Objective To evaluate the feasibility,safety and efficacy of surgical treatment of the thoracic and thoracolumbar disc herniations through the posterior far lateral approach.Methods From April 2005 to June 2010,24 con...Objective To evaluate the feasibility,safety and efficacy of surgical treatment of the thoracic and thoracolumbar disc herniations through the posterior far lateral approach.Methods From April 2005 to June 2010,24 consecutive patients展开更多
BACKGROUND Arteriovenous fistula is a rare cause of refractory heart failure,and corrective measures may lead to dramatic improvement;however,the long-term cardiac remodeling outcomes,particularly after delayed closur...BACKGROUND Arteriovenous fistula is a rare cause of refractory heart failure,and corrective measures may lead to dramatic improvement;however,the long-term cardiac remodeling outcomes,particularly after delayed closure,remain unclear.CASE SUMMARY A 57-year-old man was admitted to the hospital with complaints of exertional dyspnea for more than 10 years.Physical examination revealed wet crackles in the lungs and a continuous machinery murmur in the left lower back and groin area.Asymmetric edema and varicose veins were observed in the lower limbs.Echocar-diography revealed a dilated right ventricle with severe pulmonary hypertension.Computed tomography revealed a left common iliac arteriovenous fistula linked to prior lumbar disc surgery.Surgical repair resolved the symptoms,with echo-cardiography at 4 months showing a reduced right atrium(RA)and ventricular(RV)diameter and tricuspid regurgitation.However,during the 2-year follow-up,gradual RA and RV re-expansion(from 35 mm to 51 mm and from 26 mm to 46 mm,respectively)was observed,despite sustained clinical stability.CONCLUSION This case highlights that delayed arteriovenous fistula closure may result in in-complete right heart reverse remodeling,even after symptomatic relief.Potential mechanisms include persistent hemodynamic stress from subclinical residual shunting or functional impairment due to chronic volume overload.Early inter-vention before irreversible right heart damage is critical for optimal outcomes.展开更多
Internal herniation(IH)refers to the movement of intra-abdominal organs or tissues out of their original position through normal or abnormal orifices and fissures in the peritoneum or mesentery and into an anatomic sp...Internal herniation(IH)refers to the movement of intra-abdominal organs or tissues out of their original position through normal or abnormal orifices and fissures in the peritoneum or mesentery and into an anatomic space within the abdominal cavity.Although the incidence of small bowel obstruction(SBO)caused by IH is very low(approximately 0.2%to 0.9%),its incidence may be increased in certain specific populations or in postoperative patients.Recently Kaw et al shared their 13-year experience of managing IHs in a tertiary care hospital in India.This retrospective study analyzed and determined the clinico-demographic profiles,radiological and operative findings and postoperative course of patients with IH and the association with SBO.The results provide valuable insights into early diagnosis and establishment of a timely treatment regimen for this condition and emphasize the importance of combining rapid imaging evaluation with the traditional therapeutic approach of laparoscopic surgery,thus providing a novel perspective on the diagnosis and treatment of SBO caused by IH.展开更多
Introduction: Malignant sylvian infarction (MSI) is a type of ischemic stroke (ICS) usually affecting the entire territory of the middle cerebral artery (MCA) associated with significant cerebral edema and a mass. It ...Introduction: Malignant sylvian infarction (MSI) is a type of ischemic stroke (ICS) usually affecting the entire territory of the middle cerebral artery (MCA) associated with significant cerebral edema and a mass. It represents about 10% of all AICs, with a mortality of up to 80%. The objectives of our study were to describe the sociodemographic profile and the main clinical manifestations and identify the prognostic factors of ISM. Material and Methods: We conducted a retrospective descriptive study over a 2-year period. It included patients hospitalized for cerebral infarction involving 2/3 of the ACM territory with a NIHSS score ≥ 17 and/or a Glasgow score Results: We collected 223 patients hospitalized for ischemic stroke, of whom 21 patients (9.4%) presented with ISM. The mean age was 57.43 ± 24.24 years with a male predominance (52.4%). The mean admission time was 47 ± 0.87 hours, and hemiplegia was the frequent neurological sign (85.7%). HBP was the common cardiovascular risk factor (76.2%). The mean NIHSS at admission was 18.38 ± 12.29. Respiratory distress (p-value = 0.00015), aspiration pneumonia (p-value = 0.015) and brain herniation (p-value = 0.014) were the main complications associated with mortality. Conclusion: ISM is associated with poor prognosis in the absence of surgical treatment. Respiratory distress, aspiration pneumonia and brain herniation are associated with high mortality.展开更多
[Objectives]To investigate the clinical efficacy of Cyclic Flexion Traction(CFT)in treating Lumbar Disc Herniation(LDH)and its effects on lumbocrural pain relief,functional improvement,and nerve root decompression.[Me...[Objectives]To investigate the clinical efficacy of Cyclic Flexion Traction(CFT)in treating Lumbar Disc Herniation(LDH)and its effects on lumbocrural pain relief,functional improvement,and nerve root decompression.[Methods]Seventy LDH patients treated at the orthopedic rehabilitation outpatient and inpatient departments of Shiyan Taihe Hospital from June 2022 to December 2024 were randomly divided into a treatment group(CFT therapy,n=35)and a control group(traditional traction,n=35).The treatment group received cyclic flexion traction(traction force of 30%-50%body weight with a cycle of 60-30-30 sec),while the control group received supine position linear traction.Both groups underwent 4 weeks of treatment,with assessments including visual analog scale(VAS),Oswestry Disability Index(ODI),and straight leg raising test(SLRT)angles.[Results]The treatment group showed a significantly greater reduction in VAS scores(from 6.97 to 2.31)compared to the control group(from 6.89 to 3.74)(P<0.05).Similarly,ODI improvement(41.62→15.73 compared with 40.98→22.84)and SLRT angle increase(41.23°→76.47°compared with 42.09°→64.19°)were more pronounced in the treatment group(all P<0.05).[Conclusions]Through dynamic decompression mechanisms,CFT therapy demonstrates superior efficacy to traditional traction in pain relief,functional recovery,and nerve root decompression(effective rate 94.29%compared with 77.14%,P<0.05),representing a superior non-surgical treatment option.展开更多
