RESUMEN

OBJECTIVE: To analyze the important effect of 3D printing personalized lumbar support on lumbar pain and lumbar function in patients with lumbar disc herniation. METHODS: From October 2018 to May 2021, 60 patients initially diagnosed with lumbar disc herniation were selected and divided into an observation group and a control group, with 30 patients in each group. Among them, there were 18 males and 12 females in the observation group;the age ranged from 24 to 56 years old, with an average of (45.23±6.07) years old. The course of disease ranged from 1 to 24 months, with an average of(6.25±0.82) months, and rehabilitation treatment was carried out by wearing 3D printed personalized lumbar support. There were 19 males and 11 females in the control group;the age ranged from 25 to 57 years old, with an average of (42.78±7.58) years old. The course of disease ranged from 1 to 24 months, with an average of (6.72±1.36) months, and rehabilitation treatment is carried out by wearing traditional lumbar protective equipment. The Japanese Orthopaedic Association (JOA) scores, lumbar Oswestry dysfunction index (ODI) and visual analogue scale (VAS) were evaluated and compared between the two groups before and 1 course after treatment (3 weeks). RESULTS: There was no statistically significant difference in JOA, ODI, and VAS between two groups before treatment (P>0.05). After one course of treatment (3 weeks), JOA scores of both groups was increased compared to before treatment (P<0.05), while ODI and VAS decreased compared to before treatment (P<0.05). After treatment, JOA score of observation group was higher than that of control group (P<0.05), while ODI and VAS scores were lower than those of control group. No adverse events occurred in both groups. CONCLUSION: The application of 3D printing personalized lumbar support can effectively alleviate the pain of patients with lumbar disc herniation and improve their lumbar function of patients.

Asunto(s)

RESUMEN

OBJECTIVE@#To analyze the important effect of 3D printing personalized lumbar support on lumbar pain and lumbar function in patients with lumbar disc herniation.@*METHODS@#From October 2018 to May 2021, 60 patients initially diagnosed with lumbar disc herniation were selected and divided into an observation group and a control group, with 30 patients in each group. Among them, there were 18 males and 12 females in the observation group;the age ranged from 24 to 56 years old, with an average of (45.23±6.07) years old. The course of disease ranged from 1 to 24 months, with an average of(6.25±0.82) months, and rehabilitation treatment was carried out by wearing 3D printed personalized lumbar support. There were 19 males and 11 females in the control group;the age ranged from 25 to 57 years old, with an average of (42.78±7.58) years old. The course of disease ranged from 1 to 24 months, with an average of (6.72±1.36) months, and rehabilitation treatment is carried out by wearing traditional lumbar protective equipment. The Japanese Orthopaedic Association (JOA) scores, lumbar Oswestry dysfunction index (ODI) and visual analogue scale (VAS) were evaluated and compared between the two groups before and 1 course after treatment (3 weeks).@*RESULTS@#There was no statistically significant difference in JOA, ODI, and VAS between two groups before treatment (P>0.05). After one course of treatment (3 weeks), JOA scores of both groups was increased compared to before treatment (P<0.05), while ODI and VAS decreased compared to before treatment (P<0.05). After treatment, JOA score of observation group was higher than that of control group (P<0.05), while ODI and VAS scores were lower than those of control group. No adverse events occurred in both groups.@*CONCLUSION@#The application of 3D printing personalized lumbar support can effectively alleviate the pain of patients with lumbar disc herniation and improve their lumbar function of patients.

Asunto(s)

