[Clinical observation on Xiaoyusan plaster and Daoyin in the treatment of disease of cervical vertebrae]

Zhongguo Gu Shang. 2009 May; 22(5): 357-9Teng WROBJECTIVE: To investigate the effects of Xiaoyusan plaster and Daoyin in the treatment of cervical vertebrae disease, to search new methods in the treatment of cervical vertebrae disease. METHODS: From May 2007 to April 2008, 63 patients with disease of cervical vertebrae were treated. By odd or even numbers in random digits table, the patients were randomly divided into two groups included treatment group and control group. Thirty-three patients in the treatment group were treated with Xiaoyusan plaster and Daoyin included 21 males and 12 females with an average age of (30.60+/-7.89) years ranging from 20 to 49. Thirty patients in the control group were treated with Votalin Sustained Release Tablets included 16 males and 14 females with an average age of (32.43+/-8.00) years ranging from 20 to 49. The pain, pressing pain, activity of cervical vertebrae were observed before and after treatment in two groups. RESULTS: Compared the scores before and after treatment in treatment group: pain (t=8.953, P

Cervical spinal disc replacement.

J Bone Joint Surg Br. 2009 Jun; 91(6): 713-9Denaro V, Papalia R, Denaro L, Di Martino A, Maffulli NCervical spinal disc replacement is used in the management of degenerative cervical disc disease in an attempt to preserve cervical spinal movement and to prevent adjacent disc overload and subsequent degeneration. A large number of patients have undergone cervical spinal disc replacement, but the effectiveness of these implants is still uncertain. In most instances, degenerative change at adjacent levels represents the physiological progression of the natural history of the arthritic disc, and is unrelated to the surgeon. Complications of cervical disc replacement include loss of movement from periprosthetic ankylosis and ossification, neurological deficit, loosening and failure of the device, and worsening of any cervical kyphosis. Strict selection criteria and adherence to scientific evidence are necessary. Only prospective, randomised clinical trials with long-term follow-up will establish any real advantage of cervical spinal disc replacement over fusion.

Comparison of growth factor and cytokine expression in patients with degenerated disc disease and herniated nucleus pulposus.

Clin Biochem. 2009 Jun 26; Lee S, Moon CS, Sul D, Lee J, Bae M, Hong Y, Lee M, Choi S, Derby R, Kim B, Kim J, Yoon JS, Wolfer L, Kim J, Wang J, Hwang SW, Lee SHObjectives: This study was conducted to investigate the expression of cytokines and growth factors in disc specimens obtained from patients with herniated nucleus pulposus (HNP) and degenerated disc disease (DDD) Design and methods: MRI and Western blot analyses were performed to evaluate the levels of disc degeneration and the expression levels of cytokines and growth factors. Results: The levels of: TNF-alpha and IL-8 were significantly greater in the DDD group than in the HNP group, but no statistical differences were observed in the expression of IL-1alpha, IL-6 and IL-12 between the HNP and DDD groups. In addition, the expression of TGF alpha, VEGF and NGF was significantly higher in the DDD group than in the HNP group. Conclusion: The greater levels of cytokine and growth factor expression in the DDD group than in the HNP explain why discogenic patients usually have more severe back pain than patients with herniated discs.

[Reflex sympathetic dystrophy secondary to piriformis syndrome: a case report.]

Agri. 2009 Apr; 21(2): 75-79Akçalı D, Taş A, Cizmeci P, Oktar S, Zinnuroğlu M, Arslan E, Köseoğlu H, Babacan APiriformis syndrome is a rare cause of hip and foot pain which may be due to sciatic nerve irritation because of anatomic abnormalities of sciatic nerve and piriformis muscle or herniated disc, facet syndrome, trochanteric bursit, sacroiliac joint dysfunction, endometriosis and other conditions where sciatic nerve is irritated. There has been no reflex sympathetic dystrophy (RSD) case presented due to piriformis syndrome before. A sixty-two-year-old female patient had right foot and hip pain (VNS: 8), redness and swelling in the foot since 15 days. Her history revealed long walks and travelling 3 weeks ago and sitting on the foot for a long time for a couple of days. Physical examination revealed painful hip movement, positive straight leg rise. Erythema and hyperalgesia was present in dorsum of the right foot. Right foot dorsiflexion was weak and hyperesthesia was found in right L4-5 dermatome. Medical treatment and ultrasound treatment to piriformis muscle was not effective. The patient was injected 40 mg triamcinolon and local anesthetic in right piriformis muscle under floroscopy by diagnosis of piriformis syndrome, neuropathic pain and RSD. Pain and hyperalgesia resolved and motor weakness was better. During follow-up right foot redness resolved and pain decreased (VNS: 1). In this case report, there was vascular, muscle and skeletal signs supporting RSD, which shows us the therapoetic effect of diagnostic piriformis injection. The patient history, physical examination and diagnostic tests were evaluated by a multidisciplinary team which contributed to the treatment.