The Journal of Japanese Society of Lumbar Spine Disorders
Online ISSN : 1882-1863
Print ISSN : 1345-9074
ISSN-L : 1345-9074
Volume 12 , Issue 1
Showing 1-30 articles out of 30 articles from the selected issue
  • Kazuhisa TAKAHASHI
    2006 Volume 12 Issue 1 Pages 29-33
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    The work-related low back pain (occupational low back pain) has been a serious problem not only in western countries but in Japan, since it may influence not only the individual worker but the society to which he or she belongs. Many studies revealed that the psychosocial factors are important as well as the physical factors in the development of low back pain. To solve the problem, we need further knowledge about the mechanism of low back pain; improvement of work environment or work schedule; prevention of transition from acute to chronic pain taking into consideration of the psychosocial aspects; and/or development of effective treatment of chronic low back pain.
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  • Michiyasu KAYAOKA
    2006 Volume 12 Issue 1 Pages 34-38
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    It was devised “Occupational health guidelines for the management of low back pain at work” from Ministry of Health, Labour and Welfare. Medical checks are recommended for occupational health management of LBP. It is difficult whether we should examine lumbar X-rays. “X-ray findings have no predictive value for future LBP or disability.” is provided by generally consistent findings in multiple, high quality scientific studies. However, in Japan, study based on a bottom of cooperation of an orthopedist and an occupational health physician, EBM is investigated, and it is not performed almost. An orthopedist makes the system that all occupational health physicians can evaluate a low back pain, and it is important to collect more information.
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  • Chikanori SAKAMOTO
    2006 Volume 12 Issue 1 Pages 39-43
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    The work-related low back pain occurs in various working environments; not only in blue-collars, but also in white-collars. It has been the most predominantly observed in the occupational musculoskeletal disorders, therefore, the work-related low back pain still has been a most important problem in social and economical issues. The physical therapist and occupational therapist can play an important role for the prevention of the work-related low back pain. Their works directly approached to the individuals with low back pain by usual treatments such as physical therapy, trunk muscle exercise, and stretching develop to the back school by teaching workers the guidance of work posture, how to take appropriate rest, improvement of the work environment, and how to keep general and mental health in good condition. Working simulation system for lifting heavy materials also may be useful in order to teach workers less harmful posture. For this purpose, the team approach including therapist, doctor, nurse and medical social worker who understand work-related low back pain is necessary.
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  • Masahiro INAOKA
    2006 Volume 12 Issue 1 Pages 44-49
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    The work-related low back pain is one of the most serious problem in the work-related musculo-skeretal disorders. As a result of questionary survey to manufacturing industry workers and teachers of school for physically handicapped or mentally retarded children, it was able to confirm that there were many risk factors of low back pain in work environment, social element and physical mental element. In a group and a place of work judged that outbreak frequency of LBP is high, finding out the most serious risk factor and means to solve the problems is important. In the precaution for the work-related low back pain, not only medical treatment for the lumbar spine itself but also careful guidance of exercise therapy, brace therapy and living guidance that considered the environment of a place of work is necessary.
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  • Shigeki KODA
    2006 Volume 12 Issue 1 Pages 50-54
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    In general, occupational health activities for coping work-related health hazards are summarized into controlling hazardous risk factors, decreasing risk exposures and health care activities. In case of work-related low back pain, many hazardous and risk factors (vibration exposoure, cold exposure, heavey material handlings, working postures, working time and so on) are related to occuring low back pain in the workplaces. And the degree of factor relatedness to low back pain differ in each occupation. Occupational professionals should analyze related factors for low back pain in the workplaces and provide proper and effective improvements. As the related risk factors for low back pain are multiple, provided improvements should be coping to these multiple risk factors. Furthermore, according to successful researches and activities, the improvements with employees' particitation could prevent and protect low back pain in the workplaces.
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  • Seiji OHTORI, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
    2006 Volume 12 Issue 1 Pages 55-60
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    To clarify the afferent pathways from intervertebral discs to dorsal root ganglia (DRGs) in humans, we evaluated the effect of spinal nerve block on discogenic low back pain. Patients with discogenic low back pain originating from the L4/5 or L5/S1 intervertebral disc received a spinal nerve root block (L2 nerve block group: n=67, L4 or L5 nerve block group: n=34). Lidocaine (1.5 ml of 1% solution) was administrated to L2, L4, or L5 spinal nerves. In both groups, spinal nerve blocks were significantly effective in alleviating discogenic low back pain (P<0.05). Fifteen minutes after the block, the average visual analogue pain scale score decreased from 8.0 to 4.3 (L2 root block group) and from 7.8 to 3.4 (L4 or L5 root block group). The average effective period was significantly longer in the L2 root block group (13 days) than in the L4 or L5 root block group (8 days) (P<0.05). The upper and lower spinal nerves appear to include sensory afferent nerves from the L4/5 or L5/S1 intervertebral disc. There were differences in the intensity and the period of effective relief between the upper and lower nerve block.
