Objective:To observe the effect of acupuncture combined with the Thirteen-posture Tai Chi exercise prescription on the rehabilitation of cervical radiculopathy(CR).Methods:A total of 159 patients diagnosed with CR wer...Objective:To observe the effect of acupuncture combined with the Thirteen-posture Tai Chi exercise prescription on the rehabilitation of cervical radiculopathy(CR).Methods:A total of 159 patients diagnosed with CR were enrolled in a prospective study.They were randomly divided into an acupuncture group,an exercise group,and a combined group using the random number table method,with 53 cases in each group.All three groups received routine Western rehabilitation training.In addition,the acupuncture group was treated with“Si Tian Xue”[four points with“Tian”in their names,including Tianyou(TE16),Tianchuang(SI16),Tianrong(SI17),and Tianding(LI17)]acupuncture.The exercise group practiced according to the Thirteenposture Tai Chi exercise prescription.The combined group received“Si Tian Xue”acupuncture combined with the Thirteen-posture Tai Chi exercise prescription.All interventions lasted for 12 weeks in three groups.The neck disability index(NDI)and visual analog scale(VAS)scores were compared among the three groups before treatment and after 6 and 12 weeks of treatment.Before treatment and after 12-week treatment,the range of motion(ROM)of cervical in left rotation,right rotation,extension,and flexion,as well as the mean power frequency(MPF)of surface electromyography(sEMG)signals of the erector spinae and trapezius,the average blood flow velocity of the vertebral and basilar arteries,and the short-form 36-item health survey(SF-36)score was compared among the three groups.Results:After 6 and 12 weeks of treatment,the NDI and VAS scores of the three groups were significantly lower than those before treatment(P<0.05),and the NDI and VAS scores of the combined group were significantly lower than those of the acupuncture group and the exercise group at the same time points(P<0.05).After treatment,the cervical ROM in left rotation,right rotation,extension,and flexion in the three groups was significantly higher than that before treatment(P<0.05),and the combined group was significantly higher than the acupuncture group and the exercise group(P<0.05).After treatment,the MPF of the erector spinae and trapezius and the average blood flow velocity of the vertebral and basilar arteries in the three groups were significantly higher than those before treatment(P<0.05),and the combined group was significantly higher than the acupuncture group and the exercise group(P<0.05).After treatment,the SF-36 score of the three groups was significantly higher than that before treatment(P<0.05),and it was significantly higher in the combined group than in the acupuncture group and the exercise group(P<0.05).Conclusion:Compared to“Si Tian Xue”acupuncture or the Thirteen-posture Tai Chi exercise prescription alone,the combination of the two can more effectively improve cervical function and microcirculation,relieve pain,and improve the quality of life in patients with CR.展开更多
[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patie...[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patients diagnosed with CSR who received treatment at the International Mongolian Hospital of Inner Mongolia between October 2021 and October 2022 were selected and randomly divided into two groups:A test group and a control group,with 60 patients in each group.The patients in the test group received Mongolian medicine silver needle combined with cupping and bloodletting therapy,following the principles of syndrome differentiation in Mongolian medicine.In contrast,the patients in the control group received only the Mongolian medicine silver needle therapy.After treatment,the Mongolian medicine syndrome scores,visual analogue scale(VAS)scores,and total clinical therapeutic effects in the two groups of patients were compared both prior to and following the treatment.[Results]The improvement in VAS and Mongolian medicine syndrome scores in the test group was greater than that in the control group,with a statistically significant difference(P<0.05).The scores of the test group surpassed those of the control group,and this difference was also statistically significant(P<0.05).Furthermore,the overall therapeutic effect in the test group was 93.33%,which was markedly higher than 76.67%observed in the control group(P<0.05).[Conclusions]The therapeutic effect of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of CSR is remarkable.This approach has demonstrated efficacy in alleviating patient pain and improving the functionality of the cervical vertebrae,thereby warranting clinical promotion and application.展开更多
Traditional Mongolian Medicine(TMM)therapies have emerged as a prominent therapeutic option for Cervical Spondylotic Radiculopathy(CSR),owing to their demonstrated efficacy,cost-effectiveness,and high clinical accessi...Traditional Mongolian Medicine(TMM)therapies have emerged as a prominent therapeutic option for Cervical Spondylotic Radiculopathy(CSR),owing to their demonstrated efficacy,cost-effectiveness,and high clinical accessibility.This study systematically reviews classical Mongolian medical texts to synthesize CSR-related knowledge,including disease profiles,pathogenesis,and therapeutic strategies—through dual analytical perspectives from modern medicine and TMM theory.Furthermore,it critically evaluates recent clinical research on TMM interventions for CSR,encompassing manual therapies,herbal formulations,and holistic regimens.The integrated analysis aims to provide references for optimizing TMM clinical practices in CSR treatment.展开更多
Cervical radiculopathy(CR)poses a significant challenge due to its debilitating impact on physical function,daily activities,psychological well-being,and social engagement.Traditional Chinese Medicine(TCM)has emerged ...Cervical radiculopathy(CR)poses a significant challenge due to its debilitating impact on physical function,daily activities,psychological well-being,and social engagement.Traditional Chinese Medicine(TCM)has emerged as a valuable approach in managing CR.This study aims to present a comprehensive clinical practice guideline for the management of CR through TCM.Utilizing internationally recognized guideline standards,we meticulously developed this guideline.The Grading of Recommendations Assessment,Development,and Evaluation approach was employed to rigorously assess evidence quality and recommendation strength.Recommendations were formulated through the nominal group technique.Expert consensus identified nine clinical questions and twenty-three outcome indicators.After careful consideration of evidence quality,balance of benefits and harms,patient preferences,costs,clinical feasibility,accessibility,and clinical acceptability,the guideline working group formulated seventeen recommendations.These recommendations encompass various aspects such as diagnosis,TCM syndrome types,Chinese medicine compounds,Chinese patent medicines,acupuncture,manual therapy,traditional exercise therapy,surgical indications,and preventive measures.The majority of recommendations were weakly suggested or consensus-based,with the exception of acupuncture and manual therapy,which received strong recommendations.This guideline serves as a valuable resource for enhancing clinical decisionmaking and contributing to the comprehensive management of patients with CR.展开更多
BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which ...BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which has certain limitations of high technical requirements,steep learning curve,and narrow indications.Although unilateral biportal endoscopy(UBE)technique has a gentle learning curve and is gradually applied to treat CSR,all procedures were performed in the uniportal working channel that potentially increase the surgical risk and time in the treatment of complex cases.It is worthy to delve novel technique for more working channels in the treatment of complex CSR.AIM To propose a hybrid technique(HT)that utilizes spine endoscopy in UBE to treatment of CSR.METHODS A total of 81 patients with single-segment CSR who underwent uniportal endoscopic surgery(UES),UBE,or HT at a single institution between September 2019 and August 2021 were retrospectively studied.Perioperative patient data were compared between the groups.The pre-operative and post-operative images were compared to confirm adequate decompression of the nerve root canal.Patients'visual analogue scale(VAS)scores and neck disability index(NDI)were recorded before surgery,and three days,three months and six months after surgery.RESULTS The UBE and HT groups had a significantly shorter operation duration than the UES group.Data for bleeding and length of hospital stay were significantly higher in the UBE group than in the UES and HT groups.The hospitalization cost was lowest in the UES group and highest in the HT group.Soft tissue edema reaction bands on postoperative day 3 were larger in the UBE and HT groups than in the UES group.Post-operative VAS and NDI scores were significantly lower in all three groups than the pre-operative levels.On post-operative day 3,the VAS score for neck pain was significantly higher in the UBE and HT groups than that in the UES group.However,there were no significant differences in the VAS scores for arm pain or NDI between the three groups.The post-operative 3-month and 6-month neck pain VAS,arm pain VAS,NDI,and modified Macnab success rates did not differ statistically between the three groups.CONCLUSION The HT for CSR treatment has the advantage of double working channels to facilitate decompression and hemostasis,improving the surgical efficiency and clinical outcomes of CSR.展开更多