Background: Lumbar disc herniation is a common injury among athletes, especially those who practice disciplines with repetitive flexion movements, twisting and axial loading on the spine, such as weightlifting, gymnas...Background: Lumbar disc herniation is a common injury among athletes, especially those who practice disciplines with repetitive flexion movements, twisting and axial loading on the spine, such as weightlifting, gymnastics, hockey and American football. In refractory cases to conservative treatment, microscopic discectomy or full endoscopic discectomy are used as surgical options to relieve pain and restore patient functionality. However, the ideal time for a return to sports activities remains a matter of debate due to variations in recovery times and risks of complications associated with each technique. Methods: A review was conducted, including articles published in the last 33 years (1991-2024), as it was the earliest date matching our search criteria. Clinical studies, systematic reviews, meta-analyses, and clinical guidelines were included. Results: The most common complications when returning to sport prematurely include recurrence of the hernia, persistent pain (VAS leg 7 or higher after surgery) and reduced physical performance. The return to full activity rate of patients who underwent microdiscectomy reaches up to 90%, while the endoscopic technique shows a success rate that reaches 99%. Return to play meantime was 5.19 months (range 1.00 - 8.7 months) and mean time of 4.6 months (range 2 - 8 months) with Microdiscectomy and full endoscopic discectomy respectively. Conclusions: There is no unanimous consensus on the exact timing of return to sport due to variability in recovery times and clinical outcomes. In both techniques, evidence highlights the need for a multidisciplinary approach that integrates surgeons, physical therapists and trainers to optimize recovery and ensure a safe return.展开更多
Objective:To explore the effect of combining Duhuo Jisheng decoction with warm acupuncture and moxibustion in the treatment of patients with lumbar disc herniation.Methods:Using a random number table method,a total of...Objective:To explore the effect of combining Duhuo Jisheng decoction with warm acupuncture and moxibustion in the treatment of patients with lumbar disc herniation.Methods:Using a random number table method,a total of 100 patients with lumbar disc herniation treated at Xianning Matang Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were divided into a control group of 50 patients treated with Duhuo Jisheng decoction and a study group of 50 patients treated with Duhuo Jisheng decoction combined with warm acupuncture and moxibustion.The TCM syndrome scores,lumbar function,lumbar pain,and lumbar activity were compared between the two groups.Results:After intervention,the TCM syndrome scores,ODI,and VAS scores of both groups showed a decreasing trend compared to before intervention,and the decreasing trend was more significant in the study group(P<0.05).After intervention,the JOA and lumbar activity indicators of both groups showed an increasing trend compared to before intervention,and the increasing trend was more significant in the study group(P<0.05).Conclusion:Duhuo Jisheng decoction combined with warm acupuncture and moxibustion is an effective and safe treatment method for lumbar disc herniation,which can improve lumbar function and activity.展开更多
BACKGROUND Far lateral lumbar disc herniation(FLLDH)is a special type of lumbar disc herniation with high rate of missed diagnosis.Selective nerve root block(SNRB)has special advantages in identifying the responsible ...BACKGROUND Far lateral lumbar disc herniation(FLLDH)is a special type of lumbar disc herniation with high rate of missed diagnosis.Selective nerve root block(SNRB)has special advantages in identifying the responsible nerve root.Percutaneous transforaminal endoscopic discectomy(PTED)is a minimally invasive and effective method to treat FLLDH.However,no report has investigated PTED combined with SNRB to treat FLLDH.AIM To explore the diagnosis and treatment process,surgical technique and clinical efficacy of PTED combined with SNRB to treat FLLDH.METHODS This is a multicenter center,retrospective,observational study.Between January 2020 and January 2022,32 patients were initially diagnosed with FLLDH.All the patients were identified using SNRB to determine the responsible segment and involved nerve roots.Because of poor symptomatic control following SNRB,2 patients were excluded.30 patients diagnosed with FFLDH underwent PTED.The clinical characteristics,operative and postoperative outcomes,complication and subsequent follow-up were collected.RESULTS 30 patients who underwent SNRB combined with PTED were followed up.The average visual analogue scale(VAS)-leg score,VAS-back score,Oswestry disability index(ODI)score at the Follow-up(1 day,1 month,3 months and last follow-up)were significantly different compared per-operation.According to the modified Macnab efficacy evaluation standard,the satisfaction degree at the last follow-up was excellent(28,93.33%),good(1,3.33%),medium(1,3.33%)and poor(0,0%).CONCLUSION SNRB provides an effective method for the definite diagnosis of FLDH and responsible nerve roots.Combination therapy offers several advantages including minimal invasiveness,precision,effectiveness,safety and low recurrence rates.展开更多
Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern me...Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern medicine.Clinical decisions often must be made within minutes,yet these decisions are traditionally guided by limited information,heuristic reasoning,and past experience.In this context,the rise of medical data mining and real-time analytics offers a transformative opportunity:to extract actionable intelligence from the flood of clinical,imaging,and physiological data already being collected,and to use this intelligence to guide care in real time[1–3](Figure 1).展开更多
Background: Surgical treatment of lumbar disc herniation is a widely debated topic, with several techniques available. Percutaneous endoscopic discectomy (PELD) has gained popularity due to its lower invasiveness comp...Background: Surgical treatment of lumbar disc herniation is a widely debated topic, with several techniques available. Percutaneous endoscopic discectomy (PELD) has gained popularity due to its lower invasiveness compared to conventional techniques such as microdiscectomy/open lumbar microdiscectomy (OLMD)/tubular microdiscectomy (TMD). However, evidence on the effectiveness, recovery time and complications of these techniques is not yet clearly established. This systematic review aims to compare the preoperative and postoperative outcomes of both techniques. Methods: A comprehensive search was performed in databases including PubMed and Cochrane, following strict inclusion and exclusion criteria. Comparative studies and narrative reviews on PELD and OLMD/TMD published between 2019 and 2024 were included. Key outcomes considered were pre- and postoperative Visual Analogue Scale (VAS), hospitalization time, time to return to work, and postoperative complications. Results: The reviewed studies indicated that PELD is associated with a greater reduction in postoperative pain compared to OLMD/TMD, with a significant decrease in VAS, according to the study by Priola et al. (2019). The hospital stay was also shorter for patients undergoing PELD, averaging 2 days compared to OLMD/TMD. Furthermore, PELD favored a faster return to work and had a lower rate of postoperative complications, such as dural tears and reoperations, compared to OLMD/TMD. Conclusions: PELD demonstrates clear advantages over OLMD/TMD in terms of pain reduction, shorter hospital stay, faster return to work, and fewer postoperative complications. However, the implementation of this technique requires a significant learning curve, suggesting that its effectiveness may vary depending on the surgeon’s experience. PELD should be considered a preferred option in the resection of lumbar disc herniations, especially in patients seeking a quick and less invasive recovery.展开更多