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  • Koji OTANI, [in Japanese], [in Japanese], [in Japanese], [in Japanese] ...
    2006 Volume 12 Issue 1 Pages 61-66
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Two hundred thirty six patients whose low back pain (LBP) and/or buttock pain (BP) was evaluated by using a diagnostic block such as nerve root block, facet block, iliosacral joint block and lumbar sympathetic block, were assessed. 1) In the patients with leg pain, 65% of LBP and 82% of BP were improved after nerve root block. 2) In following patients without leg pain, 22% of LBP and 80% of BP were improved after nerve root block. LBP and/or BP showing improvement after nerve root block was considered segmental LBP and/or BP. 3) However, LBP and/or BP that did not respond to nerve root block was considered non-radicular LBP and/or BP. 40% of non-radicular LBP were improved by L2 nerve root block or lumbar sympathetic block. These cases of LBP were considered non-segmental LBP. In conclusion, lumbar sympathetic block is one of the useful diagnostic and therapeutic method for non-segmental LBP because 40% of LBP seems to be non-segmental LBP.
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  • Takashi IGARASHI, [in Japanese], [in Japanese]
    2006 Volume 12 Issue 1 Pages 67-71
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Epiduroscopy is a new technique for treatment of chronic low back pain. This endoscopic technique includes infusion of saline, lysis of adhesions and accurate placement of local anesthetics and steroids in the epidural space. At the present time, several studies have described the clinical and cost effectiveness of epiduroscopy in patients with herniated disks, lumbar spinal stenosis or severe low back pain after back surgery. Epiduroscopy could be an option for pain management of intractable low back pain in patients whose physical status is a contraindication for surgery.
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  • Kazuo KANEKO, [in Japanese]
    2006 Volume 12 Issue 1 Pages 72-76
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Nerve root infiltration (NRI) and facet joint injection were applied to patients with degenerative lumbar disorders. NRI was used for the conservative treatment in a half of the patients with radicular symptoms, especially in patients with older age, slight symptoms. The effect persisted more than 24 hours. Facet joint injection was used for clinical diagnosis of facet arthrosis. In patients with long-lasting symptoms associated with facet arthrosis, facet denervation using electric coagulation was applied. 70% of patients with facet arthosis showed relatively favor results but 25% of patient did not even if the nerve block for the facet joint was effective.
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  • Takayoshi SUGA, [in Japanese], [in Japanese], [in Japanese]
    2006 Volume 12 Issue 1 Pages 77-84
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    We state the technique of lumbar epidural block based on twenty thousand cases. About 2% complication of dural puncture and 5% of transient leg paresis happened. Effect on low back pain, leg pain, numbness, disability of work and quality of life was evaluated. It was done by once block a month.
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  • Fuminori SAITO, [in Japanese], [in Japanese], [in Japanese], [in Japan ...
    2006 Volume 12 Issue 1 Pages 85-90
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Purpose; The purpose of this study is to analyze the results of vertebroplasty for vertebral pseudarthrosis. Patients; Fifteen patients (two men, 13women; mean age, 72.6 years) with 16 painful vertebral pseudarthrosis were treated by percutaneous vertebroplasty using bone cements. They were followed for a mean of twenty-nine months. They showed severe back pain in all cases, and combined with delayed palsy in 7 cases. Results; The average operation time was 42 minutes. The complication did not occur during and after this operation. Back pain was improved immediately after operation in all cases. Delayed palsy was also improved during the course. High incidence of adjacent vertebral body fracture was observed after vertebroplasty. Conclusion; Percutaneous vertebroplasty was effective for treating vertebral pseudarthrosis. This simple procedure can be expected not only to reduce pain, but also to improve delayed palsy.