[Objectives]To systematically review the advances in the research of the theoretical basis,clinical efficacy,and mechanisms of Mongolian medical acupuncture for Cervical Spondylotic Radiculopathy(CSR),and to explore i...[Objectives]To systematically review the advances in the research of the theoretical basis,clinical efficacy,and mechanisms of Mongolian medical acupuncture for Cervical Spondylotic Radiculopathy(CSR),and to explore its relationship with the"Khii-Khisu(Wind-blood)"theory.[Methods]Relevant literature from both domestic and international sources was searched.Besides,it summarized the etiology,pathogenesis,clinical manifestations,and treatment principles of CSR in Mongolian medicine,also summarized the commonly used acupoints and combination protocols in Mongolian medical acupuncture,compared the similarities and differences between various acupuncture regimens,and explained the underlying mechanisms in light of the"Wind-blood"theory.[Results]In Mongolian medicine,Cervical Spondylotic Radiculopathy(CSR)is classified as a"Disorder of the White Meridian".Its pathogenesis is considered to be closely associated with the disorder of the Three Life-sustaining Energies(Khii,Shar,Badgan).Clinical studies have demonstrated that Mongolian medical acupuncture can significantly alleviate pain and numbness,and improve cervical spine function in CSR patients.Although there are variations in acupoint selection,the approach consistently emphasizes the combination of local and distal points,highlighting the therapeutic goals of dredging the White Meridian and regulating qi and blood.The"Wind-blood"theory provides a scientific framework for explaining the neurological and inflammatory symptoms of CSR,thereby offering a basis for pattern differentiation and treatment.[Conclusions]Mongolian medical acupuncture for CSR offers the advantages of a solid theoretical basis and established clinical efficacy.However,its advancement in the modern context requires a deeper investigation into its mechanisms,the standardization of operational protocols,and further validation of its efficacy and safety through large-sample,evidence-based studies.展开更多
On the basis of relevant literature and evidence, Clinical Practice Guidelines of Acupuncture-moxibust^on .for Cervical 5pondyloffc Radiculopathy has been formulated according to the quality of evidences and by adopti...On the basis of relevant literature and evidence, Clinical Practice Guidelines of Acupuncture-moxibust^on .for Cervical 5pondyloffc Radiculopathy has been formulated according to the quality of evidences and by adopting the method of Grades of Recommendations Assessment, Development and Evaluation （GRADE）, in which the objective of guidelines formulation, the scope of application of the guidelines, the principle of acupuncture-moxibustion treatment of cervical spondylotic radiculopathy, the time for intervention and different acupuncture-moxibustion regimens, etc. were specified.展开更多
Objective To observe the clinical efficacy of acupuncture plus warming-needle moxibustion for the treatment of cervical spondylotic radiculopathy.Methods Sixty patients with cervical spondylotic radiculopathy were ran...Objective To observe the clinical efficacy of acupuncture plus warming-needle moxibustion for the treatment of cervical spondylotic radiculopathy.Methods Sixty patients with cervical spondylotic radiculopathy were randomly divided into a warming-needle moxibustion group（group A）and an acupuncture group（group B）according to random number table,with thirty cases in each group.For the patients in the group A,Fengchi（风池 GB 20）,Jingjiaji（Jiaji points on the neck）,Dazhui（大椎 GV 14）,Dazhu（大杼 BL 11）,Jugu（巨骨 LI 16）,Tianzong（天宗 SI 11）,Tianliao（天髎 TE 15）,Jianjing（肩井 GB 21） and Hegu（合谷 LI 4） were selected for warming-needle moxibustion.In the group B,Jianliao（肩髎 TE 14）,Jianyu（肩髃 LI 15）,Quchi（曲池 LI 11）,Tianjing（天井 TE 10）,Yangchi（阳池 TE 4）,and Waiguan（外关 TE 5） were selected for acupuncture.Both groups were treated once a day and ten times constituted a course of treatment.Results Compared with the group B,significant differences were observed in the group A after a course of treatment in terms of 20-score scoring for symptoms of cervical spondylotic radiculopathy,VAS scoring and clinical efficacy[16.63±2.31 vs 15.67±2.48,2.36±1.59 vs 3.98±2.32,100%（30/30） vs 86.7%,all P〈0.05].Conclusion Acupuncture plus warming-needle moxibustion can significantly reduce neck pain and improve neck function of patients with cervical spondylotic radiculopathy,which is worthy of clinical application due to its simple manipulation.展开更多
Objective To observe the therapeutic effect of acupuncture at neck Jiájǐ （EX） points and blood-letting puncture with the plum-blossom needle on cervical spondylotic radiculopathy. Methods Sixty cases of cervic...Objective To observe the therapeutic effect of acupuncture at neck Jiájǐ （EX） points and blood-letting puncture with the plum-blossom needle on cervical spondylotic radiculopathy. Methods Sixty cases of cervical spondylotic radiculopathy were divided into a treatment group and a control group with 30 cases in each group. Acupuncture at neck Jiájǐ （EX） points （Extra） and blood-letting puncture with the plum-blossom needle were adopted for the treatment group. And acupuncture at neck Jiájǐ （EX） points was adopted for the control group. The therapeutic effect, visual analogue scale （VAS） and the numbness score were observed after 2 treatment courses. Results The total effective rate of the treatment group was 86.7% （26/30）, while the rate of the control group was 83.3% （25/30）. Comparison of the differences of the two groups was without statistic significance （P0.05）. The VAS scores of the two groups after treatment were both improved （both P0.01）, but without statistic significance between the two groups （P0.05）. The numbness scores of the two groups after treatment were both better than those before treatment （P0.01）. The therapeutic effect on numbness of the extremities of the treatment group was better than that of the control group （P0.05）. Conclusion Blood-letting puncture with the plum flower needle has a satisfactory effect on treatment of numbness of the extremities of patient with cervical spondylotic radiculopathy.展开更多
Objective To systematically evaluate the efficacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy（CSR）. Methods Chinese National Knowledge Infrastructure（CNKI）, China Biology Medi...Objective To systematically evaluate the efficacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy（CSR）. Methods Chinese National Knowledge Infrastructure（CNKI）, China Biology Medical（CBM） database, Chinese Science and Technology Periodical Database（VIP）, Wan Fang Data, Pubmed and Cochrane Library were retrieved to search the randomized controlled trials（RCT） on heat-sensitive moxibustion in treatment of CSR, and Meta analysis was conducted by applying Rev Man 5.3 software. Results Eventually, 10 papers were included in this study, including 1008 subjects. Meta analysis result showed： the total effective rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.13, 95%CI（1.06, 1.21）, Z=3.54, P=0.000 4]; the cure rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.80, 95%CI（1.52, 2.13）, Z=6.82, P〈0.000 01]; the improvement of short-form Mc Gill pain questionnaire（SF-MPQ） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–4.44, 95%CI（–6.38,-2.50）, Z=4.49, P〈0.000 01]; visual analogue scale（VAS） of treatment group was lower than that of control group, and the difference was statistically significant [MD=-0.36, 95%CI（-0.50, –0.23）, Z=5.42, P〈0.00001]; and the improvement of interleukin-6（IL-6） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–7.32, 95%CI（-11.49, –3.14）, Z=3.44, P=0.000 6]. Conclusion It is indicated from the Meta analysis result that the clinical efficacy of heat-sensitive moxibustion or acupuncture combined with heat-sensitive moxibustion in treatment of CSR is superior to that of simple acupuncture or traditional suspended moxibustion, providing a new therapeutic method for treatment of CSR. However, the abovementioned conclusion still needs to be confirmed through randomized blind controlled trials with high quality and large sample size since the sample size of included studies was small, and the quality was low.展开更多
