| Objective:1)A retrospective study of the efficacy of ultrasound guided inferior corporotransverse lingament release and CNin the treatment of posterolateral LDH and a prospective study of the efficacy of inferior corporotransverse lingament release combined with LPVB in the treatment of posterolateral LDH should be conducted to investigate the effect of inferior corporotransverse lingament tension on the degree of pain and dysfunction of posterolateral LDH.2)Exploring the relationship between inferior corporotransverse lingament and posterolateral LDH;3)A new method is explored for ultrasound-guided acupotomy and CN.Method.1)Clinical research One:A retrospective review of 85 patients with posterolateral LDH diagnosed in the Department of Pain at Xuanwu Hospital of Capital Medical University between January 2016 and March 2017.Among them,41 patients with corporotransverse lingament release combined with CN were treated as the treatment group,the 44 patients treated with CN alone as a control group.Baseline data were recorded for all enrolled patients.VAS scores and ODI scores were recorded before treatment,at the end of treatment,and at the end of the third month after treatment.SPSS 20.0 was used to perform statistical analysis of all data recorded and efficacy assessment was performed.2)Clinical research two:Among the 80 patients who had been diagnosed as posterolateral LDH in Eye Hospital of China Academy of C.M.between November 2016 and December 2017,they signed the informed consent form and volunteered to participate in the study.Using randomized control,efficacy observation recorders and statistical blindness design methods,80 patients were randomly divided into 2 groups:①40 patients in the treatment group were given ultrasound-guided acupotomy release and LPVB treatment,once every 7 days,2 times for one course of treatment;②In the control group,40 patients were treated with ultrasound-guided LPVB and treated once every 7 days,2 times for one course of treatment.Baseline data for all enrolled cases were recorded in detail,and VAS scores and ODI scores were recorded prior to treatment,at the end of the course of treatment,and at the end of the third month after the end of the course of treatment.SPSS 20.0 was used for statistical analysis of all data recorded and efficacy evaluation was performed.Result1.Research One:1).Baseline data:①Gender:There were 11 males and 30 females in the treatment group.There were 10 males and 34 females in the control group.There was no significant difference in gender between the two groups(P>0.05).②Age:The average age of the treatment group was(47.9±20.6)years,and that of the control group was(50.9±22.6)years.There was no significant difference between the two groups(P>0.05).③Course of disease:The average course of disease was(451.2±310.5)days in the treatment group and(375.2±296.2)days in the control group.There was no significant difference in the course of disease between the two groups(P>0.05).2)VAS score:①Treatment group:The average score of VAS before treatment was(7.25±1.05).The average score of VAS at the end of treatment was reduced to(3.85±1.13),which was significantly lower than before treatment(P**<0.001).The VAS average score at the end of the third month of the end of the treatment course.the score further decreased to(2.87±1.02)and was significantly lower than before treatment(P**<0.001);②Control group:The mean score of VAS before treatment was(6.97±1.14),and the average score of VAS at the end of treatment was reduced to(4.14±1.46),which was significantly lower than before treatment(P**<0.005).At the,end of the third month of treatment,the average score of VAS further decreased to(3.0±1.31),which was significantly lower than before treatment(P**<0.001).There was no significant difference in VAS scores between the two groups before treatment(P>0.05).There was no significant difference in VAS scores between the two groups at the end of treatment(P>0.05).There was no significant difference in VAS scores3)ODI score:①Treatment group:between the two groups at the end of the third month after treatment(P<0.05).The mean score of ODI before treatment was(33.17±5.21),and the average score of ODI was reduced to(15.41±4.33)at the end of treatment,which was significantly lower than before treatment(P**<0.001).At the end of the third month of treatment,the average score of ODI was further reduced to(10.36±4.12),and it was significantly different from the pre-treatment comparison(P**<0.001).② Control group:The mean score of ODI before treatment was(30.84±6.33),and the average score of ODI at the end of treatment(18.78±5.71)was significantly lower than before treatment(P**<0.001).At the end of the third month after the end of treatment,the ODI score was further reduced to(15.89±5.56),which was significantly different from the pre-treatment comparison(P**<0.001).