| Background:Low back pain is one of common disease and frequently encountered disease in humans. The cause of the pain may be the following structure:lumbar inter vertebral disc and inter vertebral joints, waist and back muscle film, neighboring ligament, muscle, nerve, etc. The percent of suffering from low back pain in life is 11%~84%.In the aspect of the etiology of LBP, there is no very accurate view. But a lot of scholars' view is that lumbar vertebra small joint degenerative change is one of the essential causes, even can be said to be the decisive factor. Lumbar osteoarthritis is a kind of lumbar degenerative disease, also known as little arthritis, joint syndrome, small joint, etc. LOA is one of the reasons for the low back pain. With setting in of an aging society in our country, this problem becomes more prominent. LOA pathological performances mainly are destruction of articular cartilage, subchondral sclerosis [1].The onset of LOA was positively correlated with patient's age, and in terms of gender,50 as the boundary, the prevalence of before that age, men is higher than women, but after the age, the female prevalence rate increased significantly [2].The percent of women over the age of 60 is 78.5% [3].For lumbar osteoarthritis, there are many kinds of treatment. The waist release operation is one of the minimally invasive surgeries, because of its small trauma, simple operation, short treatment time, low cost, small side effects; the waist release operation is applied in the clinical. Lumbar osteoarthritis will give patients health threat, such as restricted movement, even causes damage. At the same time also brings health and economic burden. So on the treatment of such diseases, in particular, we should pay attention to guide the patients in the usual life positive prevent condition from further development.Objective:Through applying the waist release operation, observe the clinical effect of the treatment of low back pain caused by lumbar osteoarthritis. Analyze the mechanisms of pain caused by lumbar osteoarthritis. Discuss the advantage and function principle of the waist release operation treating low back pain.Method:In May 2014 to May 2015,80 lumbar osteoarthritis patients who are in line with the criteria for this study treated in traumatology department of Chinese medicine hospital in Hubei province. A total of 95 cases, follow-up for half a year, divided into two groups by different treatment methods, surgical group, a total of 49 cases were followed up for failure in 7 cases,42 cases of successful follow-up, conservative group, a total of 46 cases were followed up for 8 cases of failure, success in 38 cases of follow-up, Surgical group has 42 cases, conservative group 38 cases, Surgical group are treated with he waist release operation, promoting blood circulation to remove blood stasis injection, guiding patients with functional exercise. Conservative groups are treated with promoting blood circulation to remove blood stasis injection, guiding patients with functional exercise.Chinese herbal medicine, Chinese medicine fumigation therapy. All patients shoot preoperative perturbation lumbar lateral slice, lumbar CT and lumbar MRI. To evaluate two groups patients from VAS score, The Oswestry Disability Index. Compare the surgical and conservative groups of patients with clinical curative effects. Analysis the waist release operation used in the treatment of lumbar back pain caused by osteoarthritis action principle.Result:The surgical patients successfully completed surgery; all patients were followed up for half a year.After processing the data show that two groups of treatment can reduce the pain of patients. 1. Comparison of VAS scores:(1) before the treatment, analyze surgical patients VAS score and conservative groups VAS score data in statistics, shows no significant difference before treatment in both groups(P >0.05);(2) At one week after treatment, VAS score significantly is lower than the conservative group, results show that the recent clinical curative effect is superior to conservative treatment group(P<0.05);(3)six months later, VAS score of surgical patients significantly is lower than the conservative group. Results show in half year, though two groups of patients will have a recurrence of the lumbago, but the long-term clinical efficacy of treatment is still better than that of the conservative groups(P<0.05). 2.Comparison of ODI scores:(1) before the treatment, analyze surgical patients ODI score and conservative groups ODI score data in statistics, shows no significant difference before treatment in both groups(P >0.05);(2) At one week after treatment, ODI score significantly is lower than the conservative group, results show that the recent clinical curative effect is superior to conservative treatment group(P<0.05);(3)six months later, ODI score of surgical patients significantly is lower than the conservative group. Results show that the improved scores in the functional activities of the spine is better than the conservative groups(P<0.05). 3. Comparison of improvement rate: Totality evaluate the period of the patients with either surgery or conservative from multiple aspects. The results show that two ways of treatment of LOA have produced significantly different curative effect the therapeutic effect of different treatments are obviously different(P<0.05),the clinical curative effect of the surgical patients significantly better than the conservative group of patients(P<0.05).Conclusion:1.for lumbar osteoarthritis patients, after waist release operation; the clinical curative effect was better than conservative treatment group. Compared with other operations for the treatment of LOA, waist release operation does not produce large incision operation, short time consuming, risk and large scope of operation, postoperative nursing easily, easy to recover, and the clinical curative effect of applying it to treat lumbar back pain caused by osteoarthritis is better; waist release operation is worth popularizing in clinic. 2. The mechanism of the pain caused by Lumbar osteoarthritis is lumbar spinal stability fall in osteophyte formation and sclerosis of articular cartilage; make the waist fascia inflammatory thickening, stuck and oppress spinal nerve producing waist pain associated with lower limb symptoms. 3. The main principle of treating the pain caused by lumbar osteoarthritis with waist release operation is:(1) spinal nerve's damage and regeneration;(2) inflammatory tissue of the waist fascia 's damage and repair. This release operation is damaging the original spinal nerve branch and inflammatory tissue of the waist fascia, repair and regeneration with its own ability, make the related organization repairing in order to rebuild its function. 4. Make a reasonable rehabilitation plan in the treatment; instruct patient carries on related functional exercise. Achieve the doctor-patient cooperation in order to Promoting better condition. |
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