Endoscopic cervical foraminotomy is increasingly used for cervical spondylotic radiculopathy(CSR),but there is great concern about radiation exposure because of the heavy dependence of this surgical method on fluorosc...Endoscopic cervical foraminotomy is increasingly used for cervical spondylotic radiculopathy(CSR),but there is great concern about radiation exposure because of the heavy dependence of this surgical method on fluoroscopy.The objective of this study was to introduce in detail an advanced surgical technique of keyhole foraminotomy via a percutaneous posterior full-endoscopic approach as a treatment for CSR and investigate its clinical outcomes.We retrospectively reviewed 33 consecutive patients with CSR who underwent keyhole foraminotomy via a percutaneous posterior full-endoscopic approach from October 2015 to April 2017.The patients’general characteristics,including operative time,blood loss,hospital stay,complications,and recurrence,were obtained.Clinical outcomes were evaluated using the visual analogue scale(VAS)for radicular pain,the neck disability index(NDI)for functional assessment,and the modified MacNab criteria for patient satisfaction.All operations were successfully performed(mean operation time,62 min),with no measurable blood loss or severe related complications.The mean follow-up was 25 months.The VAS and NDI scores were significantly improved as compared with those in the preoperative period(preoperative vs.final follow-up:7.6±1.6 vs.3.83±7.34 for VAS,P<0.01;69.5%±10.5%vs.17.54%±13.40%for NDI,P<0.01).Of the 33 patients,32(97.0%)had good-to-excellent global outcomes and all patients obtained symptomatic improvement.In conclusion,keyhole foraminotomy via a percutaneous posterior full-endoscopic approach is an efficient,safe,and feasible procedure for the treatment of CSR.Its simplified single-step blunt incision for localization appears to decrease radiation exposure risks.展开更多
OBJECTIVE： To ascertain if it is effective to use extradural injections and manual repositioning of the spine to treat megalgia caused by cervical spondy- Iotic radiculopathy （CSR）. METHODS： Patients with megalgia...OBJECTIVE： To ascertain if it is effective to use extradural injections and manual repositioning of the spine to treat megalgia caused by cervical spondy- Iotic radiculopathy （CSR）. METHODS： Patients with megalgia caused by CSR were divided into a treatment group （n=46） treated by extradural injection and manual repositioning of the spine and a control group （n=46） treated by a conventional method. RESULTS： The prevalence of cure was 58.69% and the total prevalence of effective cure in the treatment group was 97.83% and was 23.91% and 78.26%, respectively, in the control group： this difference between the two groups was significant （P〈 0.05）. CONCLUSION： Treatment of megalgia caused by CSR by extradural injections and manual repositioning of the spine has a good curative effect with rapid analgesia and short therapeutic course.展开更多
BACKGROUND Herpes zoster is a painful infectious disease caused by the varicella zoster virus.Herpes zoster radiculopathy,which is a type of segmental zoster paresis,can complicate the disease and cause motor weakness...BACKGROUND Herpes zoster is a painful infectious disease caused by the varicella zoster virus.Herpes zoster radiculopathy,which is a type of segmental zoster paresis,can complicate the disease and cause motor weakness.This complication should be considered when a patient with a rash complains of acute-onset motor weakness,and the diagnosis can be verified via electrodiagnostic study.CASE SUMMARY A 64-year-old female with a history of asthma presented to the emergency department with stabbing pain,an itching sensation,and a rash on the right anterior shoulder that had begun 5 d prior.Physical examination revealed multiple erythematous grouped vesicles in the right C4-5 and T1 dermatome regions.Because herpes zoster was suspected,the patient immediately received intravenous acyclovir.On the third hospital day,she complained of motor weakness in the right upper extremity.Magnetic resonance imaging of the cervical spine revealed mild intervertebral disc herniation at C4-C5 without evidence of nerve root compression.On the 12th hospital day,electrodiagnostic study revealed right cervical radiculopathy,mainly in the C5/6 roots.Six months later,monoparesis resolved,and follow-up electrodiagnostic study was normal.CONCLUSION This case emphasizes that clinicians should consider the possibility of postherpetic paresis,such as herpes zoster radiculopathy,and that electrodiagnostic study is useful for diagnosis and follow-up.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
Objective To observe the efficacy of treating young patients with cervical spondylosis radiculopathy （CRS） by collateral bloodletting, cupping, and acupoint application. Methods Sixty-one CRS patients were randomly ...Objective To observe the efficacy of treating young patients with cervical spondylosis radiculopathy （CRS） by collateral bloodletting, cupping, and acupoint application. Methods Sixty-one CRS patients were randomly divided into an acupoint application group （group A, 31 cases） and an electroacupuncture group （group B, 30 cases）. Both sides of the spine and scapula were treated with collateral bloodletting, cupping, and acupoint application over Ashi points in group A. The following points received electroacupuncture in group B： Jiaji （夹脊 EX-B2）, Fengchi （风池 GB 20）, Jianjing （肩井 GB 21）, Jianyu （肩髃 LI 15）, Waiguan （外关 TE 5）, Houxi （后溪 SI 3） and Dazhui （大椎 GV 14）. Patients in the two groups were compared in terms of scores for total symptoms and signs, and the theraputic effect of each method was analyzed. Results Total score of symptoms and signs of the two groups were both more significantly improved compared to that before treatment （9.96 ± 2.02 vs 15.87 ± 1.84, P〈0.05 in group A; 10.02 ± 1.76 vs 13.59 ± 1.52, P〈0.05 in group B）. The differences in two groups before and after treatment were 5.91 ± 1.95 in group A, 3.53 ± 1.68 in group B, they were statistically significant （P〈0.05）. The total effective rate of group A [93.6% （29/31）] was better than that of group B [83.3% （25/30）], and the differences were statistically significant （P〈0.05）. Conclusion Good therapeutic effects can be achieved in treating young CRS patients with collateral bloodletting, cupping, and acupoint application.展开更多
BACKGROUND Lumbar radiculopathy is a common symptom in the clinic and is often caused by lumbar disc herniation or osteophytes compressing the nerve root;however,it is rare for nerve roots to be compressed by epidural...BACKGROUND Lumbar radiculopathy is a common symptom in the clinic and is often caused by lumbar disc herniation or osteophytes compressing the nerve root;however,it is rare for nerve roots to be compressed by epidural gas.Few symptomatic epidural gas-containing pseudocyst cases have been reported.Furthermore,the reported cases were due to a mix of gas and obvious osteophytes;therefore,it was hard to rigorously conclude that gas was the factor responsible for radiculopathy.We provide evidence that because no epidural gas accumulated before radiculopathy occurred and the symptoms were relieved after removal of the gas,the epidural gas-containing pseudocyst was the root cause of radiculopathy in this case.CASE SUMMARY An 87-year-old man with a 3-wk history of right radiating pain was admitted to our hospital.Computed tomography(CT)and magnetic resonance imaging(MRI)examinations showed a vacuum phenomenon and huge lesions with low signal intensity located in the same area where the pain occurred.After carefully checking the images acquired in the last 3 mo,we found an abdominal CT examination performed 40 d prior because of abdominal pain.The CT images showed no gas-containing pseudocyst in the epidural space and notably,he had no leg pain at the time.To ensure a low-intensity intervention and complete decompression of the nerve,percutaneous endoscopic lumbar nerve decompression surgery was advised.A gas-containing pseudocyst was identified under endoscopy.The symptoms were relieved after surgery,and the postoperative images showed total disappearance of the vacuum phenomenon and lesions with low signal intensity on CT and MRI.Histological examination showed that the sampled gas-containing pseudocyst tissue was fibrous connective tissue.CONCLUSION This case thoroughly illustrates that an epidural gas-containing pseudocyst can result in radiculopathic pain through a comprehensive evidence chain.Percutaneous endoscopic decompression is a minimally invasive and effective treatment method.展开更多