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  • Masato NAKANO, [in Japanese], [in Japanese], [in Japanese]
    2006 Volume 12 Issue 1 Pages 91-98
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Vertebroplasty and kyphoplasty have become common for the treatment of osteoporotic vertebral fractures (OVC). Percutaneous vertebroplasty using calcium phosphate cement (CPC) has been used for the treatment of OVC with excellent clinical results. CPC is injectable and self-setting, but it is radiopaque, non-exothermic, bioactive, osteoconductive, and slowly biodegradable. Following repositioning and curettage of the pathological soft tissues, vertebroplasty using CPC was performed in patients with osteoporotic burst fracture and pseudarthrosis. In situ vertebroplasty was performed in patients with osteoporotic compression fractures. After a minimum follow-up duration of two years, vertebroplasty using CPC gave a satisfactory outcome in patients with OVC.
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  • Hiromi MATSUZAKI
    2006 Volume 12 Issue 1 Pages 99-106
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Transpedicular vertebroplasty using HA block was carried out for patients with osteoporotic spine fracture. Special tools were developed to correct the fracture and to insert HA block transpedicularly. Significant restoration of vertebral bodies was done by insertion of HA block. The mean correction loss was 14% two months postoperatively. Pain relief was clearly obtained. Extravertebral HA block leakage was observed in 7cases (16%), but did not lead to clinical complications. In addition, there was no pulmonary embolism or nerve damage. This method is effective for wedge compression fracture and flat-burst fracture with severe pain. It is important to construct a solid wall near the anterior cortex with the cancellous bone in the center of the body. It concluded that HA Block is safe material. This method is less invasive, and should be indicated for painful osteoporotic fracture.
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  • Hiroaki TAKEYACHI, [in Japanese]
    2006 Volume 12 Issue 1 Pages 107-114
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    The purpose of this study is to identify the effectiveness of chiropractic treatment of chronic low back pain (LBP) using outcome measures for low back pain. Among patients who visited Takeyachi clinic in 2005,50 samples (13males and 37 females with the average age of 48.6 years old) who has experienced chronic LBP, were examined. At the two points, initial pretreatment and the last obsereved point, severity of LBP was measured by the visual analogue scale (VAS) and low back pain related disability was evaluated by Roland-Morris disability Questionnarire (RDQ). Moreover severity of low back pain related disability was assessed. At the result, both VAS and RDQ scores of LBP showed significant improvement with treatment. Severity of low back pain related disability also showed improvement. This result may lead the effectiveness of the chiropractic treatment of chronic LBP. Further research based on a case control study will be required to prove its effectiveness.
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  • Shoko IKEDA, [in Japanese], [in Japanese], [in Japanese], [in Japanese ...
    2006 Volume 12 Issue 1 Pages 115-119
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    This study was designed to evaluate the efficacy of the lumber clinic and physical therapy for patients with low back pain (LBP). A clinical evaluation of 81 cases was carried out using the Visual Analogue Scale (VAS) for LBP, the Japanese Orthopedic Association Score (JOA score) and Finger-Floor Distance (FFD). Data was collected at the initial consultation and after 6 months. Physical therapy consisted of individualized exercise and postural advice in activities of daily living (ADL). All mean scores improved at the 6 month evaluation. Individualized exercise was effective in the improvement of ADL scores. It is suggested that the back school can be useful for improving motivation and self management of the LBP patients.
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  • Kenji ENDO, [in Japanese], [in Japanese], [in Japanese], [in Japanese] ...
    2006 Volume 12 Issue 1 Pages 120-126
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Patients may complain of accusing persistent low back pain and leg pain even though imaging such as MRI does not reveal any abnormality. It has been reported that tight filum terminale (TFT) which is tethering of the spinal cord by stiff or TFT is one cause of such a low back pain. We evaluated a TFT provocation test in this study. The TFT provocation test yielded a positive rate of 96.4% in both a standing and sitting position in TFT patients. Regarding lumbar disc herniation, 33.3% showed positive results in a standing position and 3.3% in a sitting position. In lumbar canal stenos, positive results were abtained in 2.4% in a standing position and 0% in a sitting position. Aomng normal volunteers, positive results were obtained in a standing position in 0.8% of cases, but 0% in a sitting position. These results suggest that the TFT provocation test is useful in the diagnosis of TFT.
