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題名 | Myofascial Trigger Points in Patients with Lumbar Radiculopathy Due to Disc Herniation Before and After Surgery=腰椎間盤突出症併發神經根病變病患在手術前及手術後其肌膜引痛點之探討 |
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作者 | 吳浚明; 陳幸鴻; 洪章仁; Wu, Chun-ming; Chen, Hsing-hong; Hong, Chang-zern; |
期刊 | 中華民國外科醫學會雜誌 |
出版日期 | 19970500、19970600 |
卷期 | 30:3 民86.05-06 |
頁次 | 頁175-185 |
分類號 | 415.945 |
語文 | eng |
關鍵詞 | 腰椎間盤突出症; 神經根病變; 手術; 肌膜引痛點; Radiculopathy; Lumbar spine; Myofascial pain syndrome; Disc herniation; |
中文摘要 | 本文之宗旨在探討腰間盤突出症引致之神經根病變手術前後其肌膜引 痛點之分佈變化情形。病人包括各24例年紀、性別等因素相契合之兩個研究群:A 群為手術治療組,B群為復健治療組。所有病人皆有嚴重惱人之下背痛及單側下 肢痛(坐骨神經痛)。腰椎間盤突出症之診斷由肌電圖和脊髓攝影或核磁共振確 定。病人下背部脊椎豎立肌(L5-S1)及下肢之活動性引痛點皆於治療前及治療後四 |
英文摘要 | This study is designed to investigate the distribution of myofascial triggerpoints in patients with lumbar radiculopathy before and after surgery fordisc herniation. Twenty-four patients (Group A) who underwent surgeryfor lumbar radiculopathy due to a disc lesion and another 24 age- and sexmatched non-surgical patients (Group B) with lumbar radiculopathy due todisc lesions were involved in this study. All patients had severe, intolerablepain in the lower back and a lower extremity of one side. The diagnosis wasconfirmed by magnetic resonance image (MRI) and electromyographic(EMG) tests. The active myofascial trigger points (MTrPs) in the erectorspinae (L5-S1) and in the involved lower extremity were identified 4 weeksbefore and after the treatment (surgical intervention in Group A and physicaltherapy program in Group B). The pain intensity of the MTrP based on thenumerical analog scale was also assessed before and after treatment inboth groups. It was found that the innervation levels of the limb muscleswith active MTrPs are significantly correlated with the root levels oflumbar radiculopathy (per EMG findings), especially for L5-innervatedmuscles. Either lumbar discectomy or physical therapy could effectivelyreduce either the number or the pain intensity of active MTrPs. However,it appears that lumbar discectomy was more effective in inactivatingMTrPs in the involved limb muscles than physical therapy. There was alsoa tendency that physical therapy would help to reduce the number and thepain intensity of active MTrPs in the lumbar paraspinal muscles morethan disc surgery, especially for patients with L5 radiculopathy. |
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