OBJECTIVE: To compare the therapeutic effect of thunder-fire moxibustion combined with vibration training and simple vibration training on low back pain of primary osteoporosis by 's modulus of ultrasonic wave, and seek an objective evaluating method. METHODS: A total of 60 patients were randomized into an observation group and a control group, 30 cases in each one. The patients in the two groups were treated with vibration training using whole body vibration treatment bed. In the observation group, thunder-fire moxibustion was applied at Yaoyangguan (GV 3), Mingmen (GV 4), Ganshu (BL 18), Shenshu (BL 23) and Dachangshu (BL 25). The treatment was given once every other day, 3 times a week for 4 weeks. The visual analogue score (VAS), real-time shear wave elastography (RTSWE) and medical outcomes study 36-item short-form hearth survey (SF-36) were used to evaluate pain intensity, multifidus muscle tone ('s modulus) and quality of life before treatment, after 4-week treatment and 1 month after treatment. RESULTS: Compared before treatment, the VAS scores, 's modulus of multifidus muscle and 5 dimensions of SF-36 (physical condition, body pain, general health, social function and mental health) after 4-week treatment and 1 month after treatment were significantly improved in the two groups (all <0.05), the physiological role in the observation group after 4-week treatment and 1 month after treatment were improved (both <0.05). In the observation group, the VAS scores, 's modulus of multifidus muscle and 3 dimensions of SF-36 (physiological role, body pain and general health) after 4-week treatment and 1 month after treatment were superior to the control group (all <0.05). CONCLUSION The therapeutic effect of thunder-fire moxibustion combined with vibration training is superior to simple vibration training in relieving low back pain intensity and multifidus muscle tone, and improving quality of life for primary osteoporosis. RTSWE technique can be an objective examination method to evaluate pain.
Acupuncture Points ; Humans ; Low Back Pain ; etiology ; therapy ; Moxibustion ; Osteoporosis ; complications ; Quality of Life ; Treatment Outcome ; Vibration

This study systematically searched and sorted out randomized controlled trial(RCT) of acupuncture-moxibustion treatment for non-specific low back pain by scoping review, so as to demonstrate the current state of the research evidence and provide a reference point for future clinical research and healthcare decision-making. Eight commonly used Chinese and English databases were searched, and the search time was from the establishment of the databases to July 7, 2023, so as to analyze the characteristics of the current status of the current research through visualization methods. A total of 50 studies were included, including 23 studies in Chinese and 27 studies in English. The overall number of studies showed an increasing trend. The percentage of studies published in Chinese non-core journals was 42.0%. The disease subtypes of interest were mainly chronic non-specific low back pain, accounting for 68.0% of the studies. The sample sizes of the studies were mainly concentrated in the range of 50-100 cases. A total of 15 types of interventions were categorized, with acupuncture interventions being the most studied. Duration of treatment did not exceed one month in 80.0% of the studies. Only 8.0% of the studies used minimal clinical important difference(MCID) as a basis for judgment. The follow-up period was set within 3 months in 28.0% of the studies, and 82.0% of the studies concluded that acupuncture-moxibustion was effective in the treatment of non-specific lower back pain. Adverse events were reported in 20.0% of the studies. The risk of bias in the included studies was dominated by low risk of bias and uncertain risk of bias, with fewer studies focusing on high risks of bias. In most of the studies, acupuncture-moxibustion was significantly more effective than the control group. The research on acupuncture-moxibustion treatment for non-specific low back pain is developing rapidly, but there are still insufficient studies on psychological state, safety, and other indicators, and there are still some studies with uncertain risks of bias, which is not conducive to the generalization and application of the findings. Therefore, future studies should improve and refine these shortcomings.
Humans ; Acupuncture Therapy/methods* ; Low Back Pain/etiology* ; Moxibustion/methods* ; Randomized Controlled Trials as Topic

OBJECTIVETo evaluate the combination of drop in canales sacralis with acupotomy dissolution in the treatment of lumbocrural pain caused by slipped discs.

METHODSOne hundred and thirty-nine patients with lumbocrural pain caused by slipped discs were randomly divided into 3 groups: cases in Group A were treated by the drop in canales sacralis, in Group B by acupotomy dissolution and in Group C by the combination of canales sacralis drop with acupotomy dissolution. MacNab score and VAS score were assayed before treatment and 1 week, 3 and 6 months after treatment.

RESULTThe effective rates in Groups A, B and C at 1 week, 3 and 6 months after treatment were 71.4%, 75.5%, 79.6%; 75.0%, 79.6%, 81.8% and 89.1%, 91.3%, 93.5%, respectively (P < 0.01). The pain intensity in Group C was reduced more markedly at different time points after treatment than that in Group A and Group B (P < 0.01).

CONCLUSIONThe combination of canales sacralis drop with acupotomy dissolution is superior to each method used alone in treatment of lumbocrural pain caused by slipped discs in the short-and long-term.