Intervertebral disc herniation(IVDH)is a common manifestation of intervertebral disc degeneration(IVDD)characterized by inflammation that results in the rupture of the annulus fibrosus(AF)and her-niation of the nucleu...Intervertebral disc herniation(IVDH)is a common manifestation of intervertebral disc degeneration(IVDD)characterized by inflammation that results in the rupture of the annulus fibrosus(AF)and her-niation of the nucleus pulposus(NP).While current clinical research primarily focuses on regulating the degenerative NP,the crucial role of the AF in maintaining the mechanical stability and metabolic balance of the intervertebral disc(IVD)has been overlooked.Resolving immunoregulation and AF repair is im-perative to effectively prevent recurrent herniation.Therefore,this study introduces a bioactive sealant(OD/GM/QCS-sEVs),which combines gelatin methacryloyl(GM)and oxidized dextran(OD)with quater-nized chitosan(QCS)and incorporates small extracellular vesicles(sEVs).The developed sealant possesses injectability,self-healing capabilities,tissue adhesiveness,and mechanical stability,with an average ad-hesive strength of 109.63 kPa.In vitro experiments demonstrate that OD/GM/QCS-sEVs effectively seal AF defects while preserving mechanical properties comparable to those of a normal IVD.Additionally,the sealant releases sEVs through a pH-responsive mechanism,thereby modulating macrophage polarization to the M2 phenotype via the NF-κB signaling pathway.This mechanism facilitates immunoregulation and anti-inflammatory effects,and promotes stem cell differentiation into fibrocartilage.Animal experiments confirm the ability of OD/GM/QCS-sEVs to seal defects,prevent proteoglycan loss,inhibit IVDD develop-ment,and promote AF regeneration.Overall,OD/GM/QCS-sEVs hold promise as an innovative bioactive sealant for recurrent herniation by resolving immunoregulation and AF regeneration.展开更多
Objective To evaluate the effect of Tai Chi and Qigong on patients with lumbar disc herniation(LDH).Methods Relevant data were retrieved from nine English and Chinese databases,including Cochrane Library,PubMed,and Wa...Objective To evaluate the effect of Tai Chi and Qigong on patients with lumbar disc herniation(LDH).Methods Relevant data were retrieved from nine English and Chinese databases,including Cochrane Library,PubMed,and Wanfang Data,etc.from inception to June 2024.All published randomized controlled trials assessing the effect of Tai Chi and Qigong on visual analog scale(VAS),Japanese Orthopedic Association(JOA)score,and other health indicators in participants with LDH compared to usual medical care or other treatments were included.Grey literature,trials involving the pushing of hands(Tui Shou)or Tai Chi with weapons,and trials with co-interventions(Tai Chi/Qigong plus another treatment)were excluded.Methodological quality was analyzed using the Cochrane risk of bias tool,and evidence quality was assessed using the Grading of Recommendations,Assessment,Development,and Evaluations(GRADE)tool.Results Fourteen trials(954 patients)were included in this study.Tai Chi and Qigong were associated with lower VAS pain scores(standardized mean difference−0.55,95%confidence interval[CI]−0.95 to−0.15,P=0.01),higher JOA scores(mean difference[MD]4.40,95%CI 2.62 to 6.18,P<.001)and straight leg raise test results(MD 9.40°,95%CI 7.64 to 11.15,P<0.001)in patients with LDH.Furthermore,compared with usual care,Tai Chi and Qigong showed enhanced effects on pain and JOA scores.When compared to other exercises or massage,the effect on pain scores was similar but that on JOA scores was significant.Conclusions Tai Chi and Qigong may have favorable effects on VAS pain and JOA scores compared with usual care,and on JOA scores compared with other exercises or massage in patients with LDH.Given the overall poor quality of the evidence,the results of current study should be interpreted cautiously.展开更多
BACKGROUND Whether hyperbaric oxygen therapy(HBOT)can cause paradoxical herniation is still unclear.CASE SUMMARY A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradua...BACKGROUND Whether hyperbaric oxygen therapy(HBOT)can cause paradoxical herniation is still unclear.CASE SUMMARY A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery.HBOT was administered 22 d after surgery due to speech impairment.Paradoxical herniation appeared on the second day after treatment,and the patient’s condition worsened after receiving mannitol treatment at the rehabilitation hospital.After timely skull repair,the paradoxical herniation was resolved,and the patient regained consciousness and had a good recovery as observed at the follow-up visit.CONCLUSION Paradoxical herniation is rare and may be caused by HBOT.However,the underlying mechanism is unknown,and the understanding of this phenomenon is insufficient.The use of mannitol may worsen this condition.Timely skull repair can treat paradoxical herniation and prevent serious complications.展开更多
Objective:To explore the best duration of moxibustion on lumbar disk herniation(LDH).Methods:A total of 88 patients were randomly divided into control group and 15-min,30-min,and 45-min moxibustion groups.The control ...Objective:To explore the best duration of moxibustion on lumbar disk herniation(LDH).Methods:A total of 88 patients were randomly divided into control group and 15-min,30-min,and 45-min moxibustion groups.The control group was treated with conventional therapy,while the other 3 groups were intervened with different moxibustion durations.Low back pain,dysfunction,lumbar function,and effective rates were evaluated before,in the first week and second week of intervention.Results:In low back pain,compared with the control group,the score of the 15-min group had no significant difference,but it was significantly lower in the 30-min and 45-min groups.In dysfunction and lumbar function,compared with the control group,the scores of the 15-min,30-min,and 45-min groups were significantly higher,and the scores of the 30-min and 45-min groups were significantly higher,but there was no significant difference between the 30-min and 45-min group.In effective rates,there was no significant difference between the control group and 15-min group;the effective rates of the 30-min and 45-min groups were significantly higher than those of the control group.Conclusions:Moxibustion has good therapeutic effect on LDH with specific moxibustion time.展开更多
1. Introduction The tegmental wall of the tympanic cavity is a thin plate of the temporal bone that separates the middle cranial fossa(MCF) from the ear. This anatomical region consists of two areas: an anterior one, ...1. Introduction The tegmental wall of the tympanic cavity is a thin plate of the temporal bone that separates the middle cranial fossa(MCF) from the ear. This anatomical region consists of two areas: an anterior one, comprised of the tegmen tympani(To′th et al., 2007), and a posterior one, formed by the tegmen antri and the tegmen mastoideum(Makki et al., 2011). In some patients, the tegmental region of the temporal bone can be interrupted, causing a tegmen defect(TD). A TD is sometimes associated with a meningoencephalic herniation(MEH), in which brain tissue herniates through a TD.展开更多
