OBJECTIVE: Many lumbosacral fixation techniques have been described to offer a more screw-bone purchase. The forward anatomical fixation parallel to the endplate is still the most preferred method. Literature revealed little knowledge regarding the mechanical stability of lumbosacral trans-endplate fixation compared to the traditional trans-pedicular screw fixation method. The aim of this study is to assess the pull-out strength of lumbosacral screws penetrating the end plate and comparing it to the conventional trans-pedicular screw insertion method.METHODS: Eight lumbar and eight sacral vertebrae, with average age 69.4 years, Left pedicles of the 5th lumbar vertebrae were used for trans-endplate screw fixation, group 1A, right pedicles were used for anatomical trans-pedicular screw fixation, group 1B. In the sacral vertebrae, the right side S1 pedicles were used for trans-endplate fixation, group 2A, left side pedicles were used for anatomical trans-pedicular screw fixation, group 2B. The biomechanical tests were performed using the axial compression testing machine. All tests were applied using 2 mm/min traction speed.RESULTS: The average pull-out strength values of groups 1A and 1B were 403.78±11.71 N and 306.26±17.55 N, respectively. A statistical significance was detected with p=0.012. The average pull-out strength values of groups 2A and 2B were 388.73±17.03 N and 299.84±17.52 N, respectively. A statistical significance was detected with p=0.012.CONCLUSION: The trans-endplate lumbosacral fixation method is a trustable fixation method with a stronger screw-bone purchase and offer a good alternative for surgeons specially in patients with osteoporosis.
Humans ; Lumbar Vertebrae ; Methods ; Osteoporosis ; Spine ; Surgeons ; Traction

Background: Herniated lumbar disc is a very common disease in the age group of 20-50 year olds the worldwide, likewise in Vietnam. There are many traditional therapies for treating this disease, such as electro-acupuncture, traditional massage, and traditional drugs... Objectives: To evaluate the effects and side-effects of combining electro-acupuncture, traditional massage, magnet-heating and lumbar traction in treating herniated lumbar disc. Subjects: 60 patients with herniated lumbar disc, over 20 years of age, were treated at the Department of Traditional Medicine and Rehabilitation, Hospital of Traditional Medicine between July 2006 and October 2007. Method: Prospective, clinical case-controlled trial. Participants were divided equally into two groups: intervention and control group. The treatment lasted for 30 days. Data was analyzed by SPSS software, version 11.5. Results: After 30 days of treatment, there were significant improvements in intervention patients about Lasegue sign, elasticity of lumbar spine, and daily movements when compared to control group. Outcomes after 30 days of treatment in the control group were 16.7% of very good, 43.3% of good, and 40% of moderate. Intervention group had better results, with 46.7% of very good, 46.7% of good, and 6.6% of moderate (p <0.01). There was not any side-effect observed in this trial. Conclusion: The combination of electro-acupuncture, traditional massage, magnet - heating and lumbar traction is a safe method and is an effective treatment for herniated lumbar disc.
Electro-acupuncture ; Traditional massage ; Magnet-heating ; lumbar traction ; Herniated lumbar disc

OBJECTIVETo ovserved the treatment of cervical vertebral instability with kinesitherapy combined with occipitomandibular traction.

METHODSFrom April 2005 to December 2008, 400 patients with cervical vertebral instability including 220 males and 180 females with an average age of 48.4 years old ranging from 34 to 72 years, were treated by the kinesitherapy combined with occipito-mandibular traction, contradict and amend muscle training 2 min everytime, 8 time a day. All patients were followed-up for 6 months (three treatment periods), the clinical symptom improvement, changes of clinical signs scoring and imaging were observed.

RESULTSAfter three treatment periods, the outcome were evaluated and the results were excellent in 210 cases, good in 126, accepted in 53, inefficacy in 11, the total effective rate was 97.3%. The total scores were (22.42 +/- 3.25) before the treatments and (9.03 +/- 1.92) after the treatments. The level replacement of intervertebral were (3.70 +/- 0.12) mm before the treatments and (2.96 +/- 0.09) mm after the treatments; The rotation angle was (12.64 +/- 0.21) degrees before the treatments and (8.90 +/- 0.17) degrees after the treatments.

CONCLUSIONThe kinesitherapy was a simple method with good effect to cure patients with cervical vertebral instability.

Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Motion Therapy, Continuous Passive ; Spinal Diseases ; therapy ; Traction

OBJECTIVETo investigate the correlation of premature ejaculation (PE) with central lumber intervertebral disc herniation (CLIDH) and the pathogenesis of PE, and to search for a convenient, effective and non-invasive method for the treatment of PE.

METHODSA total of 263 selected PE patients underwent CT, and those that were found with CLIDH were randomized into a treatment group (n=180) and a control (n=60), the former treated by lumbar traction and the latter with sertraline hydrochloride tablets, both for 24 weeks. CIPE-5 scores of all the patients were analyzed, and the ejaculation latency and sexual satisfaction were recorded before and after the treatment.

RESULTSAmong the 263 PE patients, CLIDH was confirmed in 240 (91%). After the treatment, CIPE-5 scores, ejaculation latency and sexual satisfaction were markedly improved in the treatment group, with significant statistic difference from pre-treatment (P < 0.01). Significant differences were also observed between the treatment and the control groups after the treatment (P < 0.05), but not in the control group between pre- and post-treatment.

CONCLUSIONCLIDH may be one of the important causes of most "unexplainable" PE cases. And lumbar traction, non-invasive, highly effective and easily manipulable, has provided a new access to the diagnosis and treatment of the PE patients with CLIDH.

Adult ; Ejaculation ; Humans ; Intervertebral Disc Displacement ; complications ; surgery ; Lumbar Vertebrae ; Male ; Middle Aged ; Sexual Dysfunction, Physiological ; etiology ; therapy ; Traction

A three-dimensional biomechanical tracting appliance is introduced in the article, which is used to treat the protrusion of intervertebral disc. The appliance is light, practical, adjustable 3D biomechanic, simple and with multiple functions and convenient operation.
Biomechanical Phenomena ; Equipment Design ; Humans ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; pathology ; Traction ; instrumentation ; methods ; Treatment Outcome

OBJECTIVETo observe the clinical effect of electroacupuncture under continuous traction in prone position for treatment of lumbar disc herniation, to search a better clinical treatment for lumbar disc herniation.

METHODSThe patients were randomly divided into group A (42 cases), group B (39 cases) and group C (38 cases). The acupuncture methods of three groups were the same, Jiaji (EX B 2), Weizhong (BL 40) and Chengshan (BL 57) etc. were selected, and the electroacupuncture was applied as a basic treatment. Continuous traction in prone position and electroacupuncture treatment were used at the same time in group A, group B was treated with supine position traction first and then electroacupuncture treatment, while group C was treated with electroacupuncture only, the therapeutic effects were observed and compared.

RESULTSThe effective rate of 95.2% in group A was superior to that of 79.5% in group B and 65.8% in group C (P < 0.05, P < 0.01).

CONCLUSIONElectroacupuncture under continuous traction in prone position is a better treatment for lumbar disc herniation.

Adult ; Electroacupuncture ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; therapy ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Traction ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the effectiveness of manual therapy and traction for lumbar disc herniation and analyze the current status of this kind of randomized clinical trial (RCT).

METHODSDatabase of CNKI, VIP, WANFANG, PubMed and OVID were searched. Some relevant journals were manually retrieved. A total of 2 874 literatures on manual therapy and traction for lumbar disc herniation were collected, of which 17 articles met the inclusion criteria. The Jadad score scale was used to evaluate the quality,and RevMan5.0 was used for meta-analysis of literatures.

RESULTSThe results of the meta-analysis of all trials involved were as followed:the combined effect of the effective rate was RR = 1.10, 95% CI [1.06, 1.14], the combined effect of the cure rate was RR = 1.36, 95% CI [1.21,1.52], the combined effect of the VAS was RR = 1.37, 95% CI [1.28, 1.45], the combined effect of the JOA was RR = 4.75, 95% CI [4.40, 5.09].

CONCLUSIONThe overall quality of the current RCT researches about manual therapy for lumbar disc herniation was lower,and did not support the conclusion that manual therapy was more effective than traction for lumbar disc herniation.

Humans ; Intervertebral Disc Displacement ; surgery ; therapy ; Lumbar Vertebrae ; surgery ; Musculoskeletal Manipulations ; methods ; Randomized Controlled Trials as Topic ; Traction ; methods

OBJECTIVETo observe the clinical effect of post-extension pulling massage in treating lumbar disc herniation.