Introduction: Cervical radiculopathy is caused by either cervical disc herniation or bone spurs due to cervical spine degeneration. It is common in middle aged and elderly patients. Those patients who are refractory t...Introduction: Cervical radiculopathy is caused by either cervical disc herniation or bone spurs due to cervical spine degeneration. It is common in middle aged and elderly patients. Those patients who are refractory to conservative treatment are candidates for surgical management. The surgical approaches for cervical radiculopathy are either anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). In spite of many reports on ACDF and PCF, only a few studies directly compare the outcomes of both techniques. Purpose: To compare anterior cervical discectomy and fusion (ACDF) with posterior cervical foraminotomy (PCF) for the treatment of cervical radiculopathy, regarding the surgical, clinical and radiological outcomes. Patient and methods: This is a prospective randomized controlled clinical study carried on 44 patients with unilateral cervical radiculopathy. They are divided into 2 groups;group (A) included 23 patients who underwent ACDF and group (B) included 21 patients who underwent PCF, with 1 year follow up. The patient age, sex, clinical manifestations, surgical outcomes as number of cervical level, operative time, blood loss, complications and length of hospital stay were recorded. Visual analogus scale (VAS) and neck disability index (NDI) were used for evaluation of clinical outcomes. Postoperative imaging was done after 1 year to detect instability or adjacent level degeneration. Chi-square and unpaired T-test were used to compare the mean values of both groups. Results: The mean age was nearly 45 years for both groups. C5-6 ACDF was the most common level in group (A), while C6-7 PCF was the most frequent operated level in group (B). PCF group had less operative time, blood loss and length of hospital stay than ACDF group. Clinical improvement of the mean values of VAS and NDI were more pronounced in PCF group as compared to ACDF group with statistically significant difference. No cases of cervical instability were recorded during the period of follow up. Conclusion: Posterior cervical foraminotomy is a safe and effective technique for the treatment of cervical radiculopathy as compared to anterior cervical discectomy and fusion. PCF has a shorter operative time, less hospital stay and better clinical outcome.展开更多
BACKGROUND Extensive research revealed the absence of reports documenting hypertensive emergencies precipitated by changes in the cervical spine posture.CASE SUMMARY We here present a 57-year-old woman diagnosed as ha...BACKGROUND Extensive research revealed the absence of reports documenting hypertensive emergencies precipitated by changes in the cervical spine posture.CASE SUMMARY We here present a 57-year-old woman diagnosed as having cervical spondylotic radiculopathy(CSR)who was scheduled for anterior cervical decompression and fusion.During post-anesthetic positioning,a sudden hypertensive surge was observed when the patient was in a supine position with the neck being slightly extended.This surge was promptly reversed through cervical flexion and head elevation.This event however required an alternate surgical approach for recovery—posterior laminoplasty and endoscopy-assisted nucleus pulposus removal.Following the 6-month outpatient follow-up period,cervical flexion and extension activities substantially improved in the patient without any episodes of increase in acute blood pressure.CONCLUSION Maintaining a safe hypotensive posture and performing rapid,thorough deco-mpression surgery may serve as effective interventions for patients presenting symptoms similar to those of CSR accompanied by hypertensive emergencies(HE).This would mitigate the underlying causes of these HEs.展开更多
OBJECTIVE: To evaluate the pain scores and rehabilitation of patientis with cervical spondylotic radiculopathy receiving massage therapy combined with traction and ultrashort wave therapy. METHODS: A total of 84 patie...OBJECTIVE: To evaluate the pain scores and rehabilitation of patientis with cervical spondylotic radiculopathy receiving massage therapy combined with traction and ultrashort wave therapy. METHODS: A total of 84 patients with cervical spondylotic radiculopathy treated in 105 Hospital of People's Liberation Army from June 2014 to June 2017 were included and divided into study group and control group according to different treatment regimens. A total of 42 patients in the study group was treated with cervical traction, ultrashort wave and massage therapy at the same time, whereas the other 42 patients in the control group were only treated with cervical traction and ultrashort wave. Comparison of the clinical efficacy and adverse reactions of the 2 groups was made and the Visual Analogue Scale (VAS) scores before and after treatment were observed to assess the patient's pain. Comparison of rehabilitation in the 2 groups was made by applying the Clinical Assessment Scale for Cervical Spondylosis (CASCS). RESULTS: After comparing the therapeutic effect between the study group and the control group, it showed that the total effective rate (90.48%) in the study group was significantly higher than that in the control group (73.81%), the difference was statistically significant (P < 0.05). By comparing the incidence of adverse reactions in the study group and the control group, results showed that the incidence of adverse reactions such as nausea, palpitations, vomiting, sweating, dizziness and colorless complexion in the study group (9.52%) was significantly lower than that in the control group (21.43%), the difference was statistically significant (P < 0.05). After the treatment, the VAS pain scores of the study group and the control group were both significantly improved (P < 0.05), but the improvement of the patients in the study group was more significantly (P < 0.05), and the difference was statistically significant. After treatment, the CASCS scores of the patients in the study group and the control group were significantly improved (P < 0.05), but the improvement of the study group was more (P < 0.05), and there was statistically significant difference. CONCLUSION: The combination of massage, traction and ultrashort wave therapy can significantly reduce the pain and reduce the incidence of adverse reactions in patients with cervical spondylotic radiculopathy, which is of great clinical significance to the rehabilitation of patients.展开更多
The purpose of this paper is to study the clinical effect of using traditional Chinese medicine rehabilitation model to treat patientswith cervicalspondylotic radiculopathy.Choosing 84 patients with cervicalspondyloti...The purpose of this paper is to study the clinical effect of using traditional Chinese medicine rehabilitation model to treat patientswith cervicalspondylotic radiculopathy.Choosing 84 patients with cervicalspondylotic radiculopathy, who used to be treated in our hospital,anddividing them into control group and treatment group by the way of random grouping,each group has 42 patients.The control group was treatedwith conventional therapy, and the treatment group was treated with rehabilitation therapy of traditional Chinese medicine.The time of symptomdisappearance of cervical spondylopathy of patients and total time of the implementation of treatment plan of the treatment group are shorterthan that of the control group,the difference between groups is remarkable（P〈0.05）;Only 2 adverse reactions occurred during the treatmentperiod,and only 4 patients relapsed within 3 months after treatment,this is significantly less than the 9 patients and 15 patients of the controlgroup,the difference is remarkable（P〈0.05）;The improvement range of clinical symptom score before and after treatment is greater than thatof the control group,difference between groups is remarkable（P〈0.05）;Total effective rate of treatment of cervicalspondylotic radiculopathyreaches 90.5%,which is higher than that of the control group（69.0%）,the difference is remarkable（P〈0.05）.Adopting traditional Chinese medicinerehabilitation model to treat patients with cervicalspondylotic radiculopathy can improve symptoms in a short period of time,reduce adversereactions,reduce the possibility of recurrence after treatment.展开更多