BACKGROUND Lumbar disc herniation(LDH)commonly occurs during spinal surgery;LDH is on the increase in younger patients and is classified as"paralysis"and"back pain."Sanhanchushi Tongbi(SPST)is a cu...BACKGROUND Lumbar disc herniation(LDH)commonly occurs during spinal surgery;LDH is on the increase in younger patients and is classified as"paralysis"and"back pain."Sanhanchushi Tongbi(SPST)is a customized prescription.It disperses cold,relieves pain,removes cold from the meridians and viscera,and treats neuropathic pain.However,few studies have investigated its mechanism of pain relief.AIM To observe the clinical therapeutic effects on LDH treated with self-prescribed SPST.METHODS A total of 211 patients with LDH syndrome were divided into two groups:107 patients in the control group were treated with conventional massage combined with traction,and 104 patients in the observation group were treated with a combination of the control regimen and self-prescribed oral SPST.The patients were treated for 4 wk.Indices of traditional Chinese medicine(TCM)syndrome score and serum inflammatory factor levels were measured.RESULTS After therapy,the TCM syndrome score in the observation group was significantly lower than that in the control group(P<0.05).The main symptoms,clinical signs,daily activities,and Japanese Orthopedic Association scores in the observation group were significantly higher than those in the control group after therapy(P<0.05).The levels of tumor necrosis factor-α,interleukin-6,and C-reactive protein were lower in the observation group than in the control group(P<0.05).In the observation group,superoxide dismutase levels were significantly higher,whereas malondialdehyde levels were significantly lower,compared with the control group(P<0.05).The overall efficacy rate in the observation group was 96.15%,which was substantially higher than that in the control group(88.79%;P<0.05).CONCLUSION Self-prescribed SPST can reduce the levels of inflammatory and pain-causing factors as well as lumbar pain in patients with LDH.展开更多
BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perfo...BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perform minimally invasive decompressive fusion of the lesioned segment,and the orthopedic surgical robot's intelligence and precision to perform percutaneous pedicle screw placement.The advancement of this procedure lies in the superposition of advantages and offsetting disadvantages of the two new technologies,and the maximum effect of treatment is achieved with maximum minimization of invasiveness and precision under the monitoring of imaging instruments to maximize the benefit of patients,and this review reports a case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE for reference.CASE SUMMARY A 44-year-old patient presented to our hospital.Combining various clinical data,we diagnosed the patient with lumbar disc herniation with radiculopathy,lumbar spondylolisthesis,and lumbar spinal stenosis.We developed a surgical plan of"UBE decompression+UBE-LIF+orthopedic surgery robot-assisted percutaneous pedicle screw implantation for internal fixation".The results were satisfactory.CONCLUSION We present an extremely rare case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE and achieved good results.Therefore,the technique is worthy of clinical promotion.展开更多
Objective: This study aims to evaluate the safety and efficacy of PETD combined with nerve root water imaging of MRI for the treatment of lumbar disc herniation. Methods: A retrospective review was performed on 62 pat...Objective: This study aims to evaluate the safety and efficacy of PETD combined with nerve root water imaging of MRI for the treatment of lumbar disc herniation. Methods: A retrospective review was performed on 62 patients with lumbar disc herniation from March 2019 to March 2021. The study included an experimental group of 30 patients and a control group of 32 patients. The experimental group underwent PETD combined with nerve root water imaging of MRI, while the control group received traditional PETD treatment. The visual analogue scoring method (VAS score), and JOA lumbar spine function score before and after surgery were compared between the two groups, and efficacy was assessed and compared using the MacNab score. Results: The mean operation time was significantly reduced in the experimental group (56.43 ±10.40 minutes) compared to the control group (65.69 ±14.12 minutes). The VAS score was compared between the two groups with preoperative (p = 0.624), one month after surgery (p = 0.325), three months after surgery (p = 0.676), one year after surgery (p = 0.341);The JOA score was compared between the two groups with preoperative (p = 0.961), one month after the surgery (p = 0.266), three months after surgery (p = 0.185), one year after surgery (p = 0.870), they were no significant statistical difference;The efficacy evaluation of the last follow-up Macnab showed that all the 30 patients in the experimental group were excellent, 31 of 32 patients in the control group were excellent, 1 case was good;There was no statistical difference in the comparison between the two groups (p > 0.05). Conclusion: The study concludes that the combined approach of PETD with nerve root water imaging of MRI is a safe, effective, and more efficient alternative to conventional PETD for treating lumbar disc herniation.展开更多
Background:The incidence of lumbar disc herniation(LDH)is notably high.Consensus among experts highlights non-surgical treatments as the primary therapeutic approach for LDH.Contemporary medicine frequently employs ph...Background:The incidence of lumbar disc herniation(LDH)is notably high.Consensus among experts highlights non-surgical treatments as the primary therapeutic approach for LDH.Contemporary medicine frequently employs pharmacotherapy and epidural injections in such treatments,which are associated with numerous adverse effects.Prolonged use can severely impair the liver and kidney functions of patients.Hence,the role of safe and effective traditional Chinese medicine techniques becomes pivotal.Among various traditional Chinese medicine approaches for treating LDH,fire dragon cupping,renowned for its remarkable efficacy,cost-effectiveness,and ease of application,is extensively utilised in clinical settings for managing LDH.Nonetheless,there is a scarcity of systematic and standardised evidence from evidence-based medicine studies.Therefore,conducting a meta-analysis is imperative.Methods:A comprehensive computerised search was conducted in databases including China National Knowledge Infrastructure,WanFang Data,VIP,China Biology Medicine disc,PubMed,EMbase,The Cochrane Library,Web of Science,and CINAHL.The search aimed to gather randomised controlled trials on fire dragon cupping therapy for LDH,spanning from the inception of these databases until December 2023.Two researchers independently screened the literature according to inclusion and exclusion criteria,extracted data,and assessed the methodological quality of the studies included,utilising RevMan 5.3 software for meta-analysis.Results:The results show that the fire dragon cupping therapy group had better clinical effectiveness(relative risk=1.23,95%confidence interval(CI)(1.14,1.33),P<0.00001),less pain(standardized mean difference=–1.33,95%CI(–1.49,–1.16),P<0.00001),and some improvement in lumbar function(Japanese Orthopaedic Association scores:mean difference=3.37,95%CI(2.31,4.43),P<0.00001.Conclusion:The fire dragon cupping therapy significantly alleviates LDH,warranting its extensive application.However,considering the limitations in the number and quality of studies included,the aforementioned conclusion necessitates further validation through more high-quality research.展开更多
