Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularl...Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.展开更多
BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental heal...BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental health problems.In recent years,the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients'physiological and psychological conditions.There-fore,investigating its clinical efficacy for treating pelvic fractures plus lum-bosacral plexus injuries is of great clinical significance.AIM To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression.METHODS Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach(January 2011 to May 2024)were retrospectively analyzed.The patients'general data were collected via questionnaire.The Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess anxiety and depression,respectively.We adopted a numerical rating scale(NRS)to evaluate pain degree,the Pittsburgh Sleep Quality Index(PSQI)to assess sleep quality,and Medical Research Council(MRC)Scale for Muscle Strength to evaluate treatment efficacy and complications.RESULTS The 136 included patients(92 male,44 female)were a mean 48.02±15.72 years old.The mean SAS score was 66.36±5.15 preoperatively vs 42.15±4.36 postoperatively,while the mean SDS score was 65.61±5.02 preoperatively vs 43.83±4.54 postoperatively,showing statistically significant differences(P<0.05).The mean NRS and PSQI scores were significantly lower pre-vs postoperatively(P<0.05).Postoperatively,67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5,22 achieved an M1-M4,and four achieved an M0.Postoperative motor function improved by a mean 4.20 grades(scale,0-5).Among the patients with old pelvic fractures and nerve injuries,19 achieved an M5,16 achieved an M1-M4,and eight achieved an M0.Motor function improved significantly by a mean 3.30 grades(scale,0-5;P<0.05).No serious postoperative complications occurred.CONCLUSION The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression,relieve pain,improve sleep quality,reduce intraoperative blood loss,and improve postoperative recovery.展开更多
AIM: To evaluate two simple angle measurements for predicting lumbosacral transitional vertebra (LSTV) in magnetic resonance imaging (MRI) studies of the spine. METHODS: The lumbar spine MRI studies of 50 subjects wit...AIM: To evaluate two simple angle measurements for predicting lumbosacral transitional vertebra (LSTV) in magnetic resonance imaging (MRI) studies of the spine. METHODS: The lumbar spine MRI studies of 50 subjects with LSTV and 50 subjects with normal lumbosacral anatomy were retrospectively evaluated. In each study, the mid-sagittal T2-weighted image was used to measure the angle formed by a line parallel to the superior surface of the sacrum and a line perpendicular to the axis of the scan table (A-angle), as well as the angle formed by a line parallel to the superior endplate of the L3 vertebra and a line parallel to the superior surface of the sacrum (B-angle). RESULTS: The total study population consisted of 100 subjects (46 males, 54 females, 51 ± 16 years old). There were no differences in age and sex between the two groups. Both A-angle and B-angle were significantly increased in subjects with LSTV compared to controls (P < 0.05). The optimal cut-off values of A-angle and B-angle for the prediction of LSTV were 39.8° (sensitivity = 80%, specificity = 80%, accuracy = 83%; 95% confidence interval = 74%-89%, P = 0.0001) and 35.9° (sensitivity = 80%, specificity = 54%, accuracy = 69%; 95% confidence interval = 59%-78%, P = 0.0005), respectively. CONCLUSION: On sagittal MR images of the lumbar spine, an increased A-angle and/or B-angle should alert the radiologist to the presence of LSTV.展开更多
AIM: To test the incremental value of 3T magnetic resonance neurography(MRN) in a series of unilateral radiculopathy patients with non-contributory magnetic resonance imaging(MRI).METHODS: Ten subjects(3 men,7 women; ...AIM: To test the incremental value of 3T magnetic resonance neurography(MRN) in a series of unilateral radiculopathy patients with non-contributory magnetic resonance imaging(MRI).METHODS: Ten subjects(3 men,7 women; mean age54 year and range 22-74 year) with unilateral lumbar radiculopathy and with previous non-contributory lumbar spine MRI underwent lumbosacral(LS) plexus MRN over a period of one year. Lumbar spine MRI performed as part of the MRN LS protocol as well as bilateral L4-S1 nerves,sciatic,femoral and lateral femoral cutaneous nerves were evaluated in each subject for neuropathy findings on both anatomic(nerve signal,course and caliber alterations) and diffusion tensor imaging(DTI)tensor maps(nerve signal and caliber alterations).Minimum fractional anisotropy(FA) and mean apparent diffusion coeffcient(ADC) of L4-S2 nerve roots,sciatic and femoral nerves were recorded.RESULTS: All anatomic studies and 80% of DTI imaging received a good-excellent imaging quality grading. In a blinded evaluation,all 10 examinations demonstrated neural and/or neuromuscular abnormality corresponding to the site of radiculopathy. A number of contributory neuropathy findings including double crush syndrome were observed. On DTI tensor maps,nerve signal and caliber alterations were more conspicuous. Although individual differences were observed among neuropathic appearing nerve(lower FA and increased ADC) as compared to its contralateral counterpart,there were no significant mean differences on statistical comparison of LS plexus nerves,femoral and sciatic nerves(P > 0.05).CONCLUSION: MRN of LS plexus is useful modality for the evaluation of patients with non-contributory MRI of lumbar spine as it can incrementally delineate the etiology and provide direct objective and non-invasive evidence of neuromuscular pathology.展开更多
Sacral fractures following posterior lumbosacral fusion are an uncommon complication. Only a few case series and case reports have been published so far. This article presents a case of totally displaced sacral fractu...Sacral fractures following posterior lumbosacral fusion are an uncommon complication. Only a few case series and case reports have been published so far. This article presents a case of totally displaced sacral fracture following posterior L4-S1 fusion in a 65-yearold patient with a 15-year history of corticosteroid use who underwent open reduction and internal fixation using iliac screws. The patient was followed for 2 years. A thorough review of the literature was conducted using the Medline database between 1994 and 2014. Immediately after the revision surgery, the patient's pain in the buttock and left leg resolved significantly. The patient was followed for 2 years. The weakness in the left lower extremity improved gradually from 3/5 to 5/5. In conclusion, the incidence of postoperative sacral fractures could have been underestimated, because most of these fractures are not visible on a plain radiograph. Computed tomography has been proved to be able to detect most such fractures and should probably be performed routinely when patients complain of renewed buttock pain within 3 mo after lumbosacral fusion. The majority of the patients responded well to conservative treatments, and extending the fusion construct to the iliac wings using iliac screws may be needed when there is concurrent fracture displacement, sagittal imbalance, neurologic symptoms, or painful nonunion.展开更多
