Spinal Column deseases

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Diseases of the Spinal Column: Fasting Treatments

Superior mesenteric artery syndrome following scoliosis surgery: its risk indicators and treatment strategy.

World J Gastroenterol. 2005 Jun 7;11(21):3307-10.
Zhu ZZ, Qiu Y.
Department of Spine Surgery,
Drum Tower Hospital , Nanjing University Medical School , Nanjing 210008, Jiangsu Province, .

AIM: To investigate the risk indicators, pattern of clinical presentation and treatment strategy of superior mesenteric artery syndrome (SMAS) after scoliosis surgery. METHODS: From July 1997 to October 2003, 640 patients with adolescent scoliosis who had undergone surgical treatment were evaluated prospectively, and among them seven patients suffered from SMAS after operation. Each patient was assigned a percentile for weight and a percentile for height. Values of the 5th, 10th, 25th, 50th, 75th, and 95th percentiles were selected to divide the observations. The sagittal Cobb angle was used to quantify thoracic or thoracolumbar kyphosis. All the seven patients presented with nausea and intermittent vomiting about 5 d after operation. An upper gastrointestinal barium contrast study showed a straight-line cutoff at the third portion of the duodenum representing extrinsic compression by the superior mesenteric artery (SMA). RESULTS: The value of height in the seven patients with SMAS was above the mean of sex- and age-matched normal population, and the height percentile ranged from 5% to 50%. On the contrary, the value of weight was below the mean of normal population with the weight percentile ranging from 5% to 25%. Among the seven patients, four had a thoracic hyperkyphosis ranging from 55 degrees to 88 degrees (average 72 degrees), two had a thoracolumbar kyphosis of 25 degrees and 32 degrees respectively. The seven patients were treated with fasting, antiemetic medication, and intravenous fluids infusion. Reduction or suspense of traction was adopted in three patients with SMAS during halo-femoral traction after anterior release of scoliosis. All the patients recovered completely with no sequelae. No one required operative intervention with a laparotomy. CONCLUSION: Height percentile < 50%, weight percentile < 25%, sagittal kyphosis, heavy and quick halo-femoral traction after spinal anterior release are the potential risk indicators for SMAS in patients undergoing correction surgery for adolescent scoliosis.

Fasting therapy for psychosomatic diseases with special reference to its indication and therapeutic mechanism.
Tohoku J Exp Med. 1976;118 Suppl:245-59.
Suzuki J, Yamauchi Y, Horikawa M, Yamagata S
It has been well known that the fasting therapy which was invented in Medical School of Tohoku University reveals an excellent effect upon various kinds of psychosomatic diseases, but its therapeutic mechanism and suitable indication are not yet explained completely. In order to corroborate these problems, this study was undertaken on 262 cases of psychosomatic diseases in the field of internal medicine. It is a complete fasting for 10 days with nothing by mouth except for drinking water, and 500 ml of parenteral fluid containing vitamins are administered intravenously every day. Absolute bed rest and self meditation are required in a closed individual room, and patients are not allowed to meet anyone but physicians and nurse in charge. The return to normal ordinary diet follows the order of fluid diet, soft diet and semiordinary diet during 5 days. In the period of the therapy, various clinical and laboratory examinations were carried out. Significance of these examinations consists in prediction of possible danger during the fasting period and elucidation of its therapeutic mechanism. Consequently, an outstanding efficacy rate of 87% with excellent prognosis was attained, and the following diseases were determined as suitable indication of this therapy; irritable colon, dysorexia nervosa, borderline hypertension, neurocirculatory asthenia, bronchial asthma, mild diabetes mellitus, obesity,
lumbago without organic findings, conversion hysteria, various neurosis with somatic symptoms and masked depression. Possible mechanism of action of the therapy is that fasting acts as an extreme stress on the function of the autonomic nervous and endocrine systems, then it regulates the function of whole body including the brain, also it acts as one of the behaviour therapy for abnormal conditioning.
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