Integrating Growth Variability of the Ilium,Fifth Lumbar Vertebra,and Clavicle with Multivariate Adaptive Regression Splines Models for Subadult Age Estimation

Subadult age estimation should rely on sampling and statistical protocols capturing development variability for more accurate age estimates. In this perspective, measurements were taken on the fifth lumbar vertebrae and/or clavicles of 534 French males and females aged 0–19 years and the ilia of 244 males and females aged 0–12 years. These variables were fitted in nonparametric multivariate adaptive regression splines (MARS) models with 95% prediction intervals (PIs) of age. The models were tested on two independent samples from Marseille and the Luis Lopes reference collection from Lisbon. Models using ilium width and module, maximum clavicle length, and lateral vertebral body heights were more than 92% accurate. Precision was lower for postpubertal individuals. Integrating punctual nonlinearities of the relationship between age and the variables and dynamic prediction intervals incorporated the normal increase in interindividual growth variability (heteroscedasticity of variance) with age for more biologically accurate predictions.     

腰椎骶化和骶椎腰化法医学鉴定16例分析

目的探讨分析腰椎骶化和骶椎腰化时腰椎如何定位及在法医学鉴定中的注意事项,为规范法医鉴定提供参考。方法回顾性分析16例有腰椎骶化或骶椎腰化的被鉴定人,结合其病因、临床表现探讨与外伤的关系,以及如何准确定位椎体。结果6例为腰椎骶化,10例为骶椎腰化,多有不同程度的腰腿痛。结论腰椎骶化和骶椎腰化是先天性脊柱畸形,是腰腿痛的常见病因,与外伤无因果关系,法医学鉴定时应该足够重视,准确定位。     

腰椎间盘突出症康复治疗的疗效观察

目的:探讨运动训练治疗对腰椎间盘突出症的疗效的影响。方法:将86例腰椎间盘突出症患者随机分成两组。试验组(48例):接受运动训练,牵引,直流电药物导入,超短波综合治疗。对照组(38例):接受牵引,直流电药物导入,超短波常规治疗。两组患者年龄、病程病情相近,具有可比性。结果:实验组和对照组近期治愈率无显著差异(p>0.05),实验组远期复发率低于对照组(p<0.05)有显著差异性。结论:运动训练加物理疗法是治疗腰间盘突出症的一种有效办法。     

温通针法治疗腰椎间盘突出症远期疗效观察

目的 比较温通针法与平补平泻针法治疗腰椎间盘突出症（lumbar disc herniation,LDH）的远期疗效。方法 将160例LDH患者按数字随机表法随机分为对照组和治疗组,每组80例。治疗组应用温通针法,对照组应用平补平泻针法,两组均每日治疗1次,15次为1个疗程。治疗前后采用改良日本骨科协会（Meliorate- Japanese orthopaedic association,M- JOA）下腰痛评分法、简化McGill量表分别对两组患者进行评分;治疗15 d后及治疗3个月后,分别观察两组临床疗效。结果 治疗15 d后及治疗3个月后,两组M- JOA评分,简化McGill量表的PRI、VAS和PPI因子评分均较治疗前显著降低（P<0.01）;治疗3个月后,治疗组简化McGill量表的VAS和PPI因子评分下降值显著大于对照组（P<0.01）;治疗15 d后和治疗3个月后,治疗组临床疗效均显著优于对照组（P＜0.05,或P＜0.01）。结论 温通针法对LDH的远期疗效优于平补平泻针刺方法。     

腰突穴臭氧注射治疗腰椎间盘突出症的临床疗效和肌电图分析

目的 观察腰突穴臭氧注射治疗腰椎间盘突出症（lumbar disc herniation,LDH）的疗效。方法 48例LDH患者均接受腰突穴臭氧注射,治疗前后用肌电图检测其腓总神经及胫神经的运动神经传导速度(motor nerve conduction velocity,MNCV)、神经远端潜伏期（distal latency,DL）。结果 经过3次腰突穴臭氧注射治疗后,48例患者临床治愈25例,好转20例,无效3例,总有效率为93.8%。与治疗前比较,LDH患者治疗后胫神经、腓总神经MNCV显著增快（P＜0.05）,DL显著缩短（P＜0.05）。结论 腰突穴臭氧注射能够有效改善LDH患者临床症状,提高神经传导速度,促进患者康复。     