BACKGROUND Intraneural ganglion cysts are benign gelatinous masses that form within the epineurium of a peripheral nerve.Only few cases of intraneural ganglion cyst arising from the hip joint have been reported.CASE S...BACKGROUND Intraneural ganglion cysts are benign gelatinous masses that form within the epineurium of a peripheral nerve.Only few cases of intraneural ganglion cyst arising from the hip joint have been reported.CASE SUMMARY A previously healthy 65-year-old woman who had been experiencing left buttock pain radiating to the dorsum of the foot for 2 years visited our clinic.Prior to visiting the clinic,she underwent lumbar spine magnetic resonance imaging and received physiotherapy,pain killers,and epidural injections based on a presumptive diagnosis of spinal stenosis for 2 years in other hospitals.Repeat magnetic resonance imaging revealed joint connection of the articular branch of the hip joint and rostral extension of the cyst along the L5 spinal nerve near the L5-S1 neural foramen.The patient was diagnosed with intraneural ganglion cyst arising from the articular branch of the hip joint based on high-resolution magnetic resonance neurography.Using the arthroscopic approach,a cystic opening within the intra-articular space was detected,and cyst decompression was then performed.The pain in the left leg was significantly relieved during the 6-mo follow-up.CONCLUSION Although intraneural ganglion cysts arising from the hip joint are rare,they can cause typical radicular pain and mimic common L5 radiculopathy.Typical cyst ascent phenomenon starting from the termination of the articular branch on magnetic resonance imaging is a crucial finding indicative of intraneural ganglion cysts arising from the hip joint.展开更多
One hundred and twenty-three lumbosacral radiculography in 67 patients, with age range from 15 to 60 years, have been performed during 1984-1986. In this paper, the anatomical concept of the lumbosacral (L<sub>4...One hundred and twenty-three lumbosacral radiculography in 67 patients, with age range from 15 to 60 years, have been performed during 1984-1986. In this paper, the anatomical concept of the lumbosacral (L<sub>4, 5</sub> and S<sub>1</sub>) nerve root canal and the technique of radiculography are reported. Basing on our results. we suggest different pathologic images of the nerve root canal. The indication and failing causes in performing radiculography are discussed. We believe that nerve root block would be of great diagnostic and therapeutic value in cases of lumbago and sciatica.展开更多
Motor root conduction time(MRCT) was calculated by combining the magnetic stimulatiou eliciting motor evoked poentials (MEP)in lumbosacral region with F wave in popliteal rossa.Motor nerve conduction time(MNCT)and MRC...Motor root conduction time(MRCT) was calculated by combining the magnetic stimulatiou eliciting motor evoked poentials (MEP)in lumbosacral region with F wave in popliteal rossa.Motor nerve conduction time(MNCT)and MRCT were calculated reliably from the tibialis and the soleal MEPS in 40 patients suffering from L5 or S1 radlculopathies owing to disc protrusion,and in 50 healthy controls.Meanwhile,corticals somatosensory evoked potentials(SEP)were recorded by segmental cutaneous nerve stimulation for comparison.The results showed that no differences were seen in MNCT in all patients,but MRCT was markedly prolonged in 85%or the patients,which was higher than the prolongation of SEP in 45% or the patients.It is concluded that magnetic stimulation of MEP is a useful technique ror non-invasive diagnosis of lumbosacral radlculopathies.展开更多
For diagnosiug lumbosacral radicuiopathy precisely, electromyogram(EMG),nerve conduction velocity(NCV),conventional H reflex and H reflex by nerve root stimulation were done in 79 patients with clinical symptoms and s...For diagnosiug lumbosacral radicuiopathy precisely, electromyogram(EMG),nerve conduction velocity(NCV),conventional H reflex and H reflex by nerve root stimulation were done in 79 patients with clinical symptoms and signs of lumbosacral radiculopathy.The rate or appearance fibrillation voltage and/or positive sharp wave in the paraspinal muscles was the highest among them.In the comparison of the affected and the healthy sides in patients with S1 radlculopathy,and of affected side and control group,H-M wave interval of H reflex by nerve root stimulation were significantly prolonged(P<0.01,P<0.05);compared with control group,the dirference or H-M wave interval between the two sides was also significantly prolonged (P<0. 05).But the differences were not so significant in patients with L5 radlculopathy.The results suggest that the abnormal changes or EMG or the paraspinal muscles and H reflex by nerve root stimulation are reliable methods of diagnosing lumbosacral radiculopathy, H reflex by nerve root stimulation can be used to differentiate L5 and S1 nerve root lesions,and measure motor conduction velocity(MCV)and sensory conduction velocity(SCV) or the proximal sciatic nerve.展开更多
in this study, conical somatosensory evoked potentials (SEPs)following electrical stimulation of the skin of LS and SI dermatomes were recorded cephalically and observed in 19 patients with clinically proved unilatera...in this study, conical somatosensory evoked potentials (SEPs)following electrical stimulation of the skin of LS and SI dermatomes were recorded cephalically and observed in 19 patients with clinically proved unilateral L5 or S1 nerve root compression, and the results were compared with those of the control group or 20 healthy volunteers and showed that dermatomal SEPs were abnormal in 12 with the rate of 63%,most or which showed abnomalities or the lateral latency difference. It is concluded that dermatomal SEP is a useful addition to the diagnosis or lumbosacral nerve root compression. When the unilateral nerve root is compressed the lateral latency dirference is a most sensitive criterion for indicating abnomality.展开更多
Objective. To introduce a new internal fixation system of spine and its characteristics. Methods. To review 16 patients with lumbosacral instability who were treated by this new technique, including their clinical out...Objective. To introduce a new internal fixation system of spine and its characteristics. Methods. To review 16 patients with lumbosacral instability who were treated by this new technique, including their clinical outcomes and radiographic evaluation. Results. Fifteen patients gained complete recovery from their preoperative symptoms. One patient who had experienced two operations before and with problems of urinary and fecal incontinence and walking difficulty still had lower limb pain, muscle weakness and urinary incontinence after operation.There is no evidence of spine glide on X-ray, implant failure, neural complication or infection during follow up. Conclusion. Diapason system can achieve good early postoperative results with few complications and ease to use for lumbosacral instability.展开更多
Unilateral reference values for Hoffmann’s amplitude could be applied to the diagnosis of lumbosacral radiculopathy, especially in patients with bilateral lesions. Here, we assessed Hoffmann’s reflex by measuring H-...Unilateral reference values for Hoffmann’s amplitude could be applied to the diagnosis of lumbosacral radiculopathy, especially in patients with bilateral lesions. Here, we assessed Hoffmann’s reflex by measuring H-wave amplitude and the ratio of H-wave amplitude to M-wave amplitude (the H/M ratio). We performed a cross-sectional survey of patients from a Taiwan rehabilitation center (n = 64, age 20 - 87) who presented with lower back pain that radiated to the leg and received a referral for electrodiagnostic examinations. Reference values for H-wave profile parameters were determined using data from lumbosacral radiculopathy-negative patients (n = 10, age 22 - 53), who had normal big toe test results, ankle reflex test results, motor and sensory nerve conductive studies and F-wave latency and who displayed no evidence of radiculopathy in electromyography and imaging studies. The 50th percentile values for H/M ratio and H-wave amplitude were 28% and 6.25 mV, respectively. An H-wave profile th percentile (H/M ratio bosacral radiculopathy (n = 64). Approximately 41% of patients with an H-wave profile th percentile showed electromyography-confirmed chronic radiculopathy. Electromyography-confirmed current radiculopathy was observed in 35% of patients with an H/R展开更多