The benefits of Lever Positioning Manipulation (LPM) in the treatment of lumbar disc herniation have been widely recognized. The emergence of virtual reality (VR) technology in the field of medicine and the successful...The benefits of Lever Positioning Manipulation (LPM) in the treatment of lumbar disc herniation have been widely recognized. The emergence of virtual reality (VR) technology in the field of medicine and the successful application of augmented reality (AR) technology in the field of surgery have brought new thinking to manipulation researchers on the treatment of lumbar disc herniation (LDH) in the era of artificial intelligence (AI). In this study, the development trend and clinical efficacy of VR technology were discussed from the development process of this technology, and the combination of information interaction technology in the field of chiropractic was found from the existing research approach of lever positioning treatment of LDH, in order to provide a useful reference for researchers.展开更多
文摘Objective To evaluate the feasibility,safety and efficacy of surgical treatment of the thoracic and thoracolumbar disc herniations through the posterior far lateral approach.Methods From April 2005 to June 2010,24 consecutive patients
基金Supported by the Scientific Research Project of Hunan Provincial Health Commission,No.202203012538。
文摘BACKGROUND Arteriovenous fistula is a rare cause of refractory heart failure,and corrective measures may lead to dramatic improvement;however,the long-term cardiac remodeling outcomes,particularly after delayed closure,remain unclear.CASE SUMMARY A 57-year-old man was admitted to the hospital with complaints of exertional dyspnea for more than 10 years.Physical examination revealed wet crackles in the lungs and a continuous machinery murmur in the left lower back and groin area.Asymmetric edema and varicose veins were observed in the lower limbs.Echocar-diography revealed a dilated right ventricle with severe pulmonary hypertension.Computed tomography revealed a left common iliac arteriovenous fistula linked to prior lumbar disc surgery.Surgical repair resolved the symptoms,with echo-cardiography at 4 months showing a reduced right atrium(RA)and ventricular(RV)diameter and tricuspid regurgitation.However,during the 2-year follow-up,gradual RA and RV re-expansion(from 35 mm to 51 mm and from 26 mm to 46 mm,respectively)was observed,despite sustained clinical stability.CONCLUSION This case highlights that delayed arteriovenous fistula closure may result in in-complete right heart reverse remodeling,even after symptomatic relief.Potential mechanisms include persistent hemodynamic stress from subclinical residual shunting or functional impairment due to chronic volume overload.Early inter-vention before irreversible right heart damage is critical for optimal outcomes.
基金Supported by the Chongqing Fundamental Research Funds,No.jbky20210001Performance Incentive-oriented Project of Chongqing,No.jxjl20220006。
文摘Internal herniation(IH)refers to the movement of intra-abdominal organs or tissues out of their original position through normal or abnormal orifices and fissures in the peritoneum or mesentery and into an anatomic space within the abdominal cavity.Although the incidence of small bowel obstruction(SBO)caused by IH is very low(approximately 0.2%to 0.9%),its incidence may be increased in certain specific populations or in postoperative patients.Recently Kaw et al shared their 13-year experience of managing IHs in a tertiary care hospital in India.This retrospective study analyzed and determined the clinico-demographic profiles,radiological and operative findings and postoperative course of patients with IH and the association with SBO.The results provide valuable insights into early diagnosis and establishment of a timely treatment regimen for this condition and emphasize the importance of combining rapid imaging evaluation with the traditional therapeutic approach of laparoscopic surgery,thus providing a novel perspective on the diagnosis and treatment of SBO caused by IH.
文摘Introduction: Malignant sylvian infarction (MSI) is a type of ischemic stroke (ICS) usually affecting the entire territory of the middle cerebral artery (MCA) associated with significant cerebral edema and a mass. It represents about 10% of all AICs, with a mortality of up to 80%. The objectives of our study were to describe the sociodemographic profile and the main clinical manifestations and identify the prognostic factors of ISM. Material and Methods: We conducted a retrospective descriptive study over a 2-year period. It included patients hospitalized for cerebral infarction involving 2/3 of the ACM territory with a NIHSS score ≥ 17 and/or a Glasgow score Results: We collected 223 patients hospitalized for ischemic stroke, of whom 21 patients (9.4%) presented with ISM. The mean age was 57.43 ± 24.24 years with a male predominance (52.4%). The mean admission time was 47 ± 0.87 hours, and hemiplegia was the frequent neurological sign (85.7%). HBP was the common cardiovascular risk factor (76.2%). The mean NIHSS at admission was 18.38 ± 12.29. Respiratory distress (p-value = 0.00015), aspiration pneumonia (p-value = 0.015) and brain herniation (p-value = 0.014) were the main complications associated with mortality. Conclusion: ISM is associated with poor prognosis in the absence of surgical treatment. Respiratory distress, aspiration pneumonia and brain herniation are associated with high mortality.
基金Supported by the Hospital-level Program of Shiyan Taihe Hospital(2022JJXM144).
文摘[Objectives]To investigate the clinical efficacy of Cyclic Flexion Traction(CFT)in treating Lumbar Disc Herniation(LDH)and its effects on lumbocrural pain relief,functional improvement,and nerve root decompression.[Methods]Seventy LDH patients treated at the orthopedic rehabilitation outpatient and inpatient departments of Shiyan Taihe Hospital from June 2022 to December 2024 were randomly divided into a treatment group(CFT therapy,n=35)and a control group(traditional traction,n=35).The treatment group received cyclic flexion traction(traction force of 30%-50%body weight with a cycle of 60-30-30 sec),while the control group received supine position linear traction.Both groups underwent 4 weeks of treatment,with assessments including visual analog scale(VAS),Oswestry Disability Index(ODI),and straight leg raising test(SLRT)angles.[Results]The treatment group showed a significantly greater reduction in VAS scores(from 6.97 to 2.31)compared to the control group(from 6.89 to 3.74)(P<0.05).Similarly,ODI improvement(41.62→15.73 compared with 40.98→22.84)and SLRT angle increase(41.23°→76.47°compared with 42.09°→64.19°)were more pronounced in the treatment group(all P<0.05).[Conclusions]Through dynamic decompression mechanisms,CFT therapy demonstrates superior efficacy to traditional traction in pain relief,functional recovery,and nerve root decompression(effective rate 94.29%compared with 77.14%,P<0.05),representing a superior non-surgical treatment option.
