OBJECTIVE: To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation(TCSOM) in treating chondromalacia patellae(CP).METHODS: Sixty cases of CP patients were randomly assigned to a TCSOM gro...OBJECTIVE: To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation(TCSOM) in treating chondromalacia patellae(CP).METHODS: Sixty cases of CP patients were randomly assigned to a TCSOM group and a Celecoxib group according to the random number table method. All patients in the TCSOM group were treated with a maximum of 10 spinal manipulations and rehabilitation training of quadriceps femoris. The symptoms before and after treatment were assessed with visual analog scale(VAS) and Kujala functional knee scoring system(KFKSS). A symptom improvement rate(SIR) was implemented in order to evaluate the effects of the treatments.RESULTS: The symptoms of 16 patients in the TC-SOM group quickly resolved after the first spinal manipulation and 8 cases were significantly improved. The VAS scores in the TCSOM group after 4weeks of treatment were significantly lower than those in the Celecoxib group. The KFKSS scores in the TCSOM group after 4 weeks of treatment were significantly higher than those in the Celecoxib group. Side effects of the treatment were not reported. Symptom improvement rate based on the VAS in the TCSOM group indicated more significant improvements than the Celecoxib group.CONCLUSION: TCSOM has greater efficacy than Celecoxib capsules for relief of the symptoms of CP.展开更多
OBJECTIVE:To investigate the effect of spinal manipulation(SM)on degenerative scoliosis by evaluating patients’visual analog scale(VAS)scores,Cobb angles,sagittal vertical axis(SVA),and apical vertebral rotation(AVR)...OBJECTIVE:To investigate the effect of spinal manipulation(SM)on degenerative scoliosis by evaluating patients’visual analog scale(VAS)scores,Cobb angles,sagittal vertical axis(SVA),and apical vertebral rotation(AVR)and to explore factors that influence treatment effect.METHODS:A total of 55 patients with degenerative scoliosis received 4 weeks of SM.After treatment,patients were divided into two groups:the remission group(VAS score<40 mm)and the non-remission group(VAS score≥40 mm).Pre-versus post-treatment VAS scores,Cobb angles,SVA,and AVR were compared in each group and in the total population.Baseline data(sex,age,symptom characteristics,duration of symptoms,VAS score,Cobb angle,SVA,and AVR)were compared between groups.Factors influencing the post-treatment VAS score were explored with multiple linear regression analysis.RESULTS:No changes were found in the Cobb angle(P=0.722)or AVR(P=0.424)after intervention in the overall population.However,the SVA(P<0.001)and VAS score(P=0.000)changed significantly after treatment.Similar changes were observed in the remission group(n=29).Multiple linear regression revealed that the only factors influencing treatment effect were symptom characteristics,SVA,and VAS score.CONCLUSION:SM relieved pain and improved sagittal imbalance in patients with degenerative scoliosis.It did not lessen the severity of coronal curvature or vertebral rotation.Factors influencing the effect of SM included symptom characteristics,VAS score,and SVA.A larger randomized trial is needed to further confirm our results.展开更多
Ninety-four patients with lumbar intervertebral disc herniation were enrolled in this study. Of these, 48 were treated with Feng＇s Spinal Manipulation, hot fomentation, and bed rest （treatment group）. The remaining...Ninety-four patients with lumbar intervertebral disc herniation were enrolled in this study. Of these, 48 were treated with Feng＇s Spinal Manipulation, hot fomentation, and bed rest （treatment group）. The remaining 46 patients were treated with hot fomentation and bed rest only （control group）. After 3 weeks of treatment, clinical parameters including the angle of straight-leg raising, visual analogue scale pain score, and Japanese Orthopaedic Association score for low back pain were improved. The treatment group had significantly better improvement in scores than the control group. Magnetic resonance myelography three-dimensional reconstruction imaging of the vertebral canal demonstrated that filling of the compressed nerve root sleeve with cerebrospinal fluid increased significantly in the treatment group. The diameter of the nerve root sleeve was significantly larger in the treatment group than in the control group. However, the sagittal diameter index of the herniated nucleus pulposus and the angle between the nerve root sleeve and the thecal sac did not change significantly in either the treatment or control groups. The effectiveness of Feng＇s Spinal Manipulation for the treatment of symptoms associated with lumbar intervertebral disc herniation may be attributable to the relief of nerve root compression, without affecting the herniated nucleus pulposus or changing the morphology or position of the nerve root.展开更多