RESUMEN

OBJECTIVE: To explore effects of acupotomy on pain, function, gait and serum inflammatory factors in patients with knee osteoarthritis(KOA). METHODS: From December 2017 to June 2019, 110 patients with KOA were collected and divided into acupotomy group(56 cases) and western medicine group(54 cases) by using random number table method. In acupotomy group, there were 16 males and 40 females, aged from 46 to 74 years old with an average of (62.98±6.68) years old, the course of disease ranged from 1 to 240 months with an average of 24.5(15.25, 33.00) months;were treated with acupotomy on the pain points around knee joint once a week for 3 weeks. In western medicine group, there were 18 males and 36 females, aged from 47 to 73 years old with an average of (64.19±5.98 ) years old;the course of disease ranged from 1 to 220 months with an average of 25.00(13.75, 33.00) months;were took celecoxib capsule orally, 200 mg once a day for 3 weeks. Oxford Knee Score(OKS) was performed before treatment, 3 weeks and 3 months after treatment. Gait kinematics analysis and serum levels of tumor necrosis factor-α(TNF-α) and interleukin-1ß (IL-1ß) were measured before and after treatment for 3 weeks. RESULTS: All patients were followed up from 6 to 24 months with an average of(15.03±4.55) months. OKS between two groups decreased significantly at 3 weeks and 3 months after treatment(P<0.001). Functional scores and overall scores in acupotomology group were significantly decreased at 3 months compared with 3 weeks after treatment(P<0.001). OKS of acupotomy group were significantly lower than those of western medicine group at 3 weeks and 3 months after treatment(P<0.05). Gait speed, frequency and length between two groups were significantly improved at 3 weeks after treatment(P<0.05). At 3 weeks after treatment, gait freguency of acupotomy group was significantly improved compared with western medicine group(P<0.05). TNF-α and IL-1ß were significantly lower in both groups at 3 weeks after treatment than before treatment(P<0.05). At 3 weeks after treatment, level of IL-1 ß was lower in western medicine group than in acupotomy group(P<0.05), and difference in TNF-α level was not statistically significant(P>0.05). CONCLUSION: Acupotomology of pain points could significantly improve pain, function, gait, and decreased serum inflammatory factors at early to mid stage of KOA patients, in particular, it is superior to non-steroidal anti-inflammatory drugs in terms of knee function recovery and cadence improvement.

Asunto(s)

RESUMEN

OBJECTIVE: To explore safety and accuracy of four-point acupotomy for the treatment of tarsal tunnel syndrome regarding release of ankle tunnel flexor retinaculum to provide an anatomical basis of clinical treatment. METHODS: Twenty-nine adult specimens (15 males and 14 females) fixed with 10% formalin, aged from 47 to 98 years old with an average age of (81.10±11.14) years old, 29 on the right side and 29 on the left side, which were selected for the study from September 2020 to October 2020. Simulate the operation of loosening flexor retinaculumt with a needle knife on the human specimen, and place the specimen on the frog position of lower limbs with medial malleolus upward to determine the center of medial malleolus. Choose 4 different positions near the flexor retinaculum to insert the needle so that the needle body was perpendicular to skin and cutting edge direction was perpendicular to the running direction of the flexor retinaculum. The needle knife penetrates the skin and explores slowly. When the flexor retinaculum was reached, the needle tip may touch the tough tissue. At this time, the cutting is loosened for 4 times. After acupotomy release operation was completed, make a lateral incision on the skin surface along acupotomy direction, open the area of the exposed flexor retinaculum, dissecting layer by layer, observe and record the needle knife and its surrounding anatomical structure. The length of acupotomy cutting marks of flexor retinaculum was measured by electronic vernier caliper. The safety and accuracy of acupotomy loosening of ankle canal flexor retinaculum were evaluated by observing the number and degree of ankle canal contents such as tendons and nerves injured by needle knife. The safety is to count the number of cases of acupotomy injury to the contents of the ankle canal, and to calculate the injury rate, that is, the number of injury cases/total cases × 100%. The effective release was defined as the release length L ≥ W/2(W is the width of the flexor retinaculum, defined as 20 mm). RESULTS: For safety, there were no acupotomy injuries to nerves or blood vessels in 58 cases, 26 cases injuried to posterior tibial tendon which 17 of these tendon injury cases, the tendon was penetrated and severely injured, and flexor digitorum longus tendon was injured in 12 cases. Among these cases, tendon was penetrated and severely injured in 4 cases, and total injury rate was 32.14%. No nerve and vessel injury on c3 and c4 point. For accuracy, 58 specimens were successfully released. The length Lc of releasing trace for acupotomy was (10.40±1.36) cm, and length range 6.38 to 12.88 cm. Among all cases, the length of releasing trace was ≥10 mm in 37 cases. The overall success rate of release was 100.00%. Layered structure of ankle tube flexor retinaculumt:fiber diaphragm from flexor retinaculum divides contents of ankle tube into different chambers inward, and fiber diaphragm meets here to synthesize a complete flexor retinaculum at the midpoint of the line between the medial malleolus tip and calcaneal tubercle(above the neurovascular course). CONCLUSION: Four-point needle-knife method of releasing flexor retinaculum for the treatment of tarsal tunnel syndrome is performed at the attachment of the two ends of flexor retinaculum;the tendon, but not the nerves and blood vessels, is easily damaged. It is safe to insert needle on the side of calcaneus. The extent of release is relatively complete, but due to the "layered" structure of the flexor retinaculum, classic surgical technique could only release one layer of flexor retinaculum when a needle is inserted at the edge of the bone and cannot achieve complete release of the full thickness of the flexor. Therefore, it remains to be determined whether the desired effect can be achieved clinically.

