善临床症状的.