腰椎的个体识别

腰椎是人体躯干骨中的主要承重骨,其形态受多种因素影响。腰椎的研究对白骨、碎尸等类型案件尸源的寻找和古人类的体征复原均有重要意义。本文着重从身高推算、性别判定和年龄判定三个方面综述了近年来腰椎在法医人类学领域的研究进展。     

Development of a Computer‐Assisted Forensic Radiographic Identification Method Using the Lateral Cervical and Lumbar Spine

Medical examiners and coroners (ME/C) in the United States hold statutory responsibility to identify deceased individuals who fall under their jurisdiction. The computer‐assisted decedent identification (CADI) project was designed to modify software used in diagnosis and treatment of spinal injuries into a mathematically validated tool for ME/C identification of fleshed decedents. CADI software analyzes the shapes of targeted vertebral bodies imaged in an array of standard radiographs and quantifies the likelihood that any two of the radiographs contain matching vertebral bodies. Six validation tests measured the repeatability, reliability, and sensitivity of the method, and the effects of age, sex, and number of radiographs in array composition. CADI returned a 92–100% success rate in identifying the true matching pair of vertebrae within arrays of five to 30 radiographs. Further development of CADI is expected to produce a novel identification method for use in ME/C offices that is reliable, timely, and cost‐effective.     

经椎间孔椎体间融合术联合加味补中益气汤治疗腰椎间盘突出症临床观察

目的 观察经椎间孔椎体间融合术（transforaminal lumbar interbody fusion,TLIF）联合补中益气汤对腰椎间盘突出症患者的临床疗效。方法 将60例腰椎间盘突出症患者分为对照组和治疗组,每组30例。对照组患者接受TLIF治疗,治疗组患者在对照组的基础上服用补中益气汤治疗,治疗前及治疗1周末、1个月末、3个月末,采用视觉模拟评分法（visual analogue score,VAS）评价下肢疼痛程度,采用日本骨科协会（Japanese Orthopaedic Association,JOA）量表评价腰椎疼痛程度。结果 治疗组疗效优于对照组（P＜0.05）;治疗1周末、1个月末和3个月末,两组VAS评分和JOA评分较治疗前均显著改善（P<0.05）,且治疗组在各观察点VAS评分和JOA评分明显优于对照组（P<0.05）。结论 与单纯TLIF治疗相比,腰椎后路TLIF联合补中益气汤能明显缓解腰椎间盘突出症患者疼痛症状。     

针灸正骨法治疗急性期腰椎间盘突出症58例

目的：探讨针灸正骨法治疗急性期腰椎间盘突出症（ＬＩＤＰ）的疗效。方法：采用单盲对比法将患随机分成两组，治疗组５８例，对照组５０例，分别采用针灸正骨法和正骨法配合静脉滴注甘露醇，地塞米松疗法相对照，进行对比观察。结果：治疗组疗效优于对照组，两组有显性差异。结论：针灸正骨法是治疗急性期ＬＩＤＰ实用，有效的方法。     

31例破裂型腰椎间盘突出症临床分析

［摘要］目的 总结破裂型腰椎间盘突出症的治疗方法，为其治疗策略的制定提供临床依据。方法 回顾31例破裂型腰椎间盘突出症的临床资料，对保守治疗和手术治疗的效果进行分析。结果 31例患者中，27例经过反复的保守治疗，疗效优0例，良1例，可2例，差24例；24例疗效差者及另外4例均接受手术治疗，疗效优14例，良11例，可1例，差2例。结论 破裂型腰椎间盘突出症应首选手术治疗。