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  • Kouichiro TOYODA
    2006 Volume 12 Issue 1 Pages 127-129
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    We studied the diagnostic value for percussion pain on spinal process in vertebral fractures. MRI images of 68 woman aged over 65 taken from 2002.11 to 2003.6 were used. Thirty nine subjects had solid vertebral fractures and 29 had no vertebral fractures. Before taking the X-ray and MRI, we marked one point indication for patients' thumb and the percussion pain lesion. There were 27 patients (40%) with marking one point indication. The sensitivity and specificity of which was 0.64 and 0.93, respectively. Twenty patients (29%) were found to have percussion pain and the sensitivity and specificity was 0.36 and 0.79, respectively. The rate of true positive was 60%. The diagnostic value of the fracture level for percussion pain on spinal process was not useful.
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  • Yoshio KUSANO, [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    2006 Volume 12 Issue 1 Pages 130-135
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Psoas abscess has become rare due to the availability of antibiotics and improvement of nourishment. We encountered four cases (two femorales, two males) with psoas abscess. Patient age at surgery was 57 years on average. We debrided psoas abscesses in all four cases. Three cases also needed vertebral debridement and interbody fusion. In Japan, we found 51 previously reported cases of psoas abscess due to pyogenic vertebral osteomyelitis and 20% of those also required vertebral debridement. In conclusion, we consider that surgical treatment of pyogenic vertebral osteomyelitis with psoas abscess is indicated in cases as showing: 1) sepsis with compromised host, 2) recurrence or lately, 3) no response to conservative therapy, 4) progressive palsy, 5) osteosclerosis around the focus on X-ray.
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  • Tadatsugu MORIMOTO
    2006 Volume 12 Issue 1 Pages 136-142
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    This paper describes the recent trends regarding low back pain (LBP) assessment in Japan. We evaluated the LBP assessment modalities presently in use in a LBP-related study (an abstract) published by the Journal of the Japanese Spine Research Society for the past five years (from 2000 to 2004). The LBP assessment modalities were thus classified into the following types: the JOA score, pain measurement, the functional status, and psychological factors. We investigated the ratio of these modalities in the object abstract total number. JOA score was 73.6%, while pain measurement was 45%, the functional status was 8.4%, and psychological factors were 3.0%. During the period from 1989 to 1998 years, the JOA score was 97.6%. A recent trend in the LBP assessment in Japan was thus found to be increased use of a multidimensional LBP assessment with the exception of the JOA score.
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  • Masaaki SHITARA
    2006 Volume 12 Issue 1 Pages 143-148
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Continuing electric stimulation was performed by the method of acupuncture using Chinese needle in 909 cases of low back pain. The sciatic nerve block (acupoint: BL54) was selected as the stabbed spot during the procedure. Once radiating pain was confirmed, stimulus was given in both sides for 15 minutes. For pain assessment, visual analogue scale (VAS) was used and this method was considered to be effective when the VAS was reduced more than 50%. As a result this therapy was considered to be effective in 681 patients (74.9%) As local anesthetics was not used, patient need not take a rest on bed after the treatment. I have shown the clinic effect of acupuncture. My method is a very safe technique and good effectiveness. Some demerits should be considered during the procedure as pain, bleeding, induration formation at stabbed points, nerve damage, local infection and broken needle but were extremely rare.
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  • Seiichiro MATSUI
    2006 Volume 12 Issue 1 Pages 149-155
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    The relations between focus of the low back pain and pain evoking motion were studied in 42 cases of non-specific low back pain. Pain at the lower part of lumbar spine tends to be evoked by standing up. Pain at the upper part of that is evoked by sitting or standing still, pain at the middle part by lumbar flexion. In some stage of standing up, lordosis of lumbosacral portion increases. This is considered to cause higher tonus in the lower part of the intrinsic muscles. In standing or sitting still, back muscles of the upper part is consider to work harder for stabilize the posture. In lumbar flexion, the angulation of he middle part of the lumber is bigger than the both rigid end (lumbosacral and thoracolumbar portion), so middle part tend to be the focus of the pain.
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  • Koji ISHII, [in Japanese], [in Japanese], [in Japanese], [in Japanese] ...
    2006 Volume 12 Issue 1 Pages 156-161
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    There have been few reports regarding aspiration for lumber facet joint synovial cysts (facet cysts). Needle aspiration through the facet joint was attempted in four patients who had facet cysts. The subjects consisted of two males and two females, aged between 43 to 85, with a mean of 66.8years. Of these, one had a cystic lesion at the same level prior to decompressive surgery. Aspiration effects were evaluated using by VAS scores, JOA scores, and MRI 4 and 16 weeks after aspiration. As a result, aspiration was possible in one patient, who had prior surgery. In this case, leg symptoms completely resolved and the cyst diminished for 11 months after the aspiration. In the remaining 3 patients, improvement of leg symptom was obtained only in one patient.