Spinal manipulation is a manual treatment technique that delivers a thrust,using specific biomechanical parameters to exert its therapeutic effects.These parameters have been shown to have a unique dose-response relat...Spinal manipulation is a manual treatment technique that delivers a thrust,using specific biomechanical parameters to exert its therapeutic effects.These parameters have been shown to have a unique dose-response relationship with the physiological responses of the therapy.So far,however,there has not been a unified approach to standardize these biomechanical characteristics.In fact,it is still undetermined how they affect the observed clinical outcomes of spinal manipulation.This study,therefore,reviewed the current body of literature to explore these dosage parameters and evaluate their significance,with respect to physiological and clinical outcomes.From the experimental studies reviewed herein,it is evident that the modulation of manipulation’s biomechanical parameters elicits transient physiological responses,including changes in neuronal activity,electromyographic responses,spinal stiffness,muscle spindle responses,paraspinal muscle activity,vertebral displacement,and segmental and intersegmental acceleration responses.However,to date,there have been few clinical trials that tested the therapeutic relevance of these changes.In addition,there were some inherent limitations in both human and animal models due to the use of mechanical devices to apply the thrust.Future studies evaluating the effects of varying biomechanical parameters of spinal manipulation should include clinicians to deliver the therapy in order to explore the true clinical significance of the dose-response relationship.展开更多
BACKGROUND Spinal manipulation therapy(SMT)has been widely used worldwide to treat musculoskeletal diseases,but it can cause serious adverse events.Spinal epidural hematoma(SEH)caused by SMT is a rare emergency that c...BACKGROUND Spinal manipulation therapy(SMT)has been widely used worldwide to treat musculoskeletal diseases,but it can cause serious adverse events.Spinal epidural hematoma(SEH)caused by SMT is a rare emergency that can cause neurological dysfunction.We herein report three cases of SEH after SMT.CASE SUMMARY The first case was a 30-year-old woman who experienced neck pain and numbness in both upper limbs immediately after SMT.Her symptoms persisted after 3 d of conservative treatment,and she was admitted to our hospital.Magnetic resonance imaging(MRI)demonstrated an SEH,extending from C6 to C7.The second case was a 55-year-old man with sudden back pain 1 d after SMT,numbness in both lower limbs,an inability to stand or walk,and difficulty urinating.MRI revealed an SEH,extending from T1 to T3.The third case was a 28-year-old man who suddenly developed symptoms of numbness in both lower limbs 4 h after SMT.He was unable to stand or walk and experienced mild back pain.MRI revealed an SEH,extending from T1 to T2.All three patients underwent surgery after failed conservative treatment.The three cases recovered to ASIA grade E on day 5,1 wk,and day 10 after surgery,respectively.All patients returned to normal after 3 mo of follow-up.CONCLUSION SEH caused by SMT is very rare,and the condition of each patient should be evaluated in full detail before operation.SEH should be diagnosed immediately and actively treated by surgery.展开更多
Traditional Chinese spinal orthopedic manipulation(TCSOM)is an external therapeutic method of traumatology and orthopedics of traditional Chinese medicine to treat trauma and set bone.The doctor exerts his force throu...Traditional Chinese spinal orthopedic manipulation(TCSOM)is an external therapeutic method of traumatology and orthopedics of traditional Chinese medicine to treat trauma and set bone.The doctor exerts his force through thumb or bilateral upper extremities on the spine or acupoints of the patient,applying various manipulatory techniques according to the conditions.Correcting the abnormal position or state of the spine serve as the most important theoretical foundation for TCSOM to treat spinal disorders and spinogenic disorders.This paper presented the definition and function of the TCSOM,with a special focus on how to make a preliminary diagnosis of spinal segments disorders,and the indications of TCSOM in different spinal segments.展开更多