③There was no significant difference in ODI score between the two groups before treatment(P>0.05).At the end of treatment,the ODI score of the treatment group was lower than that of the control group,but there was no statistical significance(P*>0.05).At the end of the third month after the end of treatment,the ODI score of the treatment group was lower than that of the control group and there was a statistically significant difference(P*<0.05).2 Research two:1)Baseline data:①Gender:There were 7 males and 33 females in the treatment group.There were 13 males and 27 females in the control group.There was no significant difference in gender between the two groups(P>0.05);②Age:The average age of the treatment group was(67.9±12.6)years,and that of the control group was(65.9 ± 12.6)years.There was no significant difference between the two groups(P>0.05);③ Course of disease:The average course of disease was(70.2 ±110.5)days in the treatment group and(76.22±96.2)days in the control group.There was no significant difference in the course of disease between the two groups(P>0.05).2)VAS score:①The average VAS before treatment in the treatment group was 7.33 ±1.46.The average VAS score at the end of treatment was(3.85± 1.53)lower than before treatment(P**<0.001).The mean VAS at the end of the third month of treatment was(4.38 ± 1.57).)Higher than the end of treatment(P*<0.05),lower than before treatment(P**<0.001).②The average VAS before treatment in the control group was(7.24±1.53).The average VAS score at the end of the treatment period was(4.34±4.46)lower than before treatment(P**<0.001).The mean VAS at the end of the third month of treatment was(5.21 ± 1.61)Higher than after treatment(P<0.001)and lower than before treatment(P**<0.001).③There was no significant difference in VAS score between the two groups before treatment(P>0.05).There was no significant difference in VAS score between the two groups at the end of treatment(P>0.05).At the end of the third month after treatment,the VAS score of the treatment group was lower than that of the control group.There was statistical significance(P*<0.05).3)ODI score:①The average ODI score before treatment in the treatment group was(20.49±6.77).The average ODI score at the end of treatment was(14.51 ±4.09)lower than before treatment(P**<0.001).The average ODI score at the end of the third month of the treatment course was(16.36±5.12).This was higher than at the end of treatment(P**<0.001)and lower than before treatment(P**<0.001);②The average ODI before treatment in the control group was(19.84±6.50).The average ODI score at the end of treatment was(16.71 ± 5.35)lower than before treatment(P**<0.001).The average ODI at the end of the third month after the treatment course was(18.89±5.96)higher than the end of treatment(P**<0.001),lower than before treatment(P*<0.05).③There was no significant difference in ODI scores between the two groups before treatment(P>0.05).At the end of treatment,ODI scores in the treatment group were lower than those in the control group,with statistical significance(P*<0.05).At the end of the third month after the end of treatment,the ODI score of the treatment group was lower than that of the control group,with statistical significance(P*<0.05).Conclusion 1:1.CN alone has a significant effect on posterolateral LDH,which can relieve pain and improve dysfunction;2.Lysis of inferior corporotransverse lingament combined with CN has significant effect on posterolateral LDH,including pain relief and improved body function;3.Lysis of inferior corporotransverse lingament combined with CN and CN alone,both have similar effects in relieving pain.The degree of postoperative pain relief increased with time;4.The inferior corporotransverse lingament release combined with CN and CN alone,the patient’s limb function has increased over time.The combined treatment showed a certain advantage over the simple CN in the improvement of function at the end of the third month after treatment.Conclusion 2:1.The inferior corporotransverse lingament acupotomy release combined with LPVB treatment can effectively improve the VAS and ODI scores of patients with posterolateral LDH,relieve pain and improve dysfunction;2.Ultrasound guidance is one of the effective means to visualize closed transcutaneous treatment such as acupotomy and LPVB;3.Inferior corporotransverse lingament compression may be one of the factors that cause posterolateral LDH pain and dysfunction;4.All invasive procedures in this study were conducted under real-time ultrasound guidance without any adverse events.This is a safer treatment plan. |
PDF Full Text Request