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  • Sachie SOETA, [in Japanese], [in Japanese], [in Japanese]
    2006 Volume 12 Issue 1 Pages 162-166
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    One of the conservative treatments for low back pain is physical therapy. Traction therapy and thermal therapy (hot pack) are commonly used in the treatment of low back pain. The purpose of this study was to clarity the effects of traction therapy and thermal therapy on ten male subjects. Total hemoglobin of the spine erector muscles was measured before and after traction therapy and thermal therapy in the prone and flexion position. The results showed significant increase of total hemoglobin in the prone position after traction therapy, and in both the prone position and the flexion position after thermal therapy. Physical therapy has different effects in different positions. This facts should be considered when selecting therapy for different patient populations.
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  • Kimiaki SATO, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
    2006 Volume 12 Issue 1 Pages 167-173
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Two hundred and thirty-three patients with lumbar spinal canal stenosis treated surgically were investigated with respect to their pre-referral preoperative drug therapy recorded in their letter of referral and medical records. Eight kinds of drug had been prescribed to 166 patients. In order of frequency the drugs were: non-steroidal anti-inflammatory drugs (112 patients), prostaglandins (107 patients), vitamin B12 (82 patients), Neurotropin®, a non-protein extract from the inflamed skin of rabbits inoculated with vaccinia virus (41 patients), vitamin E (38 patients), hypnotics, anxiolytics or antidepressant (29 patients), muscle relaxants (22 patients), and some traditional Chinese herbal medicine (12 patients). A single drug alone was prescribed to 32 patients (19.3%), and two or more drugs to the other 134 patients (80.7%). The clinical effects of any of these pre-operative drugs have yet to be established.
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  • Yoshihito SAKAI, [in Japanese], [in Japanese], [in Japanese]
    2006 Volume 12 Issue 1 Pages 174-179
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Fifty male patients with chronic low back pain (>6months) were randomized into 2 groups: Group A (n=25) was treated with the McKenzie therapy, and Group B (n=25) was treated without receiving any physical treatments. VAS, JOA-score, facial-rating scale (FRS) and SF-36 were evaluated for pain and near-infrared spectroscopy (NIRS) on trunk muscle during lumbar extension and flexion was measured for the muscle oxygenation after 2 and 4 weeks. VAS was significantly improved in Group A compared with Group B at 4weeks. (p<0.05) There were no significant changes in JOA-score, FRS and SF-36. NIRS parameters such as Oxy-Hb, Deoxy-Hb and Sd02 were not improved in both groups. VAS improvement in 4 weeks suggests that main benefit for patients with chronic low back pain appears to be increased satisfaction with care. We consider this can facilitate to invite patients to a continued course of exercise for a long time.
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  • Koki ANABUKI
    2006 Volume 12 Issue 1 Pages 180-183
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    The purpose of this study was to assess the usefulness of McKenzie therapy for low back pain and to try to classify low back pain using the McKenzie method. One hundred and six patients underwent McKenzie therapy. Extension exercise (Ext.) was effective in 71 patients (67%) but ineffective in 35. In latter group, Flexion exercise (Flex.) was effective in 15 patients (14%), but ineffective in 20 (19%). McKenzie therapy can differentiate between symptomatic discogenic pain and symptomatic spondylolytic pain in patients with spondylolysis. McKenzie therapy was therefore extremely useful in the classification and treatment of low back pain.
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  • Atsushi HONDA, [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    2006 Volume 12 Issue 1 Pages 184-189
    Published: October 31, 2006
    Released: August 31, 2007
    JOURNALS FREE ACCESS
    Clinical outcome of the Soft Flexion Brace was examined. Object was to study 22 cases (11 male; 11 female) of lumbar spinal canal stenosis, mean age 71 years old (60∼87). JOA score, continuous walking distance and back and leg pain and limb numbness by VAS (0∼100), change of Lumbar lordosis angle before and after installation using lateral X-ray on extension with standing. The mean JOA score was improved from 9.8 points before to 11.8 points after, with the average improvement rate being 38.4%. The continuous walking distance has intentionally improved from 249 to 700m. VAS recognized two significant improvements, which where in lower extremity of the limbs and the numbness. X ray shows controlled 7.7° (1∼17) in extension. Carrying the Soft Flexion Brace, the Damenkorsett type, was convenient because it weighs about 300 g. The patient seemed satisfied with installation feeling of the brace. Short-term clinical results were excellent.
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