Acupuncture Therapy ; Female ; Humans ; Instillation, Drug ; Intervertebral Disc Displacement ; complications ; therapy ; Low Back Pain ; drug therapy ; etiology ; therapy ; Lumbar Vertebrae ; Male ; Treatment Outcome

OBJECTIVETo observe the clinical efficacy and complications of intradiscal electrothermal therapy for treatment of discogenic low back pain.

METHODSForty patients with discogenic low back pain were treated with intradiscal electrothermal therapy, and the changes in the VAS, functional status and complications after the treatment were analyzed. RESULTS The VAS score was decreased and the functional status improved obviously after the treatment, which caused no severe complications.

CONCLUSIONIntradiscal electrothermal therapy is safe and effective to rapidly achieve pain relief and obviously improve the functional status of patients with discogenic low back pain with few complications.

Adult ; Electric Stimulation Therapy ; Female ; Humans ; Hyperthermia, Induced ; Intervertebral Disc Displacement ; complications ; therapy ; Low Back Pain ; etiology ; therapy ; Male ; Middle Aged ; Treatment Outcome

The recently increasing interest in historical records has led to more research on historical records in various fields of study. This trend has also affected medical research, with the medical climate and popular treatment modalities of the past now being revealed based on historical records. However, most research on medical history during the Joseon era has been based on the most well-known record, Joseon wangjo sillok or Annals of the Joseon Dynasty. Joseon wangjo sillok is a comprehensive and organized record of society during the Joseon era and contains key knowledge about medical history during the period, but it lacks details on the treatment of common disorders at the time. Seungjeongwon ilgi or Diary of the Royal Secretariat has detailed records of daily events and is a valuable resource for the daily activities of the era. And in the middle Josoen era, a variety of medical books - especially Donguibogam - was published. Therefore, the authors focused on the under-researched Seungjeongwon ilgi, Donguibogam and attempted to assess and evaluate low back pain treatment performed on Joseon royalty. The most notable characteristic of low back treatment records within the Seungjeongwon ilgi is that diagnosis and treatment was made based on an independent Korean medicine, rather than conventional Chinese medicine. This paradigm shift is represented in Dongeuibogam, and can be seen in the close relationship between Dongeuibogam and national medical exams of the day. Along with the pragmatism of the middle Joseon era, medical treatment also put more focus on pragmatic treatment methods, and records show emphasis on acupuncture and moxibustion and other points in accord with this. The authors also observed meaning and limitations of low back pain treatment during that era through comparison with current diagnosis and treatment.
Acupuncture Therapy/history/methods ; History, 17th Century ; History, 18th Century ; Humans ; Low Back Pain/etiology/*history/therapy ; Medicine, Korean Traditional/history ; Moxibustion/history/methods

OBJECTIVESTo find out the common complications induced by the operation on patients with tethered cord syndrome (TCS) and to discuss the mechanism and the treatment of these complications.

METHODSDuring 1993 and 2001, the spinal cords of 87 patients with TCS were explored and released operatively. The operative complications were analyzed retrospectively and the results of prevention and treatment of these complications were evaluated.

RESULTSThe operative complications in patients with TCS included headache (43.7%), hemorrhage (31.0%), lumbago (21.8%), retethering (18.4%), lumbar instability (12.7%), neural injury (8.1%) and CSF leakage (4.6%).

CONCLUSIONSTo reduce operative complications, the pathology of TCS should be investigated thoroughly before operation. The techniques of microsurgery and electrophysiology should be used properly and some complications were reversible after treatment. Post-operation rehabilitation training should be stressed.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Headache ; etiology ; therapy ; Hemorrhage ; etiology ; therapy ; Humans ; Infant ; Intraoperative Complications ; therapy ; Low Back Pain ; etiology ; therapy ; Male ; Neural Tube Defects ; surgery ; Postoperative Complications ; therapy ; Retrospective Studies

An 80-year-old man with insulin-dependent diabetes mellitus presented to the hospital with low back pain. He was initially managed with non-steroidal anti-inflammatory drugs, tramadol and epidural steroid injection. Transcutaneous electrical nerve stimulation (TENS), applied on the back and buttocks, was subsequently advised. Initially, TENS was applied once every 24 hours. On improvement of pain symptoms, it was increased to thrice every 24 hours. The patient then complained of symptoms of hypoglycaemia (blood sugar level < 4 mmol/L). Discontinuation of TENS resulted in raised blood sugar level. When TENS was restarted, the same hypoglycaemic response was noted. The insulin dosage was adjusted to half of the patient's routine daily requirement with continued application of TENS. This incidental finding has alerted us to hypoglycaemic episodes following TENS application, which may be due to effective pain control, decreased sympathetic stimulation, enhanced insulin sensitivity or altered muscle metabolism due to electrical stimulation.
Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Diabetes Complications ; therapy ; Diabetes Mellitus, Type 1 ; therapy ; Humans ; Hypoglycemia ; etiology ; Insulin ; therapeutic use ; Low Back Pain ; complications ; therapy ; Male ; Pain Management ; Transcutaneous Electric Nerve Stimulation ; methods ; Treatment Outcome