Asunto(s)

RESUMEN

OBJECTIVE: To observe the clinical efficacy of micro needle knife therapy on cervical vertigo. METHODS: A total of 300 patients with cervical vertigo treated from January 1, 2017 to December 31, 2019 were randomly divided into micro needle knife group (96 cases, 4 cases falling off), traditional acupuncture group (96 cases, 4 cases falling off) and oral drug group(95 cases, 5 cases falling off). The micro needle knife group was treated with micro needle knife in the local upper cervical segment once every other day for 7 times; the traditional acupuncture group was treated with traditional acupuncture once a day for 2 weeks;the oral drug group was given Merislon (betahistine mesilate tablets) orally, 6 mg each time, 3 times a day for 2 weeks. The patients were followed up before treatment, at the end of treatment and 3 months after treatment. The dizziness handicap inventory(DHI) was observed and the curative effect was evaluated according to the DHI score. RESULTS: At the end of the course of treatment and 3 months after the treatment, DHI scores of the three groups were significantly lower than those before treatment(P<0.01), and the DHI scores of micro needle knife group were lower than those of traditional acupuncture group and oral drug group at the same time point after treatment (P<0.01). There was no statistically significant difference in DHI scores between traditional acupuncture group and oral drug group at the same time after treatment(P< 0.05). The curative effect was evaluated according to DHI score:in micro needle knife group, 50 cases were cured, 28 cases were markedly effective, 14 cases were improved, the total effective rate was 95.83%; in traditional acupuncture group, 28 cases were cured, 26 cases were markedly effective, and 24 cases were improved, with the total effective rate of 81.25%;in oral drug group, 18 cases were cured, 20 cases were markedly effective, and 28 cases were improved, with the total effective rate of 69.47%. The total effective rate of micro needle knife group was significantly higher than that of other two groups (χ2=45.956, P=0.000). Among the cured patients in the three groups, the time required in the micro needle knife group was significantly less than that in the traditional acupuncture group and oral drug group(F=18.796, P=0.000). CONCLUSION: Micro needle knife loosening atlantoaxial soft tissue has obvious curative effect on cervical vertigo which clinical cure rate, effective rate and treatment time required for cured patients are better than traditional acupuncture and oral drug.

Asunto(s)

RESUMEN

OBJECTIVE@#To observe the clinical efficacy of micro needle knife therapy on cervical vertigo.@*METHODS@#A total of 300 patients with cervical vertigo treated from January 1, 2017 to December 31, 2019 were randomly divided into micro needle knife group (96 cases, 4 cases falling off), traditional acupuncture group (96 cases, 4 cases falling off) and oral drug group(95 cases, 5 cases falling off). The micro needle knife group was treated with micro needle knife in the local upper cervical segment once every other day for 7 times; the traditional acupuncture group was treated with traditional acupuncture once a day for 2 weeks;the oral drug group was given Merislon (betahistine mesilate tablets) orally, 6 mg each time, 3 times a day for 2 weeks. The patients were followed up before treatment, at the end of treatment and 3 months after treatment. The dizziness handicap inventory(DHI) was observed and the curative effect was evaluated according to the DHI score.@*RESULTS@#At the end of the course of treatment and 3 months after the treatment, DHI scores of the three groups were significantly lower than those before treatment(P<0.01), and the DHI scores of micro needle knife group were lower than those of traditional acupuncture group and oral drug group at the same time point after treatment (P<0.01). There was no statistically significant difference in DHI scores between traditional acupuncture group and oral drug group at the same time after treatment(P< 0.05). The curative effect was evaluated according to DHI score:in micro needle knife group, 50 cases were cured, 28 cases were markedly effective, 14 cases were improved, the total effective rate was 95.83%; in traditional acupuncture group, 28 cases were cured, 26 cases were markedly effective, and 24 cases were improved, with the total effective rate of 81.25%;in oral drug group, 18 cases were cured, 20 cases were markedly effective, and 28 cases were improved, with the total effective rate of 69.47%. The total effective rate of micro needle knife group was significantly higher than that of other two groups (χ2=45.956, P=0.000). Among the cured patients in the three groups, the time required in the micro needle knife group was significantly less than that in the traditional acupuncture group and oral drug group(F=18.796, P=0.000).@*CONCLUSION@#Micro needle knife loosening atlantoaxial soft tissue has obvious curative effect on cervical vertigo which clinical cure rate, effective rate and treatment time required for cured patients are better than traditional acupuncture and oral drug.