OBJECTIVE:To determine the clinical effect,treatment times,and rheoencephalogram changes in vertebral artery type cervical spondylosis patients treated with innovative Tuina manipulations.METHODS:One hundred and twent...OBJECTIVE:To determine the clinical effect,treatment times,and rheoencephalogram changes in vertebral artery type cervical spondylosis patients treated with innovative Tuina manipulations.METHODS:One hundred and twenty six cervical spondylosis patients(vertebral artery type) were randomly divided into test and control groups.Patients in the test group were treated with innovative Tuina manipulations,while those in the control group were treated with the routine Tuina manipulations according to the textbook of Chinese Massage for Acupuncture and Moxibustion majors.The clinical effects,treatment times,clinical symptoms,and cerebral blood flow were measured.RESULTS:The response to the treatment was 100% in the test group and 88.71% in the control group.Patients in the test group required(7 ± 4) treatments before recovery,while those in the control group required(15 ± 7) treatments before recovery(P<0.05).The clinical symptoms exhibited greater improvement in the test group compared to the control group(P<0.05).There were no differences in cerebral blood flow between the two groups.CONCLUSION:Both innovative Tuina manipulations and routine Tuina manipulations produced satisfactory therapeutic results in vertebral artery type cervical spondylosis patients.However,the innovative manipulation was more effective in improving the functional symptoms,although there were no changes in the cerebral blood flow.展开更多
Spinal cord injury（SCI）is a devastating ailment that results in drastic life style alterations for the patients and their family members（Mc Donald and Sadowsky,2002）.Damage post injury causes necrosis,edema,hemorr...Spinal cord injury（SCI）is a devastating ailment that results in drastic life style alterations for the patients and their family members（Mc Donald and Sadowsky,2002）.Damage post injury causes necrosis,edema,hemorrhage and vasospasm.Post injury,secondary damage is caused by ischemia,展开更多
Spinal cord injury（SCI）is a traumatic event that can lead to permanent motor and sensory deficits.After the initial trauma,axons of surviving neurons rapidly retract.While there may be a small degree of abortive spr...Spinal cord injury（SCI）is a traumatic event that can lead to permanent motor and sensory deficits.After the initial trauma,axons of surviving neurons rapidly retract.While there may be a small degree of abortive sprouting,virtually all attempts at robust regrowth across the lesion site ultimately fail.Thus,neurons below the level of the injury are permanently disconnected from their normal input,resulting in persistent loss of function.展开更多
Objective:To investigate the clinical efficacy of spinal subtle adjustment manipulation combined with acupuncture in the treatment of lumbar disc herniation(LDH).Methods:A total of 94 patients with LDH were enrolled a...Objective:To investigate the clinical efficacy of spinal subtle adjustment manipulation combined with acupuncture in the treatment of lumbar disc herniation(LDH).Methods:A total of 94 patients with LDH were enrolled and randomly divided into a control group and an observation group using a random number table method,with 47 cases in each group.The control group received acupuncture treatment;the observation group was treated with spinal subtle adjustment manipulation in addition to the intervention of the control group.The treatment lasted for 4 consecutive weeks.The Oswestry disability index(ODI)and visual analog scale(VAS)scores were compared before and after treatment;isokinetic testing was used to evaluate the biomechanical properties of lower back extensor muscle groups before and after treatment,measuring the peak torque(PT),average power(AP),and lower back flexion/extension ratio(F/E)at 60(°)/s isokinetic movements;after treatment,the comprehensive efficacy was assessed using the MacNab criteria,and the incidence of adverse reactions was compared between the two groups.Results:After treatment,the ODI and VAS scores in the observation group were significantly lower than those in the control group(P<0.05),while the AP and PT were significantly higher than those in the control group(P<0.05),and the F/E was significantly lower than that in the control group(P<0.05).The effective rate in the observation group was significantly higher than that in the control group(P<0.05).During the treatment period,the incidence of adverse reactions in both groups was 4.3%,and there was no statistically significant difference between the groups(P>0.05).Conclusion:Spinal subtle adjustment manipulation combined with acupuncture in the treatment of LDH can reduce the patients’pain and dysfunction,improve the biomechanical properties of lower back muscles,enhance the effectiveness of conservative treatment,and has a relatively high safety.展开更多