Elsberg syndrome, or HSV-2 lumbosacral radiculitis, is a rare and underrecognized neurologic condition that mimics cauda equina syndrome (CES). It typically presents with symptoms such as urinary retention, saddle ane...Elsberg syndrome, or HSV-2 lumbosacral radiculitis, is a rare and underrecognized neurologic condition that mimics cauda equina syndrome (CES). It typically presents with symptoms such as urinary retention, saddle anesthesia, and bowel incontinence. This case report describes a 59-year-old immunosuppressed male with idiopathic pulmonary fibrosis who developed Elsberg syndrome due to re-activation of latent HSV-2. The patient experienced progressive lower extremity sensory deficits and genitourinary dysfunction, culminating in a vesiculopustular rash. Diagnosis was confirmed via cerebrospinal fluid analysis and PCR testing of skin lesions. Despite early imaging findings being unremarkable, subsequent MRI revealed enhancement of the conus medullaris and cauda equina. Treatment with intravenous acyclovir, corticosteroids, and supportive therapy led to gradual functional improvement, though sensory deficits and neuropathy persisted. This case highlights the diagnostic challenges and importance of clinical suspicion for HSV-2 reactivation in immunosuppressed patients, as well as considerations for long-term symptom management.展开更多
Background:Recent studies have suggested an association between elevated pelvic incidence(PI)and the development of lumbar spondylolysis.However,there is still lack of investigation for Hart Chinese people concerning ...Background:Recent studies have suggested an association between elevated pelvic incidence(PI)and the development of lumbar spondylolysis.However,there is still lack of investigation for Hart Chinese people concerning the normal range ofspinopelvic parameters and relationship between abnormal sagittal parameters and lumbar diseases.The objective of the study was to investigate sagittal lumbosacral parameters of adult lumbar spondylolysis patients in Han Chinese population.Methods:A total of 52 adult patients with symptomatic lumbar spondylolysis treated in the General Hospital of Armed Police Force(Beijing,China)were identified as the spondylolysis group.All the 52 patients were divided into two subgroups,Subgroup A:36 patients with simple lumbar spondylolysis,and Subgroup B:16 patients with lumbar spondylolysis accompanying with mild lumbar spondylolisthesis(slip percentage〈30%).Altogether 207 healthy adults were chosen as the control group.All patients and the control group took lumbosacral lateral radiographs.Seven sagittal lumbosacral parameters,including PI,pelvic tilt(PT),sacral slope(SS),lumbar lordosis(LL),L5 incidence,L5 slope,and sacral table angle(STA),were measured in the lateral radiographs.All the parameters aforementioned were compared between the two subgroups and between the spondylolysis group and the control group with independent-sample t-test.Results:There were no statistically significant differences of all seven sagittal lumbosacral parameters between Subgroup A and Subgroup B.PI,PT,SS,and LL were higher(P〈0.05)in the spondylolysis group than those in the control group,but STA was lower(P〈0.001)in the spondylolysis group.Conclusions:Current study results suggest that increased PI and decreased STA may play important roles in the pathology of lumbar spondylolysis in Han Chinese population.展开更多
Objective： To observe theclinical effect of tuina reduction manipulation on leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation. Methods： A total of 60eligible cases were randomly alloca...Objective： To observe theclinical effect of tuina reduction manipulation on leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation. Methods： A total of 60eligible cases were randomly allocated into an observation group and a control group, 30 in each group. Cases in the observation group were treated with conventional tuina plus reduction manipulation of sacroiliac joint subluxation; whereas cases in the control group were treated with conventional tuina plus acupuncture. The clinical effects were observed after 10 times of treatment. In addition, the relapse rates were observed 2 months after treatment. Results： The total effective rate in the observation group was 80.0%, versus 50.0% in the control group, showing a statistically significant difference （P＆lt;0.05）. The relapse rate of lumbosacral pain in the observation group was 12.5%, versus 66.7% in the control group, showing a statistically significant difference （P＆lt;0.01）. The relapse rate of leg length discrepancy in the observation group was 16.7%, versus 80.0% in the control group, showing a statistically significant difference （P＆lt;0.01）. Conclusion： Tuina reduction manipulation can obtain substantial therapeutic effect for leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation, coupled with a low relapse rate.展开更多
BACKGROUND The pedicle screw technique is widely employed for vertebral body fixation in the treatment of spinal disorders.However,traditional screw placement methods require the dissection of paraspinal muscles and t...BACKGROUND The pedicle screw technique is widely employed for vertebral body fixation in the treatment of spinal disorders.However,traditional screw placement methods require the dissection of paraspinal muscles and the insertion of pedicle screws at specific transverse section angles(TSA).Larger TSA angles require more force to pull the muscle tissue,which can increase the risk of surgical trauma and ischemic injury to the lumbar muscles.AIM To study the feasibility of zero-degree TSA vertical pedicle screw technique in the lumbosacral segment.METHODS Finite element models of vertebral bodies and pedicle screw-rod systems were established for the L4-S1 spinal segments.A standard axial load of 500 N and a rotational torque of 10 N/m were applied.Simulated screw pull-out experiment was conducted to observe pedicle screw resistance to pull-out,maximum stress,load-displacement ratio,maximum stress in vertebral bodies,load-displacement ratio in vertebral bodies,and the stress distribution in pedicle screws and vertebral bodies.Differences between the 0-degree and 17-degree TSA were compared.RESULTS At 0-degree TSA,the screw pull-out force decreased by 11.35%compared to that at 17-degree TSA(P<0.05).At 0-degree and 17-degree TSA,the stress range in the screw-rod system was 335.1-657.5 MPa and 242.8-648.5 MPa,separately,which were below the fracture threshold for the screw-rod system(924 MPa).At 0-degree and 17-degree TSA,the stress range in the vertebral bodies was 68.45-78.91 MPa and 39.08-72.73 MPa,separately,which were below the typical bone yield stress range for vertebral bodies(110-125 MPa).At 0-degree TSA,the load-displacement ratio for the vertebral bodies and pedicle screws was slightly lower compared to that at 17-degree TSA,indicating slightly lower stability(P<0.05).CONCLUSION The safety and stability of 0-degree TSA are slightly lower,but the risks of screw-rod system fracture,vertebral body fracture,and rupture are within acceptable limits.展开更多