文摘Objective:To observe the effect of acupuncture combined with the Thirteen-posture Tai Chi exercise prescription on the rehabilitation of cervical radiculopathy(CR).Methods:A total of 159 patients diagnosed with CR were enrolled in a prospective study.They were randomly divided into an acupuncture group,an exercise group,and a combined group using the random number table method,with 53 cases in each group.All three groups received routine Western rehabilitation training.In addition,the acupuncture group was treated with“Si Tian Xue”[four points with“Tian”in their names,including Tianyou(TE16),Tianchuang(SI16),Tianrong(SI17),and Tianding(LI17)]acupuncture.The exercise group practiced according to the Thirteenposture Tai Chi exercise prescription.The combined group received“Si Tian Xue”acupuncture combined with the Thirteen-posture Tai Chi exercise prescription.All interventions lasted for 12 weeks in three groups.The neck disability index(NDI)and visual analog scale(VAS)scores were compared among the three groups before treatment and after 6 and 12 weeks of treatment.Before treatment and after 12-week treatment,the range of motion(ROM)of cervical in left rotation,right rotation,extension,and flexion,as well as the mean power frequency(MPF)of surface electromyography(sEMG)signals of the erector spinae and trapezius,the average blood flow velocity of the vertebral and basilar arteries,and the short-form 36-item health survey(SF-36)score was compared among the three groups.Results:After 6 and 12 weeks of treatment,the NDI and VAS scores of the three groups were significantly lower than those before treatment(P<0.05),and the NDI and VAS scores of the combined group were significantly lower than those of the acupuncture group and the exercise group at the same time points(P<0.05).After treatment,the cervical ROM in left rotation,right rotation,extension,and flexion in the three groups was significantly higher than that before treatment(P<0.05),and the combined group was significantly higher than the acupuncture group and the exercise group(P<0.05).After treatment,the MPF of the erector spinae and trapezius and the average blood flow velocity of the vertebral and basilar arteries in the three groups were significantly higher than those before treatment(P<0.05),and the combined group was significantly higher than the acupuncture group and the exercise group(P<0.05).After treatment,the SF-36 score of the three groups was significantly higher than that before treatment(P<0.05),and it was significantly higher in the combined group than in the acupuncture group and the exercise group(P<0.05).Conclusion:Compared to“Si Tian Xue”acupuncture or the Thirteen-posture Tai Chi exercise prescription alone,the combination of the two can more effectively improve cervical function and microcirculation,relieve pain,and improve the quality of life in patients with CR.
基金Supported by Project of Science and Technology Department of Inner Mongolia Autonomous Region(2019GG125).
文摘[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patients diagnosed with CSR who received treatment at the International Mongolian Hospital of Inner Mongolia between October 2021 and October 2022 were selected and randomly divided into two groups:A test group and a control group,with 60 patients in each group.The patients in the test group received Mongolian medicine silver needle combined with cupping and bloodletting therapy,following the principles of syndrome differentiation in Mongolian medicine.In contrast,the patients in the control group received only the Mongolian medicine silver needle therapy.After treatment,the Mongolian medicine syndrome scores,visual analogue scale(VAS)scores,and total clinical therapeutic effects in the two groups of patients were compared both prior to and following the treatment.[Results]The improvement in VAS and Mongolian medicine syndrome scores in the test group was greater than that in the control group,with a statistically significant difference(P<0.05).The scores of the test group surpassed those of the control group,and this difference was also statistically significant(P<0.05).Furthermore,the overall therapeutic effect in the test group was 93.33%,which was markedly higher than 76.67%observed in the control group(P<0.05).[Conclusions]The therapeutic effect of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of CSR is remarkable.This approach has demonstrated efficacy in alleviating patient pain and improving the functionality of the cervical vertebrae,thereby warranting clinical promotion and application.
基金Supported by Science and Technology Program of Inner Mongolia Autonomous Region"Clinical Observation of Warm Needling Acupuncture of Mongolian Medicine in the Treatment of Lumbar Disc Herniation"(2019GG125).
文摘Traditional Mongolian Medicine(TMM)therapies have emerged as a prominent therapeutic option for Cervical Spondylotic Radiculopathy(CSR),owing to their demonstrated efficacy,cost-effectiveness,and high clinical accessibility.This study systematically reviews classical Mongolian medical texts to synthesize CSR-related knowledge,including disease profiles,pathogenesis,and therapeutic strategies—through dual analytical perspectives from modern medicine and TMM theory.Furthermore,it critically evaluates recent clinical research on TMM interventions for CSR,encompassing manual therapies,herbal formulations,and holistic regimens.The integrated analysis aims to provide references for optimizing TMM clinical practices in CSR treatment.
基金the National Traditional Chinese Medicine Inheritance and Innovation Team Project:Innovation Team for Traditional Chinese Medicine Prevention and Treatment of Degenerative Bone and Joint Diseases(No.ZYYCXTDC-202003)2022 Young Qihuang Scholars Training Program(The letter of Department of Personnel and Education,National Administration of Traditional Chinese Medicine[2022]No.256)+1 种基金Cross Cooperation Project of Beijing Nova Program of Science and Technology:Research on High-Precision Digital Traditional Chinese Medicine Manipulation Therapy Combining Medicine and Engineering(No.20220484228)Special Project on Evidence-based Clinical Research of Traditional Chinese Medicine in the High-level Traditional Chinese Medicine Hospital Construction Project of Wangjing Hospital,China Academy of Chinese Medical Sciences:Research on the Dose-Effect Regularity of Cervical Rotation Traction Manipulation in Treating Cervical Radiculopathy and Its Mechanism of Regulating Peripheral Muscle-Cerebral Cortex Hemodynamics(No.WJYY-XZKT-2023-05)。
文摘Cervical radiculopathy(CR)poses a significant challenge due to its debilitating impact on physical function,daily activities,psychological well-being,and social engagement.Traditional Chinese Medicine(TCM)has emerged as a valuable approach in managing CR.This study aims to present a comprehensive clinical practice guideline for the management of CR through TCM.Utilizing internationally recognized guideline standards,we meticulously developed this guideline.The Grading of Recommendations Assessment,Development,and Evaluation approach was employed to rigorously assess evidence quality and recommendation strength.Recommendations were formulated through the nominal group technique.Expert consensus identified nine clinical questions and twenty-three outcome indicators.After careful consideration of evidence quality,balance of benefits and harms,patient preferences,costs,clinical feasibility,accessibility,and clinical acceptability,the guideline working group formulated seventeen recommendations.These recommendations encompass various aspects such as diagnosis,TCM syndrome types,Chinese medicine compounds,Chinese patent medicines,acupuncture,manual therapy,traditional exercise therapy,surgical indications,and preventive measures.The majority of recommendations were weakly suggested or consensus-based,with the exception of acupuncture and manual therapy,which received strong recommendations.This guideline serves as a valuable resource for enhancing clinical decisionmaking and contributing to the comprehensive management of patients with CR.