BACKGROUND A patient with type Ⅲ Kummell’s disease had a ruptured posterior cortex of the fractured vertebral body, which caused spinal cord compression. An open surgery was considered the best choice of operation. ...BACKGROUND A patient with type Ⅲ Kummell’s disease had a ruptured posterior cortex of the fractured vertebral body, which caused spinal cord compression. An open surgery was considered the best choice of operation. However, the patient and her family refused open surgery and instead demanded a minimally invasive surgical treatment such as percutaneous vertebroplasty(PVP). After preoperative discussion, we finally adopted the novel therapy of traditional Chinese medicine manipulative reduction(TCMMR) combined with PVP.CASE SUMMARY A patient with type Ⅲ Kummell’s disease exhibiting bone block-induced spinal cord compression was admitted to our hospital. She suffered from a variety of medical disorders but refused open surgery, and instead asked for PVP surgery. TCMMR, in parallel with PVP, was used to restore the height of the compressed vertebral body and reduce the symptoms of spinal cord compression by the bone block in order to strengthen the vertebral body and prevent further collapse. The surgery was very successful. The height of the compressed vertebra was restored, and the symptom of spinal cord compression by bone block was reduced successfully via TCMMR. The fractured vertebra was solidified by the PVP. The pain visual analog score declined from preoperative 7 scores to postoperative 2 scores, and the Frankel spinal cord scale increased from preoperative D degree to postoperative E degree.CONCLUSION The new method has advantages in treating patients with type Ⅲ Kummell’s disease who cannot be treated with open surgery.展开更多
The derangement of the atlantoaxial joint is one of main cervical sources of dizziness and headache, which were based on the observation on the anatomy of the upper cervical vertebrae, analysis of X-ray film of the at...The derangement of the atlantoaxial joint is one of main cervical sources of dizziness and headache, which were based on the observation on the anatomy of the upper cervical vertebrae, analysis of X-ray film of the atlantoaxial joint, and the manipulative treatment in 35 patients with cervical spondylosis. The clinical diagnosis of derangement consists of: dizziness, headache, prominence and tenderness on one side of the affected vertebra, deviation of the dens for 1 mm-4 mm on the open-mouth X-ray film, abnormal movement of the atlantoaxial joint on head-rotated open-mouth X-ray film. An accurate and delicate adjustment is the most effective treatment.展开更多
Professor Zhan Hongsheng(詹红生),as the national representative inheritor of Shanghai Shi’s Orthopedics and Traumatology,has led his team in long-term dedication to the research of Chinese spinal manipulative medicin...Professor Zhan Hongsheng(詹红生),as the national representative inheritor of Shanghai Shi’s Orthopedics and Traumatology,has led his team in long-term dedication to the research of Chinese spinal manipulative medicine.He has achieved outstanding accomplishments in areas such as school inheritance,theoretical construction,technological innovation,standard establishment,scientific research translation,and talent cultivation,thereby advancing the modernization,standardization,and internationalization of Chinese spinal manipulative medicine.展开更多
基金Supported by the Scientific and Technologic Project of Jiangsu Administration of TCM(No.LZ13243)
文摘OBJECTIVE: To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation(TCSOM) in treating chondromalacia patellae(CP).METHODS: Sixty cases of CP patients were randomly assigned to a TCSOM group and a Celecoxib group according to the random number table method. All patients in the TCSOM group were treated with a maximum of 10 spinal manipulations and rehabilitation training of quadriceps femoris. The symptoms before and after treatment were assessed with visual analog scale(VAS) and Kujala functional knee scoring system(KFKSS). A symptom improvement rate(SIR) was implemented in order to evaluate the effects of the treatments.RESULTS: The symptoms of 16 patients in the TC-SOM group quickly resolved after the first spinal manipulation and 8 cases were significantly improved. The VAS scores in the TCSOM group after 4weeks of treatment were significantly lower than those in the Celecoxib group. The KFKSS scores in the TCSOM group after 4 weeks of treatment were significantly higher than those in the Celecoxib group. Side effects of the treatment were not reported. Symptom improvement rate based on the VAS in the TCSOM group indicated more significant improvements than the Celecoxib group.CONCLUSION: TCSOM has greater efficacy than Celecoxib capsules for relief of the symptoms of CP.