文摘Background: Lumbar disc herniation is a common injury among athletes, especially those who practice disciplines with repetitive flexion movements, twisting and axial loading on the spine, such as weightlifting, gymnastics, hockey and American football. In refractory cases to conservative treatment, microscopic discectomy or full endoscopic discectomy are used as surgical options to relieve pain and restore patient functionality. However, the ideal time for a return to sports activities remains a matter of debate due to variations in recovery times and risks of complications associated with each technique. Methods: A review was conducted, including articles published in the last 33 years (1991-2024), as it was the earliest date matching our search criteria. Clinical studies, systematic reviews, meta-analyses, and clinical guidelines were included. Results: The most common complications when returning to sport prematurely include recurrence of the hernia, persistent pain (VAS leg 7 or higher after surgery) and reduced physical performance. The return to full activity rate of patients who underwent microdiscectomy reaches up to 90%, while the endoscopic technique shows a success rate that reaches 99%. Return to play meantime was 5.19 months (range 1.00 - 8.7 months) and mean time of 4.6 months (range 2 - 8 months) with Microdiscectomy and full endoscopic discectomy respectively. Conclusions: There is no unanimous consensus on the exact timing of return to sport due to variability in recovery times and clinical outcomes. In both techniques, evidence highlights the need for a multidisciplinary approach that integrates surgeons, physical therapists and trainers to optimize recovery and ensure a safe return.
文摘Objective:To explore the effect of combining Duhuo Jisheng decoction with warm acupuncture and moxibustion in the treatment of patients with lumbar disc herniation.Methods:Using a random number table method,a total of 100 patients with lumbar disc herniation treated at Xianning Matang Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were divided into a control group of 50 patients treated with Duhuo Jisheng decoction and a study group of 50 patients treated with Duhuo Jisheng decoction combined with warm acupuncture and moxibustion.The TCM syndrome scores,lumbar function,lumbar pain,and lumbar activity were compared between the two groups.Results:After intervention,the TCM syndrome scores,ODI,and VAS scores of both groups showed a decreasing trend compared to before intervention,and the decreasing trend was more significant in the study group(P<0.05).After intervention,the JOA and lumbar activity indicators of both groups showed an increasing trend compared to before intervention,and the increasing trend was more significant in the study group(P<0.05).Conclusion:Duhuo Jisheng decoction combined with warm acupuncture and moxibustion is an effective and safe treatment method for lumbar disc herniation,which can improve lumbar function and activity.
基金Supported by the National Key R&D Program of China,No.Key Special Project for Marine Environmental Security and Sustainable Development of Coral Reefs 2022-3.5the National Natural Science Foundation of China,No.82102605,82472458,and 82272533.
文摘BACKGROUND Far lateral lumbar disc herniation(FLLDH)is a special type of lumbar disc herniation with high rate of missed diagnosis.Selective nerve root block(SNRB)has special advantages in identifying the responsible nerve root.Percutaneous transforaminal endoscopic discectomy(PTED)is a minimally invasive and effective method to treat FLLDH.However,no report has investigated PTED combined with SNRB to treat FLLDH.AIM To explore the diagnosis and treatment process,surgical technique and clinical efficacy of PTED combined with SNRB to treat FLLDH.METHODS This is a multicenter center,retrospective,observational study.Between January 2020 and January 2022,32 patients were initially diagnosed with FLLDH.All the patients were identified using SNRB to determine the responsible segment and involved nerve roots.Because of poor symptomatic control following SNRB,2 patients were excluded.30 patients diagnosed with FFLDH underwent PTED.The clinical characteristics,operative and postoperative outcomes,complication and subsequent follow-up were collected.RESULTS 30 patients who underwent SNRB combined with PTED were followed up.The average visual analogue scale(VAS)-leg score,VAS-back score,Oswestry disability index(ODI)score at the Follow-up(1 day,1 month,3 months and last follow-up)were significantly different compared per-operation.According to the modified Macnab efficacy evaluation standard,the satisfaction degree at the last follow-up was excellent(28,93.33%),good(1,3.33%),medium(1,3.33%)and poor(0,0%).CONCLUSION SNRB provides an effective method for the definite diagnosis of FLDH and responsible nerve roots.Combination therapy offers several advantages including minimal invasiveness,precision,effectiveness,safety and low recurrence rates.
文摘Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern medicine.Clinical decisions often must be made within minutes,yet these decisions are traditionally guided by limited information,heuristic reasoning,and past experience.In this context,the rise of medical data mining and real-time analytics offers a transformative opportunity:to extract actionable intelligence from the flood of clinical,imaging,and physiological data already being collected,and to use this intelligence to guide care in real time[1–3](Figure 1).
文摘Background: Surgical treatment of lumbar disc herniation is a widely debated topic, with several techniques available. Percutaneous endoscopic discectomy (PELD) has gained popularity due to its lower invasiveness compared to conventional techniques such as microdiscectomy/open lumbar microdiscectomy (OLMD)/tubular microdiscectomy (TMD). However, evidence on the effectiveness, recovery time and complications of these techniques is not yet clearly established. This systematic review aims to compare the preoperative and postoperative outcomes of both techniques. Methods: A comprehensive search was performed in databases including PubMed and Cochrane, following strict inclusion and exclusion criteria. Comparative studies and narrative reviews on PELD and OLMD/TMD published between 2019 and 2024 were included. Key outcomes considered were pre- and postoperative Visual Analogue Scale (VAS), hospitalization time, time to return to work, and postoperative complications. Results: The reviewed studies indicated that PELD is associated with a greater reduction in postoperative pain compared to OLMD/TMD, with a significant decrease in VAS, according to the study by Priola et al. (2019). The hospital stay was also shorter for patients undergoing PELD, averaging 2 days compared to OLMD/TMD. Furthermore, PELD favored a faster return to work and had a lower rate of postoperative complications, such as dural tears and reoperations, compared to OLMD/TMD. Conclusions: PELD demonstrates clear advantages over OLMD/TMD in terms of pain reduction, shorter hospital stay, faster return to work, and fewer postoperative complications. However, the implementation of this technique requires a significant learning curve, suggesting that its effectiveness may vary depending on the surgeon’s experience. PELD should be considered a preferred option in the resection of lumbar disc herniations, especially in patients seeking a quick and less invasive recovery.
基金supported by the National Natural Science Foundation of China(Grant Nos.51873069,52272276,52073103,52203164)the Zhongshan Innovation Project of high-end Scientific Research Institutions(Grant No.2020AG020)+2 种基金the Key-Area Research and Development Program of Guangdong Province(No.2020B090924004)Beijing Municipal Health Commission(Grant Nos.BMHC-2018-4,BMHC-2019-9,PXM2020026275000002)the Postdoctoral Research Foundation of China(No.2022M711183).