BACKGROUND: The purpose of this study was to evaluate the clinical feasibility of an electric nerve stimulator in a lumbar transforaminal epidural block. METHODS: Using an electric nerve stimulator, transforaminal epidural blocks were performed in 105 segments of 49 patients who presented with lower back pain with radiating pain to lower extremities. The contrast medium was injected to delineate the nerve root after positioning an insulated needle at the intervertebral foramen under fluoroscopic guidance. Then, the nerve root was electrically stimulated with the insulated needle to confirm whether or not the same radiating pain was evoked. RESULTS: Of the 105 foraminal segments, the same radiating pain was evoked at 0.5 mAh in 47 segments (44.8%), at 1.0 mAh in 22 (21.0%), at 1.5 mAh in 3 (2.9%), at 2.0 mAh in 15 (14.3%), at 2.5 mAh in 4 (3.8%), and at 3.0 mAh in 5 (4.8%). No response was observed in 9 segments (8.6%). The fluoroscopy revealed successful positioning of the needle in the patients with an evoked radiating pain over 2.0 mAh. The visual analogue scale (VAS) obtained for pain improved from a mean of 7.5 to 2.7 after the block (p = 0.001). In the 9 cases without response to electrical stimulation, the patients showed an improvement on VAS from 7.8 to 3.4 (p = 0.008) also. CONCLUSIONS: A nerve stimulator can help to predict the accuracy of needle positioning as a supplemental aid for a successful lumbar transforaminal epidural block. It is sufficient to initiate a proper stimulation amplitude of the nerve at 2 mAh.
Adult ; Aged ; Aged, 80 and over ; Analgesia, Epidural ; *Electric Stimulation Therapy ; Feasibility Studies ; Female ; Humans ; Low Back Pain/etiology/*therapy ; *Lumbar Vertebrae ; Male ; Middle Aged ; *Nerve Block ; Radiculopathy/etiology/therapy ; Spinal Diseases/*complications

Postoperative infections following spine surgery are usually attributable to bacterial organisms. Staphylococcus aureus is known to be the most common single pathogen leading to this infection, and the number of infections caused by methicillin-resistant Staphylococcus aureus is increasing. However, there is a paucity of literature addressing postoperative infection with Mycobacterium tuberculosis. We encountered a case of tuberculous spondylitis after spine surgery. A man had fever with low back pain three weeks after posterior interbody fusion with instrumentation for a herniated intervertebral disc at the L4-L5 level. He had been treated with antibiotics for an extended period of time under the impression that he had a bacterial infection, but his symptoms and laboratory data had not improved. Polymerase chain reaction for Mycobacterium tuberculosis turned out to be positive. The patient's symptoms finally improved when he was treated with antituberculosis medication.
Adult ; Humans ; Low Back Pain/etiology ; Lumbar Vertebrae/surgery ; Male ; Postoperative Complications/*microbiology ; Spondylitis/etiology/*microbiology ; Thoracic Vertebrae/*microbiology/pathology ; Tuberculosis/drug therapy/*microbiology ; Tuberculosis, Spinal/complications/drug therapy/*microbiology

BACKGROUND: Selective lumbar nerve root block (SNRB) is generally accepted as an effective treatment method for back pain with sciatica. However, it requires devices producing radioactive materials such as C-arm fluoroscopy. This study evaluated the usefulness of the longitudinal view of transverse process and needles for medial branch block as landmarks under ultrasonography. METHODS: We performed selective nerve root block for 96 nerve roots in 61 patients under the guidance of ultrasound. A curved probe was used to identify the facet joints and transverse processes. Identifying the lumbar nerve roots under the skin surface and ultrasound landmarks, the cephalad and caudal medial branch blocks were undertaken under the transverse view of sonogram first. A needle for nerve root block was inserted between the two transverse processes under longitudinal view, while estimating the depth with the needle for medial branch block. We then injected 1.0 mL of contrast medium and checked the distribution of the nerve root with C-arm fluoroscopy to evaluate the accuracy. The visual analog scale (VAS) was used to access the clinical results. RESULTS: Seven SNRBs were performed for the L2 nerve root, 15 for L3, 49 for L4, and 25 for L5, respectively. Eighty-six SNRBs (89.5%) showed successful positioning of the needles. We failed in the following cases: 1 case for the L2 nerve root; 2 for L3; 3 for L4; and 4 for L5. The failed needles were positioned at wrong leveled segments in 4 cases and inappropriate place in 6 cases. VAS was improved from 7.6 +/- 0.6 to 3.5 +/- 1.3 after the procedure. CONCLUSIONS: For SNRB in lumbar spine, the transverse processes under longitudinal view as the ultrasound landmark and the needles of medial branch block to the facet joint can be a promising guidance.
Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Female ; Humans ; Low Back Pain/etiology/*therapy ; Lumbar Vertebrae/anatomy & histology/*ultrasonography ; Male ; Middle Aged ; Nerve Block/*methods ; Sciatica/etiology/*therapy ; Spinal Stenosis/complications/*diagnosis ; Zygapophyseal Joint/anatomy & histology/ultrasonography