Clinical Observation Of Treatment Of Degenerative Lumbar Spinal Stenosis With Small Needle Knife And Orthopedic Technique

Research Background:Degenerative lumbar spinal stenosis (DLSS) is due to a variety of factors that cause degenerative spinal nerve root canal, foramen bony or fibrous dysplasia structure, leading to bureaucratic internal diameter of single or multiple segments to reduce the emergence of cauda equina nerve roots pass clinical symptoms syndrome to low back pain, intermittent claudication, lower limb sensory disturbances as the main clinical manifestations. With the progress of China’s aging population, increasing trend in the incidence of this disease, the incidence of spinal disorders occupy second place, seriously affecting the quality of life of older persons.At present, mainly in the treatment of this disease Integrative conservative therapy, such as non-steroidal anti-inflammatory drugs, muscle relaxants agents steroids and laser irradiation, IF ultrasound physical therapy with internal and external medicine, acupuncture, knife and massage Orthopedics and so on. The above method of treatment in the clinical efficacy achieved significant for the majority of patients to accept. For spinal stenosis patients-with refractory or severe, surgical decompression should take reasonable way to treat personal physical condition.Small needle knife therapy by using the lesion site, stripping, loose solution, cutting and other methods, reduce the pressure of the area of inflammation, blocking its vicious stimulation of nerve blood vessels, promote blood circulation, improve tissue ischemia and anoxic state, to facilitate the repair of inflammation, relieve local muscle tension and muscle spasms, restore partial dynamic balance. Massage technique can make the local lesion blood circulation, reduce the pain caused by substances in the plasma and the accumulation, so as to relieve pain, relieve muscle spasm; Through bonesetting skill, can adjust the rotation of the vertebral anomalies, the change of curvature, can loosen up and articular process nerve root canal volume expansion, and can make some improve fiber stenosis. Two together can obviously relieve pain symptoms and improve the dysfunction of lower limbs.Purpose:Observation with small needle knife in the traditional Chinese medicine bonesetting manipulation in the treatment of degenerative lumbar spinal stenosis disease curative effect, and with the simple use of small needle knife comparing the curative effect of treatment of the disease, to explore palasy technique in the treatment of degenerative disease of cervical stenosis.Methods:using randomized controlled methods will learn the third affiliated hospital of Beijing medical university orthopaedic clinic of degenerative lumbar spinal stenosis disease patients were randomly divided into observation group and control group 30 cases each. The treatment group with small needle knife was palasy technique, the control group only by small needle knife therapy, treatment for three weeks. And before the treatment, treatment after a week, two weeks, three weeks to observe, record JOA score and VAS score. Through the statistical analysis, to evaluate its curative effect.Results:(1) the observation group and control group patients after 1 week,2 weeks,3 weeks VAS score and the JOA score compared with before treatment had significant difference (P< 0.05).(2) through the SNK test, observation group average JOA score before treatment< a week after treatment< two weeks later after<three weeks after the treatment, the observation group average VAS score before treatment> week after treatment> 2 weeks=three weeks after the treatment. That within the first week and second week treatment time points, pain relief and improvement of symptoms and signs is significant, three weeks after the curative effect with no obvious difference in the second week of, curative effect is stable.(3) the JOA score between two groups of comparison, the t test, P (after 1 week)=0.030, P=0.001 (2 weeks), P (3 weeks)=0.690, after a week,2 weeks after treatment, JOA score was statistically difference between the two groups, and the two time points in observation group JOA score> control group on average, treating the first two weeks, to the improvement of the symptoms and signs of integral observation group is better than the control group; Three weeks after the treatment, JOA score no statistical difference between the two groups. VAS score between the two groups, the t test, P (after 1 week)=0.046, P=0.034 (2 weeks), P = 0.185. (3 weeks) after a week,2 weeks after treatment, VAS score between the two groups statistically significant, comparable, and a week after treatment to observe VAS score< control group and observation group of VAS score after two weeks of treatment (the control group; Three weeks after the treatment of VAS score between the two groups has no statistical significance.(4) the evaluation of curative effect between the two groups after treatment, the X2 test, X2=5.348, P> 0.05, there was no statistically significant difference. Observation group and control group no significant difference in curative effect evaluation. But the observation group was significantly higher than the control group(36.6%).Conclusion:(1) two kinds of methods in the treatment of degenerative lumbar spinal stenosis disease is effective, can effectively alleviate pain, improve symptoms.(2) the observation group than control group in the treatment of the first two weeks of therapy, to relieve pain and improve the symptoms of lower extremity, but in three weeks after the treatment curative effect has no obvious difference between the two groups. That needle knife coordination skill can more quickly relieve pain and improve the symptoms of lower extremity, shorten the cycle of patient care.(3) from the rate of good curative effect of that, the treatment group was significantly higher than that of control group, but the gap is narrowing in the both on total effective rate.