基金Supported by the Provincial Natural Science Foundation of Gansu,No.24JRRF008Science and Technology Research Project of Songjiang District,No.2024SJKJGG105+1 种基金National Natural Science Foundation of China,No.82202694Clinical Research Innovation Plan of Shanghai General Hospital,No.CTCCR-2021C10.
文摘BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which has certain limitations of high technical requirements,steep learning curve,and narrow indications.Although unilateral biportal endoscopy(UBE)technique has a gentle learning curve and is gradually applied to treat CSR,all procedures were performed in the uniportal working channel that potentially increase the surgical risk and time in the treatment of complex cases.It is worthy to delve novel technique for more working channels in the treatment of complex CSR.AIM To propose a hybrid technique(HT)that utilizes spine endoscopy in UBE to treatment of CSR.METHODS A total of 81 patients with single-segment CSR who underwent uniportal endoscopic surgery(UES),UBE,or HT at a single institution between September 2019 and August 2021 were retrospectively studied.Perioperative patient data were compared between the groups.The pre-operative and post-operative images were compared to confirm adequate decompression of the nerve root canal.Patients'visual analogue scale(VAS)scores and neck disability index(NDI)were recorded before surgery,and three days,three months and six months after surgery.RESULTS The UBE and HT groups had a significantly shorter operation duration than the UES group.Data for bleeding and length of hospital stay were significantly higher in the UBE group than in the UES and HT groups.The hospitalization cost was lowest in the UES group and highest in the HT group.Soft tissue edema reaction bands on postoperative day 3 were larger in the UBE and HT groups than in the UES group.Post-operative VAS and NDI scores were significantly lower in all three groups than the pre-operative levels.On post-operative day 3,the VAS score for neck pain was significantly higher in the UBE and HT groups than that in the UES group.However,there were no significant differences in the VAS scores for arm pain or NDI between the three groups.The post-operative 3-month and 6-month neck pain VAS,arm pain VAS,NDI,and modified Macnab success rates did not differ statistically between the three groups.CONCLUSION The HT for CSR treatment has the advantage of double working channels to facilitate decompression and hemostasis,improving the surgical efficiency and clinical outcomes of CSR.
基金Supported by 2023 Traditional Chinese(Mongolian)Medicine Science and Technology Program Project of Inner Mongolia Autonomous Region Health Commission(ZMY-2023207).
文摘[Objectives]To systematically review the advances in the research of the theoretical basis,clinical efficacy,and mechanisms of Mongolian medical acupuncture for Cervical Spondylotic Radiculopathy(CSR),and to explore its relationship with the"Khii-Khisu(Wind-blood)"theory.[Methods]Relevant literature from both domestic and international sources was searched.Besides,it summarized the etiology,pathogenesis,clinical manifestations,and treatment principles of CSR in Mongolian medicine,also summarized the commonly used acupoints and combination protocols in Mongolian medical acupuncture,compared the similarities and differences between various acupuncture regimens,and explained the underlying mechanisms in light of the"Wind-blood"theory.[Results]In Mongolian medicine,Cervical Spondylotic Radiculopathy(CSR)is classified as a"Disorder of the White Meridian".Its pathogenesis is considered to be closely associated with the disorder of the Three Life-sustaining Energies(Khii,Shar,Badgan).Clinical studies have demonstrated that Mongolian medical acupuncture can significantly alleviate pain and numbness,and improve cervical spine function in CSR patients.Although there are variations in acupoint selection,the approach consistently emphasizes the combination of local and distal points,highlighting the therapeutic goals of dredging the White Meridian and regulating qi and blood.The"Wind-blood"theory provides a scientific framework for explaining the neurological and inflammatory symptoms of CSR,thereby offering a basis for pattern differentiation and treatment.[Conclusions]Mongolian medical acupuncture for CSR offers the advantages of a solid theoretical basis and established clinical efficacy.However,its advancement in the modern context requires a deeper investigation into its mechanisms,the standardization of operational protocols,and further validation of its efficacy and safety through large-sample,evidence-based studies.
文摘On the basis of relevant literature and evidence, Clinical Practice Guidelines of Acupuncture-moxibust^on .for Cervical 5pondyloffc Radiculopathy has been formulated according to the quality of evidences and by adopting the method of Grades of Recommendations Assessment, Development and Evaluation （GRADE）, in which the objective of guidelines formulation, the scope of application of the guidelines, the principle of acupuncture-moxibustion treatment of cervical spondylotic radiculopathy, the time for intervention and different acupuncture-moxibustion regimens, etc. were specified.
文摘Objective To observe the clinical efficacy of acupuncture plus warming-needle moxibustion for the treatment of cervical spondylotic radiculopathy.Methods Sixty patients with cervical spondylotic radiculopathy were randomly divided into a warming-needle moxibustion group（group A）and an acupuncture group（group B）according to random number table,with thirty cases in each group.For the patients in the group A,Fengchi（风池 GB 20）,Jingjiaji（Jiaji points on the neck）,Dazhui（大椎 GV 14）,Dazhu（大杼 BL 11）,Jugu（巨骨 LI 16）,Tianzong（天宗 SI 11）,Tianliao（天髎 TE 15）,Jianjing（肩井 GB 21） and Hegu（合谷 LI 4） were selected for warming-needle moxibustion.In the group B,Jianliao（肩髎 TE 14）,Jianyu（肩髃 LI 15）,Quchi（曲池 LI 11）,Tianjing（天井 TE 10）,Yangchi（阳池 TE 4）,and Waiguan（外关 TE 5） were selected for acupuncture.Both groups were treated once a day and ten times constituted a course of treatment.Results Compared with the group B,significant differences were observed in the group A after a course of treatment in terms of 20-score scoring for symptoms of cervical spondylotic radiculopathy,VAS scoring and clinical efficacy[16.63±2.31 vs 15.67±2.48,2.36±1.59 vs 3.98±2.32,100%（30/30） vs 86.7%,all P〈0.05].Conclusion Acupuncture plus warming-needle moxibustion can significantly reduce neck pain and improve neck function of patients with cervical spondylotic radiculopathy,which is worthy of clinical application due to its simple manipulation.
文摘Objective To observe the therapeutic effect of acupuncture at neck Jiájǐ （EX） points and blood-letting puncture with the plum-blossom needle on cervical spondylotic radiculopathy. Methods Sixty cases of cervical spondylotic radiculopathy were divided into a treatment group and a control group with 30 cases in each group. Acupuncture at neck Jiájǐ （EX） points （Extra） and blood-letting puncture with the plum-blossom needle were adopted for the treatment group. And acupuncture at neck Jiájǐ （EX） points was adopted for the control group. The therapeutic effect, visual analogue scale （VAS） and the numbness score were observed after 2 treatment courses. Results The total effective rate of the treatment group was 86.7% （26/30）, while the rate of the control group was 83.3% （25/30）. Comparison of the differences of the two groups was without statistic significance （P0.05）. The VAS scores of the two groups after treatment were both improved （both P0.01）, but without statistic significance between the two groups （P0.05）. The numbness scores of the two groups after treatment were both better than those before treatment （P0.01）. The therapeutic effect on numbness of the extremities of the treatment group was better than that of the control group （P0.05）. Conclusion Blood-letting puncture with the plum flower needle has a satisfactory effect on treatment of numbness of the extremities of patient with cervical spondylotic radiculopathy.
