Clinical calcium
-
Various spinal diseases that cause low back pain have two distinct pathologies, including mechanical disruption of the spinal column and compression of the cauda equina and the nerve roots. Although, the advancement in surgical techniques has brought satisfactory neural recovery, resolution of low back pain still remains unpredictable. The development of low back pain is affected by psychosocial factors besides pathological lesions in the lumbar spine leading to functional impairment. Surgical indication for low back should be carefully decided considering such nonorganic aspects of low back pain.
-
In oriental medicine, not only the local pathological state but also disharmony within the body and the stagnation of Ki are examined. For this purpose, diagnoses in modern western medicine are also used as references. The pathological condition is evaluated by the 4 diagnostic methods as original methods of oriental medicine, treatment points are decided, and acupuncture and moxibustion are performed. If meridians and reactive points that appear with Ki stagnation impairing natural healing ability can be determined, not only low back pain but also symptoms such as constipation disappear, resulting in harmony of the body and improvement in constitutional symptoms.
-
There are various causes of low back pain, but if the cause of low back pain was determined as a discogenic pain, anterior lumbar interbody fusion was indicated. The surgical treatment should be determined after MRI and other radiological imaging studies and pain response, and also it is important to examine the social factor and psychological status. Extra-peritoneal approach is selected for above L(4)-L(5) level, and trans-peritoneal approach is selected for L(5)-S(1). Recent endoscopic approaches to the anterior lumbar spine is also presented.
-
Neurophysiologic function and ischemia causes neurogenic symptoms in lumbar spinal stenosis. Neurophysiologic function and potential therapeutic agents were investigated using a chronic cauda equina compression model that was developed according to a clinical pathogenesis. In the chronic cauda equina compression model, nerve conduction velocity and blood flow in spinal nerves decreased but mechanical allodynia was not induced. Prostaglandins and 5-HT receptor antagonist effected to improve blood flow in nerve roots after cauda equina compression;therefore, they might be potential agents for lumbar spinal stenosis.
-
As the understanding for the mechanism of absorption and metabolism has not been clarified adequately, a lot of works about these issues are still carrying on. Changes in maternal blood and intracellular magnesium concentration during the early stage of pregnancy suggest magnesium may play important roles around the period of implantation. Alternation in absorption of the mineral from colon, in levels of maternal blood and those of intracellular magnesium, or in urinary excretion of magnesium during pregnancy suggest that contents of magnesium in the whole maternal body tend to be decreased with the course of pregnancy. ⋯ The magnesium deficiency is speculated to have a relation with vascular hypertonus or eclamptic seizures. Magnesium sulfate is frequently used for first choice drug, as it is effective to improve the hypertension of preeclampsia, to prevent or to cure the seizures of eclampsia. The administration of magnesium sulfate to preeclamtic women is reasonable to improve magnesium deficiency, which may be one of pathophysiological aspects of preeclampsia.