基金Supported by the Special Subject for the Construction of the National Traditional Chinese Medicine Clinical Research Base Effect of Spinal Manipulation on Degenerative Scoliosis and Factors Influencing Treatment Effect(JDZX2015271)Basic Scientific Research Project of Chinese Academy of Traditional Chinese Medicine Clinical and Experimental Study on Delaying The Degeneration of Bone and Joint(ZZ10-022)。
文摘OBJECTIVE:To investigate the effect of spinal manipulation(SM)on degenerative scoliosis by evaluating patients’visual analog scale(VAS)scores,Cobb angles,sagittal vertical axis(SVA),and apical vertebral rotation(AVR)and to explore factors that influence treatment effect.METHODS:A total of 55 patients with degenerative scoliosis received 4 weeks of SM.After treatment,patients were divided into two groups:the remission group(VAS score<40 mm)and the non-remission group(VAS score≥40 mm).Pre-versus post-treatment VAS scores,Cobb angles,SVA,and AVR were compared in each group and in the total population.Baseline data(sex,age,symptom characteristics,duration of symptoms,VAS score,Cobb angle,SVA,and AVR)were compared between groups.Factors influencing the post-treatment VAS score were explored with multiple linear regression analysis.RESULTS:No changes were found in the Cobb angle(P=0.722)or AVR(P=0.424)after intervention in the overall population.However,the SVA(P<0.001)and VAS score(P=0.000)changed significantly after treatment.Similar changes were observed in the remission group(n=29).Multiple linear regression revealed that the only factors influencing treatment effect were symptom characteristics,SVA,and VAS score.CONCLUSION:SM relieved pain and improved sagittal imbalance in patients with degenerative scoliosis.It did not lessen the severity of coronal curvature or vertebral rotation.Factors influencing the effect of SM included symptom characteristics,VAS score,and SVA.A larger randomized trial is needed to further confirm our results.
基金supported by grants from the Key Topics of China Traditional Chinese Medicine Scientific Research Project,General Logistics Department of Chinese PLA,No.10ZYZ125the Army Medical Science and Technology the125Scientific Research Projects,Chinese PLA,No.AKJ11J004
文摘Ninety-four patients with lumbar intervertebral disc herniation were enrolled in this study. Of these, 48 were treated with Feng＇s Spinal Manipulation, hot fomentation, and bed rest （treatment group）. The remaining 46 patients were treated with hot fomentation and bed rest only （control group）. After 3 weeks of treatment, clinical parameters including the angle of straight-leg raising, visual analogue scale pain score, and Japanese Orthopaedic Association score for low back pain were improved. The treatment group had significantly better improvement in scores than the control group. Magnetic resonance myelography three-dimensional reconstruction imaging of the vertebral canal demonstrated that filling of the compressed nerve root sleeve with cerebrospinal fluid increased significantly in the treatment group. The diameter of the nerve root sleeve was significantly larger in the treatment group than in the control group. However, the sagittal diameter index of the herniated nucleus pulposus and the angle between the nerve root sleeve and the thecal sac did not change significantly in either the treatment or control groups. The effectiveness of Feng＇s Spinal Manipulation for the treatment of symptoms associated with lumbar intervertebral disc herniation may be attributable to the relief of nerve root compression, without affecting the herniated nucleus pulposus or changing the morphology or position of the nerve root.
文摘Spinal manipulation is a manual treatment technique that delivers a thrust,using specific biomechanical parameters to exert its therapeutic effects.These parameters have been shown to have a unique dose-response relationship with the physiological responses of the therapy.So far,however,there has not been a unified approach to standardize these biomechanical characteristics.In fact,it is still undetermined how they affect the observed clinical outcomes of spinal manipulation.This study,therefore,reviewed the current body of literature to explore these dosage parameters and evaluate their significance,with respect to physiological and clinical outcomes.From the experimental studies reviewed herein,it is evident that the modulation of manipulation’s biomechanical parameters elicits transient physiological responses,including changes in neuronal activity,electromyographic responses,spinal stiffness,muscle spindle responses,paraspinal muscle activity,vertebral displacement,and segmental and intersegmental acceleration responses.However,to date,there have been few clinical trials that tested the therapeutic relevance of these changes.In addition,there were some inherent limitations in both human and animal models due to the use of mechanical devices to apply the thrust.Future studies evaluating the effects of varying biomechanical parameters of spinal manipulation should include clinicians to deliver the therapy in order to explore the true clinical significance of the dose-response relationship.