基金Supported by Anhui Provincial Colleges science research platform team building program:2015TD033Provincial demonstrating experiment and practice training center:20100541
文摘Objective To systematically evaluate the efficacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy（CSR）. Methods Chinese National Knowledge Infrastructure（CNKI）, China Biology Medical（CBM） database, Chinese Science and Technology Periodical Database（VIP）, Wan Fang Data, Pubmed and Cochrane Library were retrieved to search the randomized controlled trials（RCT） on heat-sensitive moxibustion in treatment of CSR, and Meta analysis was conducted by applying Rev Man 5.3 software. Results Eventually, 10 papers were included in this study, including 1008 subjects. Meta analysis result showed： the total effective rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.13, 95%CI（1.06, 1.21）, Z=3.54, P=0.000 4]; the cure rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.80, 95%CI（1.52, 2.13）, Z=6.82, P〈0.000 01]; the improvement of short-form Mc Gill pain questionnaire（SF-MPQ） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–4.44, 95%CI（–6.38,-2.50）, Z=4.49, P〈0.000 01]; visual analogue scale（VAS） of treatment group was lower than that of control group, and the difference was statistically significant [MD=-0.36, 95%CI（-0.50, –0.23）, Z=5.42, P〈0.00001]; and the improvement of interleukin-6（IL-6） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–7.32, 95%CI（-11.49, –3.14）, Z=3.44, P=0.000 6]. Conclusion It is indicated from the Meta analysis result that the clinical efficacy of heat-sensitive moxibustion or acupuncture combined with heat-sensitive moxibustion in treatment of CSR is superior to that of simple acupuncture or traditional suspended moxibustion, providing a new therapeutic method for treatment of CSR. However, the abovementioned conclusion still needs to be confirmed through randomized blind controlled trials with high quality and large sample size since the sample size of included studies was small, and the quality was low.
文摘Endoscopic cervical foraminotomy is increasingly used for cervical spondylotic radiculopathy(CSR),but there is great concern about radiation exposure because of the heavy dependence of this surgical method on fluoroscopy.The objective of this study was to introduce in detail an advanced surgical technique of keyhole foraminotomy via a percutaneous posterior full-endoscopic approach as a treatment for CSR and investigate its clinical outcomes.We retrospectively reviewed 33 consecutive patients with CSR who underwent keyhole foraminotomy via a percutaneous posterior full-endoscopic approach from October 2015 to April 2017.The patients’general characteristics,including operative time,blood loss,hospital stay,complications,and recurrence,were obtained.Clinical outcomes were evaluated using the visual analogue scale(VAS)for radicular pain,the neck disability index(NDI)for functional assessment,and the modified MacNab criteria for patient satisfaction.All operations were successfully performed(mean operation time,62 min),with no measurable blood loss or severe related complications.The mean follow-up was 25 months.The VAS and NDI scores were significantly improved as compared with those in the preoperative period(preoperative vs.final follow-up:7.6±1.6 vs.3.83±7.34 for VAS,P<0.01;69.5%±10.5%vs.17.54%±13.40%for NDI,P<0.01).Of the 33 patients,32(97.0%)had good-to-excellent global outcomes and all patients obtained symptomatic improvement.In conclusion,keyhole foraminotomy via a percutaneous posterior full-endoscopic approach is an efficient,safe,and feasible procedure for the treatment of CSR.Its simplified single-step blunt incision for localization appears to decrease radiation exposure risks.
文摘OBJECTIVE： To ascertain if it is effective to use extradural injections and manual repositioning of the spine to treat megalgia caused by cervical spondy- Iotic radiculopathy （CSR）. METHODS： Patients with megalgia caused by CSR were divided into a treatment group （n=46） treated by extradural injection and manual repositioning of the spine and a control group （n=46） treated by a conventional method. RESULTS： The prevalence of cure was 58.69% and the total prevalence of effective cure in the treatment group was 97.83% and was 23.91% and 78.26%, respectively, in the control group： this difference between the two groups was significant （P〈 0.05）. CONCLUSION： Treatment of megalgia caused by CSR by extradural injections and manual repositioning of the spine has a good curative effect with rapid analgesia and short therapeutic course.
文摘BACKGROUND Herpes zoster is a painful infectious disease caused by the varicella zoster virus.Herpes zoster radiculopathy,which is a type of segmental zoster paresis,can complicate the disease and cause motor weakness.This complication should be considered when a patient with a rash complains of acute-onset motor weakness,and the diagnosis can be verified via electrodiagnostic study.CASE SUMMARY A 64-year-old female with a history of asthma presented to the emergency department with stabbing pain,an itching sensation,and a rash on the right anterior shoulder that had begun 5 d prior.Physical examination revealed multiple erythematous grouped vesicles in the right C4-5 and T1 dermatome regions.Because herpes zoster was suspected,the patient immediately received intravenous acyclovir.On the third hospital day,she complained of motor weakness in the right upper extremity.Magnetic resonance imaging of the cervical spine revealed mild intervertebral disc herniation at C4-C5 without evidence of nerve root compression.On the 12th hospital day,electrodiagnostic study revealed right cervical radiculopathy,mainly in the C5/6 roots.Six months later,monoparesis resolved,and follow-up electrodiagnostic study was normal.CONCLUSION This case emphasizes that clinicians should consider the possibility of postherpetic paresis,such as herpes zoster radiculopathy,and that electrodiagnostic study is useful for diagnosis and follow-up.
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Objective To observe the efficacy of treating young patients with cervical spondylosis radiculopathy （CRS） by collateral bloodletting, cupping, and acupoint application. Methods Sixty-one CRS patients were randomly divided into an acupoint application group （group A, 31 cases） and an electroacupuncture group （group B, 30 cases）. Both sides of the spine and scapula were treated with collateral bloodletting, cupping, and acupoint application over Ashi points in group A. The following points received electroacupuncture in group B： Jiaji （夹脊 EX-B2）, Fengchi （风池 GB 20）, Jianjing （肩井 GB 21）, Jianyu （肩髃 LI 15）, Waiguan （外关 TE 5）, Houxi （后溪 SI 3） and Dazhui （大椎 GV 14）. Patients in the two groups were compared in terms of scores for total symptoms and signs, and the theraputic effect of each method was analyzed. Results Total score of symptoms and signs of the two groups were both more significantly improved compared to that before treatment （9.96 ± 2.02 vs 15.87 ± 1.84, P〈0.05 in group A; 10.02 ± 1.76 vs 13.59 ± 1.52, P〈0.05 in group B）. The differences in two groups before and after treatment were 5.91 ± 1.95 in group A, 3.53 ± 1.68 in group B, they were statistically significant （P〈0.05）. The total effective rate of group A [93.6% （29/31）] was better than that of group B [83.3% （25/30）], and the differences were statistically significant （P〈0.05）. Conclusion Good therapeutic effects can be achieved in treating young CRS patients with collateral bloodletting, cupping, and acupoint application.
基金the Top-notch Young Talent of Chongqing Traditional Chinese Medicine,No.CQSZYY2020008Natural Science Foundation of Chongqing,No.cstc2020jcyj-msxm2234Capacity Building Project of Traditional Chinese Medicine Service for Public Health Emergencies in Chongqing Hospital of Traditional Chinese Medicine,No.cqszyy2020yjzx13.
