Lumbar disc herniation
Conditions
Interventions
Acupotomy Spinal Canal Decompression Group:Acupotomy Spinal Canal Decompression
Acupotomy Extraforaminal Decompression Group (including Facet Joint and Peripheral Muscle Decompression:Acupotomy Extraforaminal Decompression (including Facet Joint and Peripheral Muscle Decompressio
Acupotomy Spinal Canal Decompression + acupotomyNeedle Knife Extraforaminal Decompression Group:Acupotomy Spinal Canal Decompression + acupotomyNeedle Knife Extraforaminal Decompression
Sponsors
The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital
Eligibility
Sex/Gender
All
Age
20 Years to 85 Years
Inclusion criteria
Inclusion criteria: 1)Diagnostic Criteria Traditional Chinese Medicine Diagnostic Criteria According to the "Traditional Chinese Medicine Diagnosis and Efficacy Standard for Disease Syndromes in Traditional Chinese Medicine" (ZY/T001.1-94), the following criteria are used for diagnosing lumbar disc herniation: 1.A history of lumbar trauma, chronic strain, or cold-damp conditions. Most patients have a history of chronic low back pain before onset. 2. Commonly occurs in young and middle-aged adults. Pain radiates from the lumbar region to the buttocks and lower limbs, with exacerbation of pain during increased abdominal pressure (e.g., coughing or sneezing). 3.Spinal curvature abnormality, disappearance of the normal lumbar curve, localized tenderness near the affected vertebrae radiating down to the lower limb, and limited lumbar mobility. 4. Sensory hypersensitivity or dullness in the nerve distribution area of the affected lower limb; long-term cases may show muscle atrophy. Positive straight leg raise and exacerbation tests. Diminished or absent knee and Achilles reflexes, with weakened dorsal extension of the big toe. 5. X-ray examination: abnormal spinal curvature, loss of the normal lumbar lordosis, possible narrowing of the affected intervertebral disc, and osteophyte formation at the disc edges. CT scans may show the location and degree of disc protrusion. Western Medicine Diagnostic Criteria 1.According to the "2020 Guidelines for the Diagnosis and Treatment of Lumbar Disc Herniation" established by the Spine Surgery Group of the Chinese Orthopaedic Association: 2. Low back pain and leg pain in typical areas of the lumbosacral nerve root distribution, with leg pain often being more severe than back pain. 3. Presence of two of the four neurogenic signs: muscle atrophy, muscle weakness, sensory abnormality, and reflex changes in the corresponding nerve distribution area. Positive nerve root tension tests, including straight leg raise or femoral nerve stretch tests. 4.Abnormalities on imaging studies, including X-ray, CT, MRI, or special contrast studies, consistent with clinical syptoms. 2) Inclusion Criteria: 1. Patients who meet the above diagnostic criteria and are confirmed to have lumbar disc herniation. 2. Age between 20 and 85 years old. 3. No immune dysfunction or significant genetic abnormalities, and no severe cardiovascular or cerebrovascular diseases. 4. Exclusion of ankylosing spondylitis, spinal stenosis, spinal canal tumors, or tuberculosis. 5. No use of corticosteroids or anti-rheumatic medications within the past two months. 6. Voluntary participation and willingness to cooperate with the treatment protocol, with signed informed consent.
Exclusion criteria
Exclusion criteria: Exclusion Criteria: 1.Individuals who do not meet the inclusion criteria. 2.Pregnant women, or individuals with severe heart, liver, or kidney dysfunction; those with blood disorders, tumors, respiratory, cardiovascular, or cerebrovascular diseases, autoimmune diseases, extreme frailty, or a tendency for mental illness. 3.Patients with large disc protrusions causing severe neurological dysfunction, cauda equina compression, or those with other surgical indications. 4.Individuals who have used corticosteroids or non-prescription painkillers within the past two weeks. 5.Other conditions as judged by the researcher that may decrease the likelihood of successful enrollment or complicate the enrollment process, such as frequent changes in work environment that may lead to loss to follow-up.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Low back pain Visual Analogue Scale score;Low back pain Japanese Orthopaedic Association score; | — |
Secondary
| Measure | Time frame |
|---|---|
| General Information;Short Form-36 Short Form Health Survey;Patient satisfaction; | — |
Countries
China
Contacts
Public ContactFangming Liu
The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital
Outcome results
None listed