基金Supported by Chinese People’s Liberation Army Medical Technology Youth Training Program,No.20QNPY071.
文摘BACKGROUND Spinal manipulation therapy(SMT)has been widely used worldwide to treat musculoskeletal diseases,but it can cause serious adverse events.Spinal epidural hematoma(SEH)caused by SMT is a rare emergency that can cause neurological dysfunction.We herein report three cases of SEH after SMT.CASE SUMMARY The first case was a 30-year-old woman who experienced neck pain and numbness in both upper limbs immediately after SMT.Her symptoms persisted after 3 d of conservative treatment,and she was admitted to our hospital.Magnetic resonance imaging(MRI)demonstrated an SEH,extending from C6 to C7.The second case was a 55-year-old man with sudden back pain 1 d after SMT,numbness in both lower limbs,an inability to stand or walk,and difficulty urinating.MRI revealed an SEH,extending from T1 to T3.The third case was a 28-year-old man who suddenly developed symptoms of numbness in both lower limbs 4 h after SMT.He was unable to stand or walk and experienced mild back pain.MRI revealed an SEH,extending from T1 to T2.All three patients underwent surgery after failed conservative treatment.The three cases recovered to ASIA grade E on day 5,1 wk,and day 10 after surgery,respectively.All patients returned to normal after 3 mo of follow-up.CONCLUSION SEH caused by SMT is very rare,and the condition of each patient should be evaluated in full detail before operation.SEH should be diagnosed immediately and actively treated by surgery.
基金The study was supported by the High Level Talent Training Project of“Six Talents Summit”of Jiangsu Province(No.2016-WSN-004)Scientific and Technologic Project of Jiangsu Administration of Traditional Chinese Medicine(No.YB201851).
文摘Traditional Chinese spinal orthopedic manipulation(TCSOM)is an external therapeutic method of traumatology and orthopedics of traditional Chinese medicine to treat trauma and set bone.The doctor exerts his force through thumb or bilateral upper extremities on the spine or acupoints of the patient,applying various manipulatory techniques according to the conditions.Correcting the abnormal position or state of the spine serve as the most important theoretical foundation for TCSOM to treat spinal disorders and spinogenic disorders.This paper presented the definition and function of the TCSOM,with a special focus on how to make a preliminary diagnosis of spinal segments disorders,and the indications of TCSOM in different spinal segments.
基金Supported by the Fund of Capital Medical Development and Research(No.Ⅲ-11)the Subject Growth Fund of Guang'anmen Hospital,China Academy of Chinese Medical Sciences(No.81392)
文摘OBJECTIVE:To determine the clinical effect,treatment times,and rheoencephalogram changes in vertebral artery type cervical spondylosis patients treated with innovative Tuina manipulations.METHODS:One hundred and twenty six cervical spondylosis patients(vertebral artery type) were randomly divided into test and control groups.Patients in the test group were treated with innovative Tuina manipulations,while those in the control group were treated with the routine Tuina manipulations according to the textbook of Chinese Massage for Acupuncture and Moxibustion majors.The clinical effects,treatment times,clinical symptoms,and cerebral blood flow were measured.RESULTS:The response to the treatment was 100% in the test group and 88.71% in the control group.Patients in the test group required(7 ± 4) treatments before recovery,while those in the control group required(15 ± 7) treatments before recovery(P<0.05).The clinical symptoms exhibited greater improvement in the test group compared to the control group(P<0.05).There were no differences in cerebral blood flow between the two groups.CONCLUSION:Both innovative Tuina manipulations and routine Tuina manipulations produced satisfactory therapeutic results in vertebral artery type cervical spondylosis patients.However,the innovative manipulation was more effective in improving the functional symptoms,although there were no changes in the cerebral blood flow.
文摘Spinal cord injury（SCI）is a devastating ailment that results in drastic life style alterations for the patients and their family members（Mc Donald and Sadowsky,2002）.Damage post injury causes necrosis,edema,hemorrhage and vasospasm.Post injury,secondary damage is caused by ischemia,
基金funded by NIH R01 NS085426(VJT)the Craig H.Neilsen Foundation(DW)
文摘Spinal cord injury（SCI）is a traumatic event that can lead to permanent motor and sensory deficits.After the initial trauma,axons of surviving neurons rapidly retract.While there may be a small degree of abortive sprouting,virtually all attempts at robust regrowth across the lesion site ultimately fail.Thus,neurons below the level of the injury are permanently disconnected from their normal input,resulting in persistent loss of function.