METHODSFrom January 2008 to December 2008, 61 patients with lumbar disc herniation, 34 males and 27 females, ranging in age from 17 to 67 years with an average of 42.6 years, were treated with post-extension pulling massage after continued traction for 30 minutes (on alternate days one time, 3 times as a course of treatment). There was bulging type in 9 cases, hernia type in 22, free type in 30. After a course of treatment, the clinical effects were evaluated according to standard of Macnab, the items included pain, lumbar activity, normal work and life of patients.

RESULTSAll patients were followed up from 1 to 9 months with an average of 4.6 months. After treatment, the symptoms and signs of patients had obviously improved in above aspects. According to standard of Macnab, 48 cases got excellent result, 10 good, 2 fair, 1 poor.

CONCLUSIONThe post-extension pulling massage in treating lumbar disc herniation can obtain satisfactory results, which have localized site of action, small compression for vertebral body and can reduce accidental injury.

Diskectomy ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; pathology ; Lumbosacral Region ; pathology ; Male ; Massage ; methods ; Spine ; Traction ; Treatment Outcome

Vertebral osteophytes are a characteristic feature of intervertebral disc degeneration. In the lumbar spinal region, the two major structures in close proximity anterior to the spine are the inferior vena cava and the abdominal aorta, both of which have been reported to be affected by osteophytes. The purpose of this study was to determine the distribution, classification and lengths of osteophytes in the lumbar vertebrae. One hundred and eighty lumbar columns of 90 males and 90 females from Chiang Mai, Thailand, in the age range 15 to 96 years (mean age, 63 years) were collected. The measuring length of osteophytes was assessed on vertebral body and articular facet. Statistical analysis was performed by descriptive analysis, chi-square and Pearson Correlation. Lumbar osteophytes were presented in 175 specimens (97.2%), 88 males and 87 females. The highest frequency was at L4, most were on the superior, inferior surface of body and articular facet (39.7%, 38.4%, and 22%), respectively. The greatest mean length was 3.47+/-2.21 mm at L5, and the longest length of anterior superior surface of body was 28.56 mm. The osteophyte length was significantly correlated directly with age (P<0.01), and males were significantly greater than females (P<0.05). The highest prevalence of osteophytes was on the anterior side of superior surface of body (30.4%), and the classification was traction. It can be proposed that the abdominal aorta could be damaged, especially a risk of rupture of abdominal aortic aneurysm.
Aorta, Abdominal ; Aortic Aneurysm, Abdominal* ; Classification ; Female ; Humans ; Intervertebral Disc Degeneration ; Lumbar Vertebrae* ; Male ; Osteophyte* ; Prevalence ; Rupture* ; Spine ; Thailand* ; Traction ; Vena Cava, Inferior

OBJECTIVETo retrospectively review the clinical features and treatment strategy of lumbar disc herniation in adolescents initially misdiagnosed as idiopathic scoliosis.

METHODSFrom 1998 to 2007, nineteen adolescents with lumbar disc herniation were admitted to our hospital. All of them presented a scoliotic curve as their first complaint. There were 10 males and 9 females with the age ranged from 14 to 20 years. The disc herniation located at L(4,5) in 10 patients, at L(5)S(1) in 7, and at L(4)-S(1) in 2. The Cobb angle ranged from 23 degrees to 38 degrees . The distance from the C(7) plumb line to the central sacral line averaged 4.7 cm. All the patients underwent conventional open discectomy, followed by a pelvic traction for 3 weeks. A cast fixation for one month was recommended for further correction of scoliosis if the curve improvement was not obvious.

RESULTSFourteen (73.7%) patients had a disc herniation at the convex side of lumbar curve, and 5 (26.3%) patients had a disc herniation at the concave side, which showed a marginal statistical correlation between the side of the disc herniation and the direction of lumbar curve (P = 0.07). Leg pain and numbness disappeared in the 19 patients after surgical decompression. After the pelvic traction for 3 weeks postoperatively, the Cobb angle reduced to 14 degrees, with the mean distance from the C(7) plumb line to the central sacral line of 2.2 cm. At a mean follow-up of 21 months, neither the recurrence of back pain and leg pain nor the loss of spontaneous scoliosis correction was found.

CONCLUSIONSCare should be taken to the diagnosis of lumbar disc herniation in adolescents with spine deformity as their chief complaint. Satisfactory clinical results can be achieved by early diagnosis and proper treatment.

Adolescent ; Adult ; Diskectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; complications ; diagnosis ; surgery ; Lumbar Vertebrae ; Male ; Retrospective Studies ; Scoliosis ; etiology ; Traction