Objective:To observe the effect of acupuncture and bloodletting therapy at the lumbosacral region for chronic prostatitis.Methods:A total of 36 patients with chronic prostatitis were collected,and treated in the Depar...Objective:To observe the effect of acupuncture and bloodletting therapy at the lumbosacral region for chronic prostatitis.Methods:A total of 36 patients with chronic prostatitis were collected,and treated in the Department of Acupuncture and Moxibustion and the External Treatment Center of Chinese Medicine,Affiliated Hospital of Shandong University of Traditional Chinese medicine.The patients were treated with acupuncture,combined with bloodletting therapy at the lumbosacral region.The treatment for 4 weeks was as one course and 2 consecutive courses of treatment were required.The therapeutic effect,including the score of the National Institute of Health-Chronic prostatitis symptom index(NIH-CPSI),was assessed.Results:After 1 and 2 courses of treatment,the symptom scores and NIH-CPSI total score were all reduced as compared with that before treatment,respectively(all P<0.01).After 2 courses of treatment,the score of each symptom and NIH-CPSI total score were reduced as compared with that after 1 course of treatment,respectively(all P<0.01).Regrading the 3 syndromes/patterns of chronic prostatitis in the patients,i.e.downward invasion of damp heat,qi and blood stagnation and liver qi stagnation,after 1 and 2 courses of treatment,NIH-CPSI total scores were all reduced as compared with that before treatment(all P<0.01).Additionally,after 2 courses of treatment,NIH-CPSI total score of each syndrome/pattern was reduced as compared with that after 1 course of treatment(all P<0.01).For kidney yin deficiency,after 2 courses of treatment,NIH-CPSI total score was reduced as compared with that either before treatment or after 1 course of treatment(both P<0.01).The total effective rate was 91.67%after 1 course of treatment and 97.22%after 2 courses of treatment.No obvious adverse events occurred during the treatment.Conclusion:The combined treatment with acupuncture and bloodletting therapy at the lumbosacral region effectively relieves the symptoms of chronic prostatitis and improves the quality of life in the patients.展开更多
Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functio...Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functional electrical stimulation technology.In this study,the locations of motor function sites in the lumbosacral spinal cord were determined with functional electrical stimulation technology.A three-dimensional map of the lumbosacral spinal cord comprising the relationship between the motor function sites and the corresponding muscle was drawn.Based on the individual experimental parameters and normalized coordinates of the motor function sites,the motor function sites that control a certain muscle were calculated.Phasing pulse sequences were delivered to the determined motor function sites in the spinal cord and hip extension,hip flexion,ankle plantarflexion,and ankle dorsiflexion movements were successfully achieved.The results show that the map of the spinal cord motor function sites was valid.This map can provide guidance for the selection of electrical stimulation sites during the rebuilding of motor function after spinal cord injury.展开更多
Objective: This study evaluated the effectiveness of acupuncture treatment on postoperative pain in patients with degenerative lumbar spine disease, and explored the relationship between the postoperative analgesic ef...Objective: This study evaluated the effectiveness of acupuncture treatment on postoperative pain in patients with degenerative lumbar spine disease, and explored the relationship between the postoperative analgesic effect of acupuncture and the sensation of acupuncture experienced by the patients.Methods: This retrospective study analyzed the medical records of 97 patients who had undergone an operation by the same surgeon due to degenerative lumbar disease. These patients were divided into acupuncture group(n = 32), patient-controlled analgesia(PCA) group(n = 27), and oral analgesia group(n = 38) according to the different postoperative analgesic methods. During their hospitalization, patients completed daily evaluations of their pain using a visual analogue scale(VAS), and injection times of supplemental meperidine were recorded. Also, the Chinese version of the Massachusetts General Hospital Acupuncture Sensation Scale(C-MASS) was used in the acupuncture group.Results: Each of the three treatment groups showed significant reductions in postoperative pain, as shown by reduced VAS scores. The acupuncture group, however, had less rebound pain(P < 0.05) than the other two groups. Both the acupuncture and PCA groups experienced acute analgesic effects that were superior to those in the oral analgesia group. In addition, the higher the C-MASS index on the second day after surgery, the lower the VAS score on the fourth day after surgery. There was also a significant difference in the“dull pain” in the acupuncture sensation.Conclusion: The results demonstrated that acupuncture was beneficial for postoperative pain and discomfort after simple surgery for degenerative spinal disease. It is worth noting that there was a disproportionate relevance between the patient’s acupuncture sensation and the improvement of pain VAS score.展开更多
Relative flexibility between the hamstring and lumbar extensor muscles, which can be evaluated using lumbopelvic curvature during active knee extension in sitting, can sometimes be assessed in physical therapy. Howeve...Relative flexibility between the hamstring and lumbar extensor muscles, which can be evaluated using lumbopelvic curvature during active knee extension in sitting, can sometimes be assessed in physical therapy. However, reliability for its quantitative measure has not been established yet and its establishment was the aim of the current study. Twenty-seven individuals with clinically tight hamstring muscles were recruited. On two separate sessions, the lumbopelvic curvature was evaluated in sitting when the right knee was moved from 90° flexion to 10° flexion on 15 occasions using a flexible ruler by two examiners on Day 1 and one on Day 2. Lines drawn tangential to the lumbopelvic curvature were traced at T12 and S2 vertebral levels and the angle between the two vertical lines was calculated. Using Day 1 data, the minimum number of repetitions and inter-examiner reliability were assessed. Inter-session reliability was also examined. As a result, there was no statistical difference (P?> 0.05) in the mean absolute difference between the mean value of N-1 and N repetitions (6 ≤ N ≤ 15) in the lumbopelvic curvature angle, indicating that five was considered the minimum number of repetitions. Intraclass correlation coefficient (ICC)(1, 5)?for the inter-session reliability and ICC(2, 5)?for the inter-examiner reliability was 0.97 and 0.93, respectively, indicating excellent reliability. The measure for the lumbopelvic curvature during active knee extension in sitting, which was established in the current study, will be a foundation for further research regarding the relative flexibility of the lumbar and adjunct regions.展开更多
文摘Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.
