[Treatment of the 3rd lumbar vertebrae transverse process syndrome with spatula]

To investigate the application and clinical effects of spatula for the treatment of the 3rd lumbar vertebrae transverse process syndrome.

From December 2009 to October 2010, 38 patients with the 3rd lumbar vertebrae transverse process syndrome were treated by spatula, of them, 33 patients were follow-up. Among the patients,19 cases were male and 14 cases were female,with an average age of (37.6+/-7.8) years (ranged from 28 to 58 years). The course of this diseases ranged from 10 days to 14 months with an average of (126.9+/-14.7) days. The main symptoms of the patients including unilateral lumbar pain, lateral bend waist limitation,the ache became even worse after exertion or prolonged sitting and radiated to the affected side of thigh and popliteal fossa,but the pain never exceed knee joint. The tenderness at the tip of the 3rd lumbar vertebrae was obviously and the contract muscle bundle could be touched. The X-rays showed the two sides of the transverse were asymmetric. CT or MRI was used to exclude spinal stenosis,tumor,and intervertebral disk hernia. Spatula was applied for sow discord and solution accretion, and injected compound medicine (0.2% Lidocaine 3 ml, Triamcinolone acetonide 5 ml, add 0.9% physiological sailine 2 ml to 10 ml). If the symptoms did not improved after the first treatment, start the second treatment one week later, but it was not more than three times. According to the standard of JOA score, the effects before and after treatment were evaluated by low back pain, leg pain or numbness, gait, Straight Leg Raising test, sensory and movement disorder,bladder function test.

Thirty-three patients were followed up for 2-12 months with an average of 4 months. All of the incisions were healed without complications. The clinical symptoms were improved and 22 cases were treated once, 7 cases twice and 4 cases 3 times. According to JOA evaluation criteria,the score before and after treatment was increased from (7.03+/-3.81) to (13.29+/-3.78), and 26 cases got excellent result, 5 good, 2 fair.

3rd lumbar vertebrae transverse process syndrome is one of the indications of the spatula. If the diagnose is correct, lesions position precisely located and operation performed properly, the treatment by spatula showed confirmed therapeutic effects, low complication and high safety.