文摘Intervertebral disc herniation(IVDH)is a common manifestation of intervertebral disc degeneration(IVDD)characterized by inflammation that results in the rupture of the annulus fibrosus(AF)and her-niation of the nucleus pulposus(NP).While current clinical research primarily focuses on regulating the degenerative NP,the crucial role of the AF in maintaining the mechanical stability and metabolic balance of the intervertebral disc(IVD)has been overlooked.Resolving immunoregulation and AF repair is im-perative to effectively prevent recurrent herniation.Therefore,this study introduces a bioactive sealant(OD/GM/QCS-sEVs),which combines gelatin methacryloyl(GM)and oxidized dextran(OD)with quater-nized chitosan(QCS)and incorporates small extracellular vesicles(sEVs).The developed sealant possesses injectability,self-healing capabilities,tissue adhesiveness,and mechanical stability,with an average ad-hesive strength of 109.63 kPa.In vitro experiments demonstrate that OD/GM/QCS-sEVs effectively seal AF defects while preserving mechanical properties comparable to those of a normal IVD.Additionally,the sealant releases sEVs through a pH-responsive mechanism,thereby modulating macrophage polarization to the M2 phenotype via the NF-κB signaling pathway.This mechanism facilitates immunoregulation and anti-inflammatory effects,and promotes stem cell differentiation into fibrocartilage.Animal experiments confirm the ability of OD/GM/QCS-sEVs to seal defects,prevent proteoglycan loss,inhibit IVDD develop-ment,and promote AF regeneration.Overall,OD/GM/QCS-sEVs hold promise as an innovative bioactive sealant for recurrent herniation by resolving immunoregulation and AF regeneration.
基金supported by a Seed Funding of the Beijing University of Chinese Medicine(90011451310034).
文摘Objective To evaluate the effect of Tai Chi and Qigong on patients with lumbar disc herniation(LDH).Methods Relevant data were retrieved from nine English and Chinese databases,including Cochrane Library,PubMed,and Wanfang Data,etc.from inception to June 2024.All published randomized controlled trials assessing the effect of Tai Chi and Qigong on visual analog scale(VAS),Japanese Orthopedic Association(JOA)score,and other health indicators in participants with LDH compared to usual medical care or other treatments were included.Grey literature,trials involving the pushing of hands(Tui Shou)or Tai Chi with weapons,and trials with co-interventions(Tai Chi/Qigong plus another treatment)were excluded.Methodological quality was analyzed using the Cochrane risk of bias tool,and evidence quality was assessed using the Grading of Recommendations,Assessment,Development,and Evaluations(GRADE)tool.Results Fourteen trials(954 patients)were included in this study.Tai Chi and Qigong were associated with lower VAS pain scores(standardized mean difference−0.55,95%confidence interval[CI]−0.95 to−0.15,P=0.01),higher JOA scores(mean difference[MD]4.40,95%CI 2.62 to 6.18,P<.001)and straight leg raise test results(MD 9.40°,95%CI 7.64 to 11.15,P<0.001)in patients with LDH.Furthermore,compared with usual care,Tai Chi and Qigong showed enhanced effects on pain and JOA scores.When compared to other exercises or massage,the effect on pain scores was similar but that on JOA scores was significant.Conclusions Tai Chi and Qigong may have favorable effects on VAS pain and JOA scores compared with usual care,and on JOA scores compared with other exercises or massage in patients with LDH.Given the overall poor quality of the evidence,the results of current study should be interpreted cautiously.
文摘BACKGROUND Whether hyperbaric oxygen therapy(HBOT)can cause paradoxical herniation is still unclear.CASE SUMMARY A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery.HBOT was administered 22 d after surgery due to speech impairment.Paradoxical herniation appeared on the second day after treatment,and the patient’s condition worsened after receiving mannitol treatment at the rehabilitation hospital.After timely skull repair,the paradoxical herniation was resolved,and the patient regained consciousness and had a good recovery as observed at the follow-up visit.CONCLUSION Paradoxical herniation is rare and may be caused by HBOT.However,the underlying mechanism is unknown,and the understanding of this phenomenon is insufficient.The use of mannitol may worsen this condition.Timely skull repair can treat paradoxical herniation and prevent serious complications.
文摘Objective:To explore the best duration of moxibustion on lumbar disk herniation(LDH).Methods:A total of 88 patients were randomly divided into control group and 15-min,30-min,and 45-min moxibustion groups.The control group was treated with conventional therapy,while the other 3 groups were intervened with different moxibustion durations.Low back pain,dysfunction,lumbar function,and effective rates were evaluated before,in the first week and second week of intervention.Results:In low back pain,compared with the control group,the score of the 15-min group had no significant difference,but it was significantly lower in the 30-min and 45-min groups.In dysfunction and lumbar function,compared with the control group,the scores of the 15-min,30-min,and 45-min groups were significantly higher,and the scores of the 30-min and 45-min groups were significantly higher,but there was no significant difference between the 30-min and 45-min group.In effective rates,there was no significant difference between the control group and 15-min group;the effective rates of the 30-min and 45-min groups were significantly higher than those of the control group.Conclusions:Moxibustion has good therapeutic effect on LDH with specific moxibustion time.
文摘1. Introduction The tegmental wall of the tympanic cavity is a thin plate of the temporal bone that separates the middle cranial fossa(MCF) from the ear. This anatomical region consists of two areas: an anterior one, comprised of the tegmen tympani(To′th et al., 2007), and a posterior one, formed by the tegmen antri and the tegmen mastoideum(Makki et al., 2011). In some patients, the tegmental region of the temporal bone can be interrupted, causing a tegmen defect(TD). A TD is sometimes associated with a meningoencephalic herniation(MEH), in which brain tissue herniates through a TD.
文摘BACKGROUND Lumbar disc herniation(LDH)commonly occurs during spinal surgery;LDH is on the increase in younger patients and is classified as"paralysis"and"back pain."Sanhanchushi Tongbi(SPST)is a customized prescription.It disperses cold,relieves pain,removes cold from the meridians and viscera,and treats neuropathic pain.However,few studies have investigated its mechanism of pain relief.AIM To observe the clinical therapeutic effects on LDH treated with self-prescribed SPST.METHODS A total of 211 patients with LDH syndrome were divided into two groups:107 patients in the control group were treated with conventional massage combined with traction,and 104 patients in the observation group were treated with a combination of the control regimen and self-prescribed oral SPST.The patients were treated for 4 wk.Indices of traditional Chinese medicine(TCM)syndrome score and serum inflammatory factor levels were measured.RESULTS After therapy,the TCM syndrome score in the observation group was significantly lower than that in the control group(P<0.05).The main symptoms,clinical signs,daily activities,and Japanese Orthopedic Association scores in the observation group were significantly higher than those in the control group after therapy(P<0.05).The levels of tumor necrosis factor-α,interleukin-6,and C-reactive protein were lower in the observation group than in the control group(P<0.05).In the observation group,superoxide dismutase levels were significantly higher,whereas malondialdehyde levels were significantly lower,compared with the control group(P<0.05).The overall efficacy rate in the observation group was 96.15%,which was substantially higher than that in the control group(88.79%;P<0.05).CONCLUSION Self-prescribed SPST can reduce the levels of inflammatory and pain-causing factors as well as lumbar pain in patients with LDH.