基金Supported by National Key Research and Development Plan,No.2022YFC2504303National Natural Science Foundation of China,No.82072411+1 种基金Guangzhou Area Clinical High-tech and Major Technology Projects,No.2024PL-GX11Internal Medicine Research Fund Project of Huadu District People's Hospital,Guangzhou(Excellent Youth Project),No.2020B06.
文摘BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental health problems.In recent years,the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients'physiological and psychological conditions.There-fore,investigating its clinical efficacy for treating pelvic fractures plus lum-bosacral plexus injuries is of great clinical significance.AIM To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression.METHODS Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach(January 2011 to May 2024)were retrospectively analyzed.The patients'general data were collected via questionnaire.The Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess anxiety and depression,respectively.We adopted a numerical rating scale(NRS)to evaluate pain degree,the Pittsburgh Sleep Quality Index(PSQI)to assess sleep quality,and Medical Research Council(MRC)Scale for Muscle Strength to evaluate treatment efficacy and complications.RESULTS The 136 included patients(92 male,44 female)were a mean 48.02±15.72 years old.The mean SAS score was 66.36±5.15 preoperatively vs 42.15±4.36 postoperatively,while the mean SDS score was 65.61±5.02 preoperatively vs 43.83±4.54 postoperatively,showing statistically significant differences(P<0.05).The mean NRS and PSQI scores were significantly lower pre-vs postoperatively(P<0.05).Postoperatively,67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5,22 achieved an M1-M4,and four achieved an M0.Postoperative motor function improved by a mean 4.20 grades(scale,0-5).Among the patients with old pelvic fractures and nerve injuries,19 achieved an M5,16 achieved an M1-M4,and eight achieved an M0.Motor function improved significantly by a mean 3.30 grades(scale,0-5;P<0.05).No serious postoperative complications occurred.CONCLUSION The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression,relieve pain,improve sleep quality,reduce intraoperative blood loss,and improve postoperative recovery.
文摘AIM: To evaluate two simple angle measurements for predicting lumbosacral transitional vertebra (LSTV) in magnetic resonance imaging (MRI) studies of the spine. METHODS: The lumbar spine MRI studies of 50 subjects with LSTV and 50 subjects with normal lumbosacral anatomy were retrospectively evaluated. In each study, the mid-sagittal T2-weighted image was used to measure the angle formed by a line parallel to the superior surface of the sacrum and a line perpendicular to the axis of the scan table (A-angle), as well as the angle formed by a line parallel to the superior endplate of the L3 vertebra and a line parallel to the superior surface of the sacrum (B-angle). RESULTS: The total study population consisted of 100 subjects (46 males, 54 females, 51 ± 16 years old). There were no differences in age and sex between the two groups. Both A-angle and B-angle were significantly increased in subjects with LSTV compared to controls (P < 0.05). The optimal cut-off values of A-angle and B-angle for the prediction of LSTV were 39.8° (sensitivity = 80%, specificity = 80%, accuracy = 83%; 95% confidence interval = 74%-89%, P = 0.0001) and 35.9° (sensitivity = 80%, specificity = 54%, accuracy = 69%; 95% confidence interval = 59%-78%, P = 0.0005), respectively. CONCLUSION: On sagittal MR images of the lumbar spine, an increased A-angle and/or B-angle should alert the radiologist to the presence of LSTV.
文摘AIM: To test the incremental value of 3T magnetic resonance neurography(MRN) in a series of unilateral radiculopathy patients with non-contributory magnetic resonance imaging(MRI).METHODS: Ten subjects(3 men,7 women; mean age54 year and range 22-74 year) with unilateral lumbar radiculopathy and with previous non-contributory lumbar spine MRI underwent lumbosacral(LS) plexus MRN over a period of one year. Lumbar spine MRI performed as part of the MRN LS protocol as well as bilateral L4-S1 nerves,sciatic,femoral and lateral femoral cutaneous nerves were evaluated in each subject for neuropathy findings on both anatomic(nerve signal,course and caliber alterations) and diffusion tensor imaging(DTI)tensor maps(nerve signal and caliber alterations).Minimum fractional anisotropy(FA) and mean apparent diffusion coeffcient(ADC) of L4-S2 nerve roots,sciatic and femoral nerves were recorded.RESULTS: All anatomic studies and 80% of DTI imaging received a good-excellent imaging quality grading. In a blinded evaluation,all 10 examinations demonstrated neural and/or neuromuscular abnormality corresponding to the site of radiculopathy. A number of contributory neuropathy findings including double crush syndrome were observed. On DTI tensor maps,nerve signal and caliber alterations were more conspicuous. Although individual differences were observed among neuropathic appearing nerve(lower FA and increased ADC) as compared to its contralateral counterpart,there were no significant mean differences on statistical comparison of LS plexus nerves,femoral and sciatic nerves(P > 0.05).CONCLUSION: MRN of LS plexus is useful modality for the evaluation of patients with non-contributory MRI of lumbar spine as it can incrementally delineate the etiology and provide direct objective and non-invasive evidence of neuromuscular pathology.
