Clinical Study Of Ultrasound-guided Lumbar Nerve Root Block Combined With Chiropractic In The Treatment Of Lumbar Disc Herniation

BackgroundLow back and leg pain is one of the most common chronic pain diseases in clinic,Low back and leg pain often lasts for a long time,resulting in the loss of the patient’s ability to work,it imposes severe burdens and stresses on society and families.Lumbar disc herniation is the most common cause of low back and leg pain.Lumbar disc herniation mechanical compression adjacent to the lumbar nerve root,the release of a variety of inflammatory factors of the disc nucleus pulposus chemical stimulation of nerve root and other factors lead to nerve root inflammation,causing chronic pain and dysfunction in the lower back and leg.The treatment of lumbar disc herniation includes conservative treatment,minimally invasive treatment and surgical treatment.Conservative treatment includes rest,medication,physical therapy,etc."American Chiropractic" therapy is a physiotherapy method of treating lumbar disc herniation,which is popular in Europe and America for more than 100 years.The method is based on the biomechanical idea that disc herniation is caused by uneven pressure in the disc,through the combination of manipulation and instrument therapy,we can reduce the intervertebral disc pressure,reposition the herniated intervertebral disc and balance the intervertebral disc pressure.But in clinical practice,due to factors such as muscle stiffness caused by pain and nerve root edema caused by inflammatory stimulation,patients suffer from severe pain and slow response to treatment,patients have even rejected the treatment because they could not tolerate the pain.Ultrasound-guided nerve root block is a real-time ultrasound-guided injection of antiinflammatory and analgesic fluid into the intervertebral foraminal nerve root of the lesion,accurate,safe and effective,but the effect does not last for the patients with a herniated disc pressing on a nerve root.If the combination of "American chiropractic" therapy and ultrasound-guided nerve root block is applied in the treatment of patients with lumbar disc herniation,can we learn from each other and complement each other in curative effect?On the one hand,through the ultrasound-guided nerve root block,the effect of immediate elimination/relief of pain and muscle relaxation can not only reduce the pain of patients but also provide conditions for the treatment of chiropractic.On the other hand,through chiropractic therapy,the herniated intervertebral disc can be reabsorbed to achieve the purpose of long-term treatment.Meanwhile,with the injection of anti-inflammatory and analgesic fluid,the recovery speed and quality of patients can be improved.In order to verify this clinical combination therapy,our group conducted the following clinical observation study.ObjectiveTo investigate the clinical effect of lumbar nerve root block combined with chiropractic in the treatment of lumbar disc herniation.Method120 patients with lumbar disc herniation were randomly divided into two groups,Combination group:ultrasound-guided lumbar nerve root block combined with American Chiropractic group(group A): 60 cases;Smiple ultrasound-guided lumbar nerve root block group(group B): 60 cases.Group A was treated with ultrasound-guided lumbar nerve root block combined with American Chiropractic therapy,group B was treated with simple ultrasound-guided lumbar nerve root block.Compare the efficacy before treatment and 1 month,3 month and 6 months afer treatment.ResultThe results of the study showed that the combination group(Group A)did better on VAS and Oswestry 1 month,3month,6month after treatment than before the treatment,there were significant statistical differences,(p<0.01);The simple nerve block group(Group B)did better on VAS and Oswestry 1 month,3 month,3month,6month after treatment than before the treatment,there were significant statistical differences,(p<0.01);The combination group(Group A)was better to the simple nerve block group(group B)on VAS and Oswestry 1 month,3month,6month after treatment,(p<0.05).ConclusionUltrasound-guided lumbar nerve root block combined with American Chiropractic is more effective on pain relief and lumbar and leg functional recovery than simple lumbar nerve root block in the treatment of lumbar disc herniation 1 month,3month,6month after treatment.