Asunto(s)

RESUMEN

Objective:To study the clinical efficacy of ultrasound-guided radiofrequency acupotomy in early and middle-stage knee osteoarthritis (KOA).Methods:A total of 62 patients with KOA were enrolled and then randomly divided into the radiofrequency acupuncture group and the control group. The two groups were treated with radiofrequency acupotomy and conventional acupotomy under ultrasound guidance, respectively. The treatments were conducted once a week, twice in total. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) of all the patients was evaluated before the treatment as well as the day, 2 weeks, and 1 month after the treatment.Results:Before the treatment, the differences between the two groups in gender, age, body mass index (BMI), WOMAC pain score, WOMAC stiffness score, WOMAC function score, and WOMAC total score were not statistically significant (all P>0.05), indicating the two groups were comparable. On the day, 2 weeks, and 1 month after the treatment, the above WOMAC scores of the two groups were lower than those before the treatment, and the differences were statistically significant (all P<0.01). The WOMAC scores of the radiofrequency acupotomy group were lower than those of the control group at the same period, and the differences were statistically significant (all P<0.05). Conclusions:For patients with early and middle-stage KOA, ultrasound-guided radiofrequency acupotomy therapy has proven clinical efficacy in relieving pain and improving knee joint function.

RESUMEN

Objective To explore the clinical effect of using small needle knife in autologous fat grafting for the treatment of atrophic scar.Methods Twelve patients with atrophic scar were included in this study during March 2014 and December 2016 in the Hangzhou First People's Hospital,Zhejiang University School of Medicine.We used small needle knife during fat grafting to treat the atrophic scar.Observer Scar Assessment Scale (POSAS) was used to assess the clinical effect of the patients.Results Aesthetic and functional improvements were observed.Resolution of pain and increases in scar elasticity were objectively assessable.Improvement of both clinical evaluation and patient perception was obtained.Conclusions Use of small needle knife during fat grafting is a good alternative for the treatment of atrophic scars.

RESUMEN

OBJECTIVE: To study clinical effects of needle Dao for the treatment of carpal tunnel syndrome. METHODS: From July 2014 to December 2016, 60 patients with carpal tunnel syndrome were divided into two groups: needle Dao treatment group(treatment group), and brace and medicine treatment group(control group), 30 cases in each group. There were 8 males and 22 females in the treatment group, with an average age of (49.38±7.43) years old. There were 7 males and 23 females in the control group, with an average age of (50.23±8.71) years old. There were no statistically significant differences between two groups before treatment in age, sex, course of disease, sensory nerve conduction velocity (SCV), sensory nerve action potential (SNAP), and distal motor latency(DML). The patients in the treatment group were treated with needle Dao for 1 to 2 times, while the patients in the control group were given celecoxib, vitamin B1 and vitamin B12, with the brace fixed. After treatment, the changes of SCV, SNAP and DML in two groups were observed. RESULTS: After treatment, the SCV were (48.63±7.33) m/s and (41.24±6.15) m/s in treatment group and control group separately, the SNAP were (9.89±3.71) m/s and (8.22±2.19) m/s, and the DML were(5.11±2.28) m/s and (6.13±2.23) m/s. The SCV, SNAP and DML after treatment were better than those before treatment(P<0.05). And the results of SCV, SNAP and DML of patients in the treatment group were better than those of patients in the control group(P<0.001). CONCLUSIONS: Needle Dao can effectively improve the overall treatment efficiency of patients with carpal tunnel syndrome and reduce the symptoms of patients, which is feasible and suitable to use in clinical.