文摘Sacral fractures following posterior lumbosacral fusion are an uncommon complication. Only a few case series and case reports have been published so far. This article presents a case of totally displaced sacral fracture following posterior L4-S1 fusion in a 65-yearold patient with a 15-year history of corticosteroid use who underwent open reduction and internal fixation using iliac screws. The patient was followed for 2 years. A thorough review of the literature was conducted using the Medline database between 1994 and 2014. Immediately after the revision surgery, the patient's pain in the buttock and left leg resolved significantly. The patient was followed for 2 years. The weakness in the left lower extremity improved gradually from 3/5 to 5/5. In conclusion, the incidence of postoperative sacral fractures could have been underestimated, because most of these fractures are not visible on a plain radiograph. Computed tomography has been proved to be able to detect most such fractures and should probably be performed routinely when patients complain of renewed buttock pain within 3 mo after lumbosacral fusion. The majority of the patients responded well to conservative treatments, and extending the fusion construct to the iliac wings using iliac screws may be needed when there is concurrent fracture displacement, sagittal imbalance, neurologic symptoms, or painful nonunion.
文摘BACKGROUND Intraneural ganglion cysts are benign gelatinous masses that form within the epineurium of a peripheral nerve.Only few cases of intraneural ganglion cyst arising from the hip joint have been reported.CASE SUMMARY A previously healthy 65-year-old woman who had been experiencing left buttock pain radiating to the dorsum of the foot for 2 years visited our clinic.Prior to visiting the clinic,she underwent lumbar spine magnetic resonance imaging and received physiotherapy,pain killers,and epidural injections based on a presumptive diagnosis of spinal stenosis for 2 years in other hospitals.Repeat magnetic resonance imaging revealed joint connection of the articular branch of the hip joint and rostral extension of the cyst along the L5 spinal nerve near the L5-S1 neural foramen.The patient was diagnosed with intraneural ganglion cyst arising from the articular branch of the hip joint based on high-resolution magnetic resonance neurography.Using the arthroscopic approach,a cystic opening within the intra-articular space was detected,and cyst decompression was then performed.The pain in the left leg was significantly relieved during the 6-mo follow-up.CONCLUSION Although intraneural ganglion cysts arising from the hip joint are rare,they can cause typical radicular pain and mimic common L5 radiculopathy.Typical cyst ascent phenomenon starting from the termination of the articular branch on magnetic resonance imaging is a crucial finding indicative of intraneural ganglion cysts arising from the hip joint.
文摘One hundred and twenty-three lumbosacral radiculography in 67 patients, with age range from 15 to 60 years, have been performed during 1984-1986. In this paper, the anatomical concept of the lumbosacral (L<sub>4, 5</sub> and S<sub>1</sub>) nerve root canal and the technique of radiculography are reported. Basing on our results. we suggest different pathologic images of the nerve root canal. The indication and failing causes in performing radiculography are discussed. We believe that nerve root block would be of great diagnostic and therapeutic value in cases of lumbago and sciatica.
文摘Motor root conduction time(MRCT) was calculated by combining the magnetic stimulatiou eliciting motor evoked poentials (MEP)in lumbosacral region with F wave in popliteal rossa.Motor nerve conduction time(MNCT)and MRCT were calculated reliably from the tibialis and the soleal MEPS in 40 patients suffering from L5 or S1 radlculopathies owing to disc protrusion,and in 50 healthy controls.Meanwhile,corticals somatosensory evoked potentials(SEP)were recorded by segmental cutaneous nerve stimulation for comparison.The results showed that no differences were seen in MNCT in all patients,but MRCT was markedly prolonged in 85%or the patients,which was higher than the prolongation of SEP in 45% or the patients.It is concluded that magnetic stimulation of MEP is a useful technique ror non-invasive diagnosis of lumbosacral radlculopathies.
文摘For diagnosiug lumbosacral radicuiopathy precisely, electromyogram(EMG),nerve conduction velocity(NCV),conventional H reflex and H reflex by nerve root stimulation were done in 79 patients with clinical symptoms and signs of lumbosacral radiculopathy.The rate or appearance fibrillation voltage and/or positive sharp wave in the paraspinal muscles was the highest among them.In the comparison of the affected and the healthy sides in patients with S1 radlculopathy,and of affected side and control group,H-M wave interval of H reflex by nerve root stimulation were significantly prolonged(P<0.01,P<0.05);compared with control group,the dirference or H-M wave interval between the two sides was also significantly prolonged (P<0. 05).But the differences were not so significant in patients with L5 radlculopathy.The results suggest that the abnormal changes or EMG or the paraspinal muscles and H reflex by nerve root stimulation are reliable methods of diagnosing lumbosacral radiculopathy, H reflex by nerve root stimulation can be used to differentiate L5 and S1 nerve root lesions,and measure motor conduction velocity(MCV)and sensory conduction velocity(SCV) or the proximal sciatic nerve.
文摘in this study, conical somatosensory evoked potentials (SEPs)following electrical stimulation of the skin of LS and SI dermatomes were recorded cephalically and observed in 19 patients with clinically proved unilateral L5 or S1 nerve root compression, and the results were compared with those of the control group or 20 healthy volunteers and showed that dermatomal SEPs were abnormal in 12 with the rate of 63%,most or which showed abnomalities or the lateral latency difference. It is concluded that dermatomal SEP is a useful addition to the diagnosis or lumbosacral nerve root compression. When the unilateral nerve root is compressed the lateral latency dirference is a most sensitive criterion for indicating abnomality.
文摘Objective. To introduce a new internal fixation system of spine and its characteristics. Methods. To review 16 patients with lumbosacral instability who were treated by this new technique, including their clinical outcomes and radiographic evaluation. Results. Fifteen patients gained complete recovery from their preoperative symptoms. One patient who had experienced two operations before and with problems of urinary and fecal incontinence and walking difficulty still had lower limb pain, muscle weakness and urinary incontinence after operation.There is no evidence of spine glide on X-ray, implant failure, neural complication or infection during follow up. Conclusion. Diapason system can achieve good early postoperative results with few complications and ease to use for lumbosacral instability.
