ObjectiveTo probe into the clinical value of supine cervical vertebra traction with neck flexion in treating cervical spondylotic radiculopathy. MethodsFrom August 2011 to December 2013, 71 patients were divided randomly into a treatment group of 36 cases and a control group of 35 cases. They were treated respectively with supine cervical vertebra traction with neck flexion, and cervical vertebra traction on a sitting position. Both groups had acupuncture, moxibustion, massage and medium frequency electrotherapy. The period of observation was 15 days. We evaluated the results by surveying physiological curvature of the cervical spine on lateral radiograph, and visual analogue scale (VAS), neck disability index (NDI), criteria of diagnosis and therapeutic effect of syndromes in traditional Chinese medicine syndrome and clinical assessment scale for cervical spondylosis (CASCS) were also used. ResultsPhysiological curvature of cervical spine was much improved in both groups after treatment (P<0.05). The distance of cervical vertebra arc between vertebral anterior edge sequences in treatment group before treating was (4.07±3.63) mm and it was (9.03±4.31) mm after treatment. For the control group, those two numbers were respectively (4.13±3.02) and (8.87±3.97) mm. There was no significant difference in the distance of cervical vertebra arc and its increase between vertebral anterior edge between the two groups after treatment. There was significant difference in the efficiency rate between the two groups (P<0.05) (treatment group 100.00%, control group 97.14%). When cured rate and cured-markedly effective rate were added, the treatment group (80.56%) was much better than the control group (51.43%) (P<0.01). As to VAS score, NDI and CASCS scores, both groups got much better after treatment (P<0.01). For VAS, the treatment group decreased from 8.43±0.75 before treatment to 1.40±0.61 after treatment, while the control group from 8.35±0.78 before treatment to 2.55±0.59 after treatment. For NDI, the treatment group decreased from 54.13±7.44 before treatment to 10.78±4.55 after treatment, while the control group from 55.85±8.72 to 12.66±5.48. For CASCS, the treatment group rose from 34.88±5.39 before treatment to 74.65±6.73 after treatment, while the control group from 34.77±4.89 to 69.03±6.21. After treatment, VAS score of the treatment group was much lower than the control group (P<0.01). There was no difference between the two groups on NDI (P>0.05). CASCS score of the treatment group was significantly higher than the control group after the treatment (P<0.01). There was no significant difference in the increase of CASCS score between the two groups after treatment (P>0.05). ConclusionVertebra traction combined with acupuncture, moxibustion, massage and medium frequency electrotherapy is therapeutic for cervical spondylotic radiculopathy and traction at a supine and flexing position is better.
ObjectiveTo investigate the morphology of endplate shape in teens with lumbar degenerative disc disease by means of MRI and the correlation between endplate shape and lumbar disc degeneration. MethodsA retrospective study was performed on 31 teenage patients with lumbar disc herniation who underwent MRI examination between January 2011 and April 2015. The morphology of endplate was classified into three groups:concave, flat and irregular based on the midsagittal T1-weighed MRI. The degree of disc degeneration was graded on T1-weighed MRI according to Pfirrmann's method with one to five points representing grade Ⅰ to Ⅴ. All endplates were determined by Modic grading system. The associations between morphology of endplate in lower lumbar spine and disc degenerative degree as well as Modic changes were evaluated retrospectively. ResultsAmong the 93 endplates, concave represented the maximum proportion (52/93). Irregular endplate increased from L3/4(4/21) to L5/S1(10/21) gradually. The average degenerative degree for concave, flat and irregular endplate was respectively (1.19±0.11) points, (2.25±0.43) points and (3.33±0.51) point, which showed significant differences (P<0.05). Irregular was the majority in protruding sections, and concave was the majority of non-protruding sections. There were 27 modic changes in 93 endplates, in which irregular was the most, showing significant difference (P<0.05), while the difference between concave and flat endplate was not significant (P>0.05). ConclusionWe can use endplate morphology, modic changes and disc degeneration to reflect degree of disc degeneration in teenage patients. Since the L5/S1 segments bear the greatest power in the lower lumbar spine, they are most prone to disc degeneration with more irregular endplates.