Asunto(s)

RESUMEN

<p><b>OBJECTIVE</b>To study clinical effects of needle Dao for the treatment of carpal tunnel syndrome.</p><p><b>METHODS</b>From July 2014 to December 2016, 60 patients with carpal tunnel syndrome were divided into two groups: needle Dao treatment group(treatment group), and brace and medicine treatment group(control group), 30 cases in each group. There were 8 males and 22 females in the treatment group, with an average age of (49.38±7.43) years old. There were 7 males and 23 females in the control group, with an average age of (50.23±8.71) years old. There were no statistically significant differences between two groups before treatment in age, sex, course of disease, sensory nerve conduction velocity (SCV), sensory nerve action potential (SNAP), and distal motor latency(DML). The patients in the treatment group were treated with needle Dao for 1 to 2 times, while the patients in the control group were given celecoxib, vitamin B1 and vitamin B12, with the brace fixed. After treatment, the changes of SCV, SNAP and DML in two groups were observed.</p><p><b>RESULTS</b>After treatment, the SCV were (48.63±7.33) m/s and (41.24±6.15) m/s in treatment group and control group separately, the SNAP were (9.89±3.71) m/s and (8.22±2.19) m/s, and the DML were(5.11±2.28) m/s and (6.13±2.23) m/s. The SCV, SNAP and DML after treatment were better than those before treatment(<0.05). And the results of SCV, SNAP and DML of patients in the treatment group were better than those of patients in the control group(<0.001).</p><p><b>CONCLUSIONS</b>Needle Dao can effectively improve the overall treatment efficiency of patients with carpal tunnel syndrome and reduce the symptoms of patients, which is feasible and suitable to use in clinical.</p>

RESUMEN

Objective To evaluate the clinical effect of acupotomy therapy combined with acupuncture based on distal points selection for lumbar intervertebral disc protrusion ( LIDP) . Methods Sixty-eight LIDP patients were randomly divided into treatment group (N=33) and control group(N=35). The treatment group were given acupotomy therapy on the proximal positive response points in the lumbosacral region for relaxing the tendons,and acupuncture therapy based on distal points selection of Shugu, the Shu-stream point of the foot Taiyang bladder meridian, Zulinqi and Weizhong, the shu-stream point and the blood xi-cleft point of the foot Shaoyang gallbladder meridian respectively, twice a week, 2 weeks constituting one course of treatment. The control group was given conventional electroacupuncture therapy on Huatuo clip points, Dachangshu point, bilateral Shenshu points, Yinmen point, bilateral Zibian points and bilateral Yanglingquan points, and together with TDP radiation therapy, 5 times a week, 2 weeks constituting one course of treatment. The two groups received follow-up for one month. The low back pain scores of Japanese orthopaedic society ( JOA) and visual analog scores ( VAS) of pain were used for the evaluation of therapeutic effect after the treatment. Results ( 1) After treatment, the JOA scores were increased and VAS scores were decreased in both groups compared with those before treatment ( P< 0.05) , and the increase of JOA scores and the decrease of VAS in the treatment group were superior to those in the control group ( P< 0.05) . There was statistically significant difference of VAS scores between the two groups ( P < 0.05) during the follow-up period. ( 2) The total effective rate was 87.9%in the treatment group, and was 77.1%in the control group, the difference being significant (P<0.05) . Conclusion The acupotomy therapy combined with acupuncture based on distal points selection is effective and safe for lumbar intervertebral disc protrusion, which has the advantages of reliable long-term effect and low recurrence rate, showing good prospects for extensive clinical application.

RESUMEN

Objective To study the curative effect of limited-acupotomy therapy on chronic lumbosacral osteo-fascial compartment syndrome. Methods 59 patients were randomly recruited into a control group (with 29 patients) and a treatment group (with 30 patients). The control group was treated with general-acupotomy therapy, and treatment group was treated with limited-acupotomy therapy. Evaluate the curative effects before the first and the second therapy, and 3 months after the therapy respectively, as well as VAS pain, JOA and CODI scores. Results The curative effect was 96.56% and 100% respectively in the control group and the treatment group 3 months after the treatment. The difference between the two groups was not statistically significant(χ2＝0.19,P＞ 0.05). As to VAS pain scores, JOA and CODI scores, the difference among the three stages of the treatment were significant (in control group F＝165.70, 99.90, 106.60 respectively, in treatment group F＝279.76, 154.34, 67.36 respectively, P＜0.01)in both groups respectively, but the difference between the two groups were not significant(P＞0.05) in each stage. Conclusion Limited-acupotomy therapy was safe and effective in treating chronic lumbosacral osteo-fascial compartment syndrome.