文摘Unilateral reference values for Hoffmann’s amplitude could be applied to the diagnosis of lumbosacral radiculopathy, especially in patients with bilateral lesions. Here, we assessed Hoffmann’s reflex by measuring H-wave amplitude and the ratio of H-wave amplitude to M-wave amplitude (the H/M ratio). We performed a cross-sectional survey of patients from a Taiwan rehabilitation center (n = 64, age 20 - 87) who presented with lower back pain that radiated to the leg and received a referral for electrodiagnostic examinations. Reference values for H-wave profile parameters were determined using data from lumbosacral radiculopathy-negative patients (n = 10, age 22 - 53), who had normal big toe test results, ankle reflex test results, motor and sensory nerve conductive studies and F-wave latency and who displayed no evidence of radiculopathy in electromyography and imaging studies. The 50th percentile values for H/M ratio and H-wave amplitude were 28% and 6.25 mV, respectively. An H-wave profile th percentile (H/M ratio bosacral radiculopathy (n = 64). Approximately 41% of patients with an H-wave profile th percentile showed electromyography-confirmed chronic radiculopathy. Electromyography-confirmed current radiculopathy was observed in 35% of patients with an H/R
文摘Elsberg syndrome, or HSV-2 lumbosacral radiculitis, is a rare and underrecognized neurologic condition that mimics cauda equina syndrome (CES). It typically presents with symptoms such as urinary retention, saddle anesthesia, and bowel incontinence. This case report describes a 59-year-old immunosuppressed male with idiopathic pulmonary fibrosis who developed Elsberg syndrome due to re-activation of latent HSV-2. The patient experienced progressive lower extremity sensory deficits and genitourinary dysfunction, culminating in a vesiculopustular rash. Diagnosis was confirmed via cerebrospinal fluid analysis and PCR testing of skin lesions. Despite early imaging findings being unremarkable, subsequent MRI revealed enhancement of the conus medullaris and cauda equina. Treatment with intravenous acyclovir, corticosteroids, and supportive therapy led to gradual functional improvement, though sensory deficits and neuropathy persisted. This case highlights the diagnostic challenges and importance of clinical suspicion for HSV-2 reactivation in immunosuppressed patients, as well as considerations for long-term symptom management.
文摘Background:Recent studies have suggested an association between elevated pelvic incidence(PI)and the development of lumbar spondylolysis.However,there is still lack of investigation for Hart Chinese people concerning the normal range ofspinopelvic parameters and relationship between abnormal sagittal parameters and lumbar diseases.The objective of the study was to investigate sagittal lumbosacral parameters of adult lumbar spondylolysis patients in Han Chinese population.Methods:A total of 52 adult patients with symptomatic lumbar spondylolysis treated in the General Hospital of Armed Police Force(Beijing,China)were identified as the spondylolysis group.All the 52 patients were divided into two subgroups,Subgroup A:36 patients with simple lumbar spondylolysis,and Subgroup B:16 patients with lumbar spondylolysis accompanying with mild lumbar spondylolisthesis(slip percentage〈30%).Altogether 207 healthy adults were chosen as the control group.All patients and the control group took lumbosacral lateral radiographs.Seven sagittal lumbosacral parameters,including PI,pelvic tilt(PT),sacral slope(SS),lumbar lordosis(LL),L5 incidence,L5 slope,and sacral table angle(STA),were measured in the lateral radiographs.All the parameters aforementioned were compared between the two subgroups and between the spondylolysis group and the control group with independent-sample t-test.Results:There were no statistically significant differences of all seven sagittal lumbosacral parameters between Subgroup A and Subgroup B.PI,PT,SS,and LL were higher(P〈0.05)in the spondylolysis group than those in the control group,but STA was lower(P〈0.001)in the spondylolysis group.Conclusions:Current study results suggest that increased PI and decreased STA may play important roles in the pathology of lumbar spondylolysis in Han Chinese population.
基金supported by Shaanxi University of Chinese Medicine and the First Affiliated Hospital of Shaanxi University of Chinese Medicine
文摘Objective： To observe theclinical effect of tuina reduction manipulation on leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation. Methods： A total of 60eligible cases were randomly allocated into an observation group and a control group, 30 in each group. Cases in the observation group were treated with conventional tuina plus reduction manipulation of sacroiliac joint subluxation; whereas cases in the control group were treated with conventional tuina plus acupuncture. The clinical effects were observed after 10 times of treatment. In addition, the relapse rates were observed 2 months after treatment. Results： The total effective rate in the observation group was 80.0%, versus 50.0% in the control group, showing a statistically significant difference （P＆lt;0.05）. The relapse rate of lumbosacral pain in the observation group was 12.5%, versus 66.7% in the control group, showing a statistically significant difference （P＆lt;0.01）. The relapse rate of leg length discrepancy in the observation group was 16.7%, versus 80.0% in the control group, showing a statistically significant difference （P＆lt;0.01）. Conclusion： Tuina reduction manipulation can obtain substantial therapeutic effect for leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation, coupled with a low relapse rate.
基金the institutional review board of Mingzhou Hospital of Ningbo(No.202208501).
文摘BACKGROUND The pedicle screw technique is widely employed for vertebral body fixation in the treatment of spinal disorders.However,traditional screw placement methods require the dissection of paraspinal muscles and the insertion of pedicle screws at specific transverse section angles(TSA).Larger TSA angles require more force to pull the muscle tissue,which can increase the risk of surgical trauma and ischemic injury to the lumbar muscles.AIM To study the feasibility of zero-degree TSA vertical pedicle screw technique in the lumbosacral segment.METHODS Finite element models of vertebral bodies and pedicle screw-rod systems were established for the L4-S1 spinal segments.A standard axial load of 500 N and a rotational torque of 10 N/m were applied.Simulated screw pull-out experiment was conducted to observe pedicle screw resistance to pull-out,maximum stress,load-displacement ratio,maximum stress in vertebral bodies,load-displacement ratio in vertebral bodies,and the stress distribution in pedicle screws and vertebral bodies.Differences between the 0-degree and 17-degree TSA were compared.RESULTS At 0-degree TSA,the screw pull-out force decreased by 11.35%compared to that at 17-degree TSA(P<0.05).At 0-degree and 17-degree TSA,the stress range in the screw-rod system was 335.1-657.5 MPa and 242.8-648.5 MPa,separately,which were below the fracture threshold for the screw-rod system(924 MPa).At 0-degree and 17-degree TSA,the stress range in the vertebral bodies was 68.45-78.91 MPa and 39.08-72.73 MPa,separately,which were below the typical bone yield stress range for vertebral bodies(110-125 MPa).At 0-degree TSA,the load-displacement ratio for the vertebral bodies and pedicle screws was slightly lower compared to that at 17-degree TSA,indicating slightly lower stability(P<0.05).CONCLUSION The safety and stability of 0-degree TSA are slightly lower,but the risks of screw-rod system fracture,vertebral body fracture,and rupture are within acceptable limits.