文摘BACKGROUND Lumbar radiculopathy is a common symptom in the clinic and is often caused by lumbar disc herniation or osteophytes compressing the nerve root;however,it is rare for nerve roots to be compressed by epidural gas.Few symptomatic epidural gas-containing pseudocyst cases have been reported.Furthermore,the reported cases were due to a mix of gas and obvious osteophytes;therefore,it was hard to rigorously conclude that gas was the factor responsible for radiculopathy.We provide evidence that because no epidural gas accumulated before radiculopathy occurred and the symptoms were relieved after removal of the gas,the epidural gas-containing pseudocyst was the root cause of radiculopathy in this case.CASE SUMMARY An 87-year-old man with a 3-wk history of right radiating pain was admitted to our hospital.Computed tomography(CT)and magnetic resonance imaging(MRI)examinations showed a vacuum phenomenon and huge lesions with low signal intensity located in the same area where the pain occurred.After carefully checking the images acquired in the last 3 mo,we found an abdominal CT examination performed 40 d prior because of abdominal pain.The CT images showed no gas-containing pseudocyst in the epidural space and notably,he had no leg pain at the time.To ensure a low-intensity intervention and complete decompression of the nerve,percutaneous endoscopic lumbar nerve decompression surgery was advised.A gas-containing pseudocyst was identified under endoscopy.The symptoms were relieved after surgery,and the postoperative images showed total disappearance of the vacuum phenomenon and lesions with low signal intensity on CT and MRI.Histological examination showed that the sampled gas-containing pseudocyst tissue was fibrous connective tissue.CONCLUSION This case thoroughly illustrates that an epidural gas-containing pseudocyst can result in radiculopathic pain through a comprehensive evidence chain.Percutaneous endoscopic decompression is a minimally invasive and effective treatment method.
文摘Introduction: Cervical radiculopathy is caused by either cervical disc herniation or bone spurs due to cervical spine degeneration. It is common in middle aged and elderly patients. Those patients who are refractory to conservative treatment are candidates for surgical management. The surgical approaches for cervical radiculopathy are either anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). In spite of many reports on ACDF and PCF, only a few studies directly compare the outcomes of both techniques. Purpose: To compare anterior cervical discectomy and fusion (ACDF) with posterior cervical foraminotomy (PCF) for the treatment of cervical radiculopathy, regarding the surgical, clinical and radiological outcomes. Patient and methods: This is a prospective randomized controlled clinical study carried on 44 patients with unilateral cervical radiculopathy. They are divided into 2 groups;group (A) included 23 patients who underwent ACDF and group (B) included 21 patients who underwent PCF, with 1 year follow up. The patient age, sex, clinical manifestations, surgical outcomes as number of cervical level, operative time, blood loss, complications and length of hospital stay were recorded. Visual analogus scale (VAS) and neck disability index (NDI) were used for evaluation of clinical outcomes. Postoperative imaging was done after 1 year to detect instability or adjacent level degeneration. Chi-square and unpaired T-test were used to compare the mean values of both groups. Results: The mean age was nearly 45 years for both groups. C5-6 ACDF was the most common level in group (A), while C6-7 PCF was the most frequent operated level in group (B). PCF group had less operative time, blood loss and length of hospital stay than ACDF group. Clinical improvement of the mean values of VAS and NDI were more pronounced in PCF group as compared to ACDF group with statistically significant difference. No cases of cervical instability were recorded during the period of follow up. Conclusion: Posterior cervical foraminotomy is a safe and effective technique for the treatment of cervical radiculopathy as compared to anterior cervical discectomy and fusion. PCF has a shorter operative time, less hospital stay and better clinical outcome.
文摘BACKGROUND Extensive research revealed the absence of reports documenting hypertensive emergencies precipitated by changes in the cervical spine posture.CASE SUMMARY We here present a 57-year-old woman diagnosed as having cervical spondylotic radiculopathy(CSR)who was scheduled for anterior cervical decompression and fusion.During post-anesthetic positioning,a sudden hypertensive surge was observed when the patient was in a supine position with the neck being slightly extended.This surge was promptly reversed through cervical flexion and head elevation.This event however required an alternate surgical approach for recovery—posterior laminoplasty and endoscopy-assisted nucleus pulposus removal.Following the 6-month outpatient follow-up period,cervical flexion and extension activities substantially improved in the patient without any episodes of increase in acute blood pressure.CONCLUSION Maintaining a safe hypotensive posture and performing rapid,thorough deco-mpression surgery may serve as effective interventions for patients presenting symptoms similar to those of CSR accompanied by hypertensive emergencies(HE).This would mitigate the underlying causes of these HEs.
文摘OBJECTIVE: To evaluate the pain scores and rehabilitation of patientis with cervical spondylotic radiculopathy receiving massage therapy combined with traction and ultrashort wave therapy. METHODS: A total of 84 patients with cervical spondylotic radiculopathy treated in 105 Hospital of People's Liberation Army from June 2014 to June 2017 were included and divided into study group and control group according to different treatment regimens. A total of 42 patients in the study group was treated with cervical traction, ultrashort wave and massage therapy at the same time, whereas the other 42 patients in the control group were only treated with cervical traction and ultrashort wave. Comparison of the clinical efficacy and adverse reactions of the 2 groups was made and the Visual Analogue Scale (VAS) scores before and after treatment were observed to assess the patient's pain. Comparison of rehabilitation in the 2 groups was made by applying the Clinical Assessment Scale for Cervical Spondylosis (CASCS). RESULTS: After comparing the therapeutic effect between the study group and the control group, it showed that the total effective rate (90.48%) in the study group was significantly higher than that in the control group (73.81%), the difference was statistically significant (P < 0.05). By comparing the incidence of adverse reactions in the study group and the control group, results showed that the incidence of adverse reactions such as nausea, palpitations, vomiting, sweating, dizziness and colorless complexion in the study group (9.52%) was significantly lower than that in the control group (21.43%), the difference was statistically significant (P < 0.05). After the treatment, the VAS pain scores of the study group and the control group were both significantly improved (P < 0.05), but the improvement of the patients in the study group was more significantly (P < 0.05), and the difference was statistically significant. After treatment, the CASCS scores of the patients in the study group and the control group were significantly improved (P < 0.05), but the improvement of the study group was more (P < 0.05), and there was statistically significant difference. CONCLUSION: The combination of massage, traction and ultrashort wave therapy can significantly reduce the pain and reduce the incidence of adverse reactions in patients with cervical spondylotic radiculopathy, which is of great clinical significance to the rehabilitation of patients.
文摘The purpose of this paper is to study the clinical effect of using traditional Chinese medicine rehabilitation model to treat patientswith cervicalspondylotic radiculopathy.Choosing 84 patients with cervicalspondylotic radiculopathy, who used to be treated in our hospital,anddividing them into control group and treatment group by the way of random grouping,each group has 42 patients.The control group was treatedwith conventional therapy, and the treatment group was treated with rehabilitation therapy of traditional Chinese medicine.The time of symptomdisappearance of cervical spondylopathy of patients and total time of the implementation of treatment plan of the treatment group are shorterthan that of the control group,the difference between groups is remarkable（P〈0.05）;Only 2 adverse reactions occurred during the treatmentperiod,and only 4 patients relapsed within 3 months after treatment,this is significantly less than the 9 patients and 15 patients of the controlgroup,the difference is remarkable（P〈0.05）;The improvement range of clinical symptom score before and after treatment is greater than thatof the control group,difference between groups is remarkable（P〈0.05）;Total effective rate of treatment of cervicalspondylotic radiculopathyreaches 90.5%,which is higher than that of the control group（69.0%）,the difference is remarkable（P〈0.05）.Adopting traditional Chinese medicinerehabilitation model to treat patients with cervicalspondylotic radiculopathy can improve symptoms in a short period of time,reduce adversereactions,reduce the possibility of recurrence after treatment.