基金Supported by National Natural Science Foundation of China(Regional Program),No.82060879,No.82360947Gansu Province Key Talent Project,No.2024-4+2 种基金Natural Science Foundation of Gansu Province,No.20JR10RA356Gansu Provincial Joint Research Fund,No.23JRRA1534National Administration of Traditional Chinese Medicine High Level Key Discipline Construction Project of Traditional Chinese Medicine(Traditional Chinese Orthopedics and Traumatology Science),No.203.
文摘BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perform minimally invasive decompressive fusion of the lesioned segment,and the orthopedic surgical robot's intelligence and precision to perform percutaneous pedicle screw placement.The advancement of this procedure lies in the superposition of advantages and offsetting disadvantages of the two new technologies,and the maximum effect of treatment is achieved with maximum minimization of invasiveness and precision under the monitoring of imaging instruments to maximize the benefit of patients,and this review reports a case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE for reference.CASE SUMMARY A 44-year-old patient presented to our hospital.Combining various clinical data,we diagnosed the patient with lumbar disc herniation with radiculopathy,lumbar spondylolisthesis,and lumbar spinal stenosis.We developed a surgical plan of"UBE decompression+UBE-LIF+orthopedic surgery robot-assisted percutaneous pedicle screw implantation for internal fixation".The results were satisfactory.CONCLUSION We present an extremely rare case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE and achieved good results.Therefore,the technique is worthy of clinical promotion.
文摘Objective: This study aims to evaluate the safety and efficacy of PETD combined with nerve root water imaging of MRI for the treatment of lumbar disc herniation. Methods: A retrospective review was performed on 62 patients with lumbar disc herniation from March 2019 to March 2021. The study included an experimental group of 30 patients and a control group of 32 patients. The experimental group underwent PETD combined with nerve root water imaging of MRI, while the control group received traditional PETD treatment. The visual analogue scoring method (VAS score), and JOA lumbar spine function score before and after surgery were compared between the two groups, and efficacy was assessed and compared using the MacNab score. Results: The mean operation time was significantly reduced in the experimental group (56.43 ±10.40 minutes) compared to the control group (65.69 ±14.12 minutes). The VAS score was compared between the two groups with preoperative (p = 0.624), one month after surgery (p = 0.325), three months after surgery (p = 0.676), one year after surgery (p = 0.341);The JOA score was compared between the two groups with preoperative (p = 0.961), one month after the surgery (p = 0.266), three months after surgery (p = 0.185), one year after surgery (p = 0.870), they were no significant statistical difference;The efficacy evaluation of the last follow-up Macnab showed that all the 30 patients in the experimental group were excellent, 31 of 32 patients in the control group were excellent, 1 case was good;There was no statistical difference in the comparison between the two groups (p > 0.05). Conclusion: The study concludes that the combined approach of PETD with nerve root water imaging of MRI is a safe, effective, and more efficient alternative to conventional PETD for treating lumbar disc herniation.
基金supported by the 2022 study on the effectiveness of Fire Dragon Cupping in treating cold-dampness obstructive type shoulder stiffness,funded by the Bao'an District Healthcare Research Project in Shenzhen(Shen Bao Ke[2023]No.13,Project No.2022JD237)2023 study on the therapeutic observation and mechanism exploration of Fire Dragon Cupping in cold-dampness obstructive type acute gout,funded by the Guangdong Provincial Administration of Traditional Chinese Medicine(Yue Zhong Yi Han[2023]No.205,Project No.20242077)+1 种基金National Clinical Key Specialty(Traditional Chinese Medicine)Construction Project(2013-239)Sanming Project of Medicine in Shenzhen(No.SZZYSM202206014).
文摘Background:The incidence of lumbar disc herniation(LDH)is notably high.Consensus among experts highlights non-surgical treatments as the primary therapeutic approach for LDH.Contemporary medicine frequently employs pharmacotherapy and epidural injections in such treatments,which are associated with numerous adverse effects.Prolonged use can severely impair the liver and kidney functions of patients.Hence,the role of safe and effective traditional Chinese medicine techniques becomes pivotal.Among various traditional Chinese medicine approaches for treating LDH,fire dragon cupping,renowned for its remarkable efficacy,cost-effectiveness,and ease of application,is extensively utilised in clinical settings for managing LDH.Nonetheless,there is a scarcity of systematic and standardised evidence from evidence-based medicine studies.Therefore,conducting a meta-analysis is imperative.Methods:A comprehensive computerised search was conducted in databases including China National Knowledge Infrastructure,WanFang Data,VIP,China Biology Medicine disc,PubMed,EMbase,The Cochrane Library,Web of Science,and CINAHL.The search aimed to gather randomised controlled trials on fire dragon cupping therapy for LDH,spanning from the inception of these databases until December 2023.Two researchers independently screened the literature according to inclusion and exclusion criteria,extracted data,and assessed the methodological quality of the studies included,utilising RevMan 5.3 software for meta-analysis.Results:The results show that the fire dragon cupping therapy group had better clinical effectiveness(relative risk=1.23,95%confidence interval(CI)(1.14,1.33),P<0.00001),less pain(standardized mean difference=–1.33,95%CI(–1.49,–1.16),P<0.00001),and some improvement in lumbar function(Japanese Orthopaedic Association scores:mean difference=3.37,95%CI(2.31,4.43),P<0.00001.Conclusion:The fire dragon cupping therapy significantly alleviates LDH,warranting its extensive application.However,considering the limitations in the number and quality of studies included,the aforementioned conclusion necessitates further validation through more high-quality research.
基金Supported by Zhoushan Young and Middle-aged Clinical Famous TCM Physician Project in 2024(Zhoushan Finance and Social Security[2024]No.52).
文摘The benefits of Lever Positioning Manipulation (LPM) in the treatment of lumbar disc herniation have been widely recognized. The emergence of virtual reality (VR) technology in the field of medicine and the successful application of augmented reality (AR) technology in the field of surgery have brought new thinking to manipulation researchers on the treatment of lumbar disc herniation (LDH) in the era of artificial intelligence (AI). In this study, the development trend and clinical efficacy of VR technology were discussed from the development process of this technology, and the combination of information interaction technology in the field of chiropractic was found from the existing research approach of lever positioning treatment of LDH, in order to provide a useful reference for researchers.