文摘Objective:To investigate the clinical efficacy of spinal subtle adjustment manipulation combined with acupuncture in the treatment of lumbar disc herniation(LDH).Methods:A total of 94 patients with LDH were enrolled and randomly divided into a control group and an observation group using a random number table method,with 47 cases in each group.The control group received acupuncture treatment;the observation group was treated with spinal subtle adjustment manipulation in addition to the intervention of the control group.The treatment lasted for 4 consecutive weeks.The Oswestry disability index(ODI)and visual analog scale(VAS)scores were compared before and after treatment;isokinetic testing was used to evaluate the biomechanical properties of lower back extensor muscle groups before and after treatment,measuring the peak torque(PT),average power(AP),and lower back flexion/extension ratio(F/E)at 60(°)/s isokinetic movements;after treatment,the comprehensive efficacy was assessed using the MacNab criteria,and the incidence of adverse reactions was compared between the two groups.Results:After treatment,the ODI and VAS scores in the observation group were significantly lower than those in the control group(P<0.05),while the AP and PT were significantly higher than those in the control group(P<0.05),and the F/E was significantly lower than that in the control group(P<0.05).The effective rate in the observation group was significantly higher than that in the control group(P<0.05).During the treatment period,the incidence of adverse reactions in both groups was 4.3%,and there was no statistically significant difference between the groups(P>0.05).Conclusion:Spinal subtle adjustment manipulation combined with acupuncture in the treatment of LDH can reduce the patients’pain and dysfunction,improve the biomechanical properties of lower back muscles,enhance the effectiveness of conservative treatment,and has a relatively high safety.
文摘BACKGROUND A patient with type Ⅲ Kummell’s disease had a ruptured posterior cortex of the fractured vertebral body, which caused spinal cord compression. An open surgery was considered the best choice of operation. However, the patient and her family refused open surgery and instead demanded a minimally invasive surgical treatment such as percutaneous vertebroplasty(PVP). After preoperative discussion, we finally adopted the novel therapy of traditional Chinese medicine manipulative reduction(TCMMR) combined with PVP.CASE SUMMARY A patient with type Ⅲ Kummell’s disease exhibiting bone block-induced spinal cord compression was admitted to our hospital. She suffered from a variety of medical disorders but refused open surgery, and instead asked for PVP surgery. TCMMR, in parallel with PVP, was used to restore the height of the compressed vertebral body and reduce the symptoms of spinal cord compression by the bone block in order to strengthen the vertebral body and prevent further collapse. The surgery was very successful. The height of the compressed vertebra was restored, and the symptom of spinal cord compression by bone block was reduced successfully via TCMMR. The fractured vertebra was solidified by the PVP. The pain visual analog score declined from preoperative 7 scores to postoperative 2 scores, and the Frankel spinal cord scale increased from preoperative D degree to postoperative E degree.CONCLUSION The new method has advantages in treating patients with type Ⅲ Kummell’s disease who cannot be treated with open surgery.
文摘The derangement of the atlantoaxial joint is one of main cervical sources of dizziness and headache, which were based on the observation on the anatomy of the upper cervical vertebrae, analysis of X-ray film of the atlantoaxial joint, and the manipulative treatment in 35 patients with cervical spondylosis. The clinical diagnosis of derangement consists of: dizziness, headache, prominence and tenderness on one side of the affected vertebra, deviation of the dens for 1 mm-4 mm on the open-mouth X-ray film, abnormal movement of the atlantoaxial joint on head-rotated open-mouth X-ray film. An accurate and delicate adjustment is the most effective treatment.
文摘Professor Zhan Hongsheng(詹红生),as the national representative inheritor of Shanghai Shi’s Orthopedics and Traumatology,has led his team in long-term dedication to the research of Chinese spinal manipulative medicine.He has achieved outstanding accomplishments in areas such as school inheritance,theoretical construction,technological innovation,standard establishment,scientific research translation,and talent cultivation,thereby advancing the modernization,standardization,and internationalization of Chinese spinal manipulative medicine.