基金Supported by Shandong Special Project of High-Level Personnel Training of Traditional Chinese Medicine,Shandong Health Leading Talent Cultivation Special Program。
文摘Objective:To observe the effect of acupuncture and bloodletting therapy at the lumbosacral region for chronic prostatitis.Methods:A total of 36 patients with chronic prostatitis were collected,and treated in the Department of Acupuncture and Moxibustion and the External Treatment Center of Chinese Medicine,Affiliated Hospital of Shandong University of Traditional Chinese medicine.The patients were treated with acupuncture,combined with bloodletting therapy at the lumbosacral region.The treatment for 4 weeks was as one course and 2 consecutive courses of treatment were required.The therapeutic effect,including the score of the National Institute of Health-Chronic prostatitis symptom index(NIH-CPSI),was assessed.Results:After 1 and 2 courses of treatment,the symptom scores and NIH-CPSI total score were all reduced as compared with that before treatment,respectively(all P<0.01).After 2 courses of treatment,the score of each symptom and NIH-CPSI total score were reduced as compared with that after 1 course of treatment,respectively(all P<0.01).Regrading the 3 syndromes/patterns of chronic prostatitis in the patients,i.e.downward invasion of damp heat,qi and blood stagnation and liver qi stagnation,after 1 and 2 courses of treatment,NIH-CPSI total scores were all reduced as compared with that before treatment(all P<0.01).Additionally,after 2 courses of treatment,NIH-CPSI total score of each syndrome/pattern was reduced as compared with that after 1 course of treatment(all P<0.01).For kidney yin deficiency,after 2 courses of treatment,NIH-CPSI total score was reduced as compared with that either before treatment or after 1 course of treatment(both P<0.01).The total effective rate was 91.67%after 1 course of treatment and 97.22%after 2 courses of treatment.No obvious adverse events occurred during the treatment.Conclusion:The combined treatment with acupuncture and bloodletting therapy at the lumbosacral region effectively relieves the symptoms of chronic prostatitis and improves the quality of life in the patients.
基金supported by the National Natural Science Foundation of China,No.81371663,61534003the Top-notch Academic Programs Project of Jiangsu Higher Education Institutions of China,No.PPZY2015B135
文摘Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functional electrical stimulation technology.In this study,the locations of motor function sites in the lumbosacral spinal cord were determined with functional electrical stimulation technology.A three-dimensional map of the lumbosacral spinal cord comprising the relationship between the motor function sites and the corresponding muscle was drawn.Based on the individual experimental parameters and normalized coordinates of the motor function sites,the motor function sites that control a certain muscle were calculated.Phasing pulse sequences were delivered to the determined motor function sites in the spinal cord and hip extension,hip flexion,ankle plantarflexion,and ankle dorsiflexion movements were successfully achieved.The results show that the map of the spinal cord motor function sites was valid.This map can provide guidance for the selection of electrical stimulation sites during the rebuilding of motor function after spinal cord injury.
文摘Objective: This study evaluated the effectiveness of acupuncture treatment on postoperative pain in patients with degenerative lumbar spine disease, and explored the relationship between the postoperative analgesic effect of acupuncture and the sensation of acupuncture experienced by the patients.Methods: This retrospective study analyzed the medical records of 97 patients who had undergone an operation by the same surgeon due to degenerative lumbar disease. These patients were divided into acupuncture group(n = 32), patient-controlled analgesia(PCA) group(n = 27), and oral analgesia group(n = 38) according to the different postoperative analgesic methods. During their hospitalization, patients completed daily evaluations of their pain using a visual analogue scale(VAS), and injection times of supplemental meperidine were recorded. Also, the Chinese version of the Massachusetts General Hospital Acupuncture Sensation Scale(C-MASS) was used in the acupuncture group.Results: Each of the three treatment groups showed significant reductions in postoperative pain, as shown by reduced VAS scores. The acupuncture group, however, had less rebound pain(P < 0.05) than the other two groups. Both the acupuncture and PCA groups experienced acute analgesic effects that were superior to those in the oral analgesia group. In addition, the higher the C-MASS index on the second day after surgery, the lower the VAS score on the fourth day after surgery. There was also a significant difference in the“dull pain” in the acupuncture sensation.Conclusion: The results demonstrated that acupuncture was beneficial for postoperative pain and discomfort after simple surgery for degenerative spinal disease. It is worth noting that there was a disproportionate relevance between the patient’s acupuncture sensation and the improvement of pain VAS score.
文摘Relative flexibility between the hamstring and lumbar extensor muscles, which can be evaluated using lumbopelvic curvature during active knee extension in sitting, can sometimes be assessed in physical therapy. However, reliability for its quantitative measure has not been established yet and its establishment was the aim of the current study. Twenty-seven individuals with clinically tight hamstring muscles were recruited. On two separate sessions, the lumbopelvic curvature was evaluated in sitting when the right knee was moved from 90° flexion to 10° flexion on 15 occasions using a flexible ruler by two examiners on Day 1 and one on Day 2. Lines drawn tangential to the lumbopelvic curvature were traced at T12 and S2 vertebral levels and the angle between the two vertical lines was calculated. Using Day 1 data, the minimum number of repetitions and inter-examiner reliability were assessed. Inter-session reliability was also examined. As a result, there was no statistical difference (P?> 0.05) in the mean absolute difference between the mean value of N-1 and N repetitions (6 ≤ N ≤ 15) in the lumbopelvic curvature angle, indicating that five was considered the minimum number of repetitions. Intraclass correlation coefficient (ICC)(1, 5)?for the inter-session reliability and ICC(2, 5)?for the inter-examiner reliability was 0.97 and 0.93, respectively, indicating excellent reliability. The measure for the lumbopelvic curvature during active knee extension in sitting, which was established in the current study, will be a foundation for further research regarding the relative flexibility of the lumbar and adjunct regions.
