RU2421255C1 - Method of treating cervical disk herniation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely - to neurology, vertebrology and restorative medicine. The method involves drug-induced analgetic blockade. The blockage is combined with interstitial carpain electrophoresis of an anaesthetic injection place. Current intensity for electrophoresis is 4-7 mA. Duration of a procedure is 10-12 minutes. The procedures are daily; the therapeutic course is 12-15 procedures.

EFFECT: method provides managing pain syndrome, reducing the volume of hernial bulge, restoring radicular conductivity, increasing duration of remission.

1 ex, 3 dwg

Description

The invention relates to medicine, namely to neurology, vertebrology and rehabilitation medicine, and can be used to treat hernias of the cervical intervertebral discs.

A known method of treating neurological orthopedic and traumatological pathologies (RU 2141359 C1, 03/23/1998), comprising electrophoretic administration of a solution of Karipazin, 50-100 mg of which with an activity of 350 PE are dissolved in 5-10 ml of physiological saline and 0.02-0.06 are added ml of dimethyl sulfoxide. A solution of caripazine is moistened with filter paper, applied to the skin in an area depending on the specific pathology, an electrically conductive pad heated to 37 ° -39 ° C, and a positive electrode are placed on top. The introduction is carried out for 15-20 minutes at a current of 10-15 μA, spend at least 3 courses with an interval of 30-45 days, 20-30 procedures per course. Modifications of this method involve the different placement of gaskets with a positive and negative electrode, as well as the additional use of aminophylline or potassium iodide for laying under the negative electrode. Caripazine is the sum of proteolytic enzymes obtained from the dried milky sap of a melon tree, or papaya (Carica papaya L.), fam. father (Cariacaceae). Other formulations derived from dried papaya milk juice, such as Karipain, are also known at present. Caripain is available in 1 g vials and is characterized by a wide spectrum of proteolytic activity (350 Fip - PE).

The main disadvantage of the method of treatment of neurological orthopedic and traumatological pathologies is the long course of treatment, when the total duration of the course of treatment can reach 180 days.

The closest prototype adopted the method of analgesic blockade in pathology of the spinal cord and spine (RU 2108065 C1 from 1998.04.10). The implementation of this method occurs by introducing an anesthetic into a certain area, while the needle is inserted perpendicular to the skin and parallel to the projection of the spinous process until it stops in the outer sections of the vertebral arch, in the cervical and thoracic sections 2-2.5 cm from the tip of the spinous process, and in lumbar 2.5-3 cm followed by the introduction of an anesthetic in an amount of 20-25 ml and 500 mg of vitamin B12 to prolong the analgesic effect. This method is a prototype. The disadvantage of this method is the inability to use it for the treatment of hernias of the cervical intervertebral discs.

The essence of the invention lies in the fact that the treatment of hernias of the lumbar intervertebral discs includes drug-mediated analgesic blockade in combination with drug interstitial electrophoresis of the injection site of the anesthetic with the drug Karipain at a current strength of 4-7 mA, the duration of the procedure is 10-12 minutes daily, for a treatment course of 12- 15 treatments.

The technical result is the elimination of pain, a decrease in the volume of hernial protrusion, the restoration of radicular conduction.

The pain syndrome is eliminated by the combined use of drug analgesic blockade and drug interstitial electrophoresis of the injection site of the anesthetic with the drug Karipain at a current strength of 4-7 mA, the duration of the procedure is 10-12 minutes daily, for the course of treatment 12-15 procedures.

Reducing the volume of hernial protrusion is achieved by a complex effect on the structures forming the hernial protrusion. As a result of changes in the physical properties of these structures, the severity of the hernia decreases. In some cases, after the treatment, the presence of a hernia is not determined.

The restoration of radicular conduction is achieved as a result of the implementation of the method for the treatment of hernias of the cervical intervertebral discs and is expressed in the improvement of the excitation conduction along the motor and sensory nerve conductors of the upper limbs. This is due to a decrease (or disappearance) of compression of the roots of the herniated disc.

The invention is illustrated by drawings, where in Fig.1 shows a General scheme for the treatment of hernias of the cervical intervertebral discs (MTD); figure 2 - image, the result of the study of patient T. by the method of magnetic resonance imaging (MRI) of the cervical spine before treatment by the proposed method (transverse or axial section at the level of MPD S3-4); figure 3 - image, the result of the study of patient T. by MRI of the cervical spine after treatment of the proposed method (transverse or axial section at the level of the MTD S3-4).

Figure 1 is additionally indicated: 1 - galvanizer; 2 - anode; 3 - cathode; 4 - surface electrode; 5 - needle (needle electrode). Figure 2 is additionally indicated: 6 - MTD; 7 - spinal canal; an arrow indicating a hernial protrusion of the S3-4 MTD towards the spinal canal; Figure 3 is additionally indicated: 6 - MTD; 7 - spinal canal; arrow pointing to MTD S3-4 without hernial protrusion.

A method for the treatment of hernias of the cervical intervertebral discs is as follows. The patient is lying on his stomach. An analgesic blockade is performed in case of pathology of the spinal cord and spine (RU 2108065 C1 of 1998.04.10) of the intervertebral foramen of the cervical vertebrae of the corresponding segment with the presence of a hernia MTD 6. After this, the syringe is separated from the needle cannula 5, while the needle 5 remains in the patient’s body. Then, a cathode 3 is attached to the needle 5. A surface electrode 4 is mounted on the occipital region, which is connected to the anode 2. The surface electrode 4 is immersed in a cloth moistened with Karipain solution (for example, manufactured by NPK AS-KOM LLC in Moscow; TU 9158- 010-58013622-2006), while the contents of one bottle (1 g) are dissolved in 10 ml of physiological saline.

After connecting all the electrodes, interstitial electrophoresis of the injection site of the anesthetic is carried out using a galvanizer 1 (for example, “Potok-1”, manufactured by MedKompleks LLC “AVK”, Moscow, Russian Federation), gradually increasing the current strength to 4 -7 mA, the duration of the procedure is 10-12 minutes daily, for the course of treatment 12-15 procedures.

An example of a specific implementation of the method.

The proposed method for the treatment of hernias of the lumbar intervertebral discs (FIG. 1) is implemented on a galvanizer 1 having outputs for connecting electrodes — anode 2 and cathode 3. During the treatment session, the patient is lying on his stomach. The tolerance of anesthetics is clarified in the patient, a test for the administration of anesthetic is carried out. If there is a negative test result, the place of implementation of the analgesic blockade is treated with an antiseptic solution (for example, 70% ethyl alcohol solution). An analgesic blockade of the site of the segment of the cervical spine is performed, corresponding to a hernia of the intervertebral disc (for example, 2% lidocaine solution). After the implementation of the analgesic blockade, the syringe is separated from the cannula of the needle 5, while the needle 5 remains in the patient's body. Then, a cathode 3 is attached to the needle 5. A surface electrode 4 is mounted on the occipital region, which is connected to the anode 2. The surface electrode 4 is immersed in a tissue moistened with Karipain solution in physiological saline (1 g of Karipain in 10 ml of physiological saline). The electrodes anode 2 and cathode 3 are connected to a galvanizer 1. After connecting all the electrodes, interstitial drug electrophoresis is carried out at a current strength of 4-7 mA, the duration of the procedure is 10-12 minutes daily, and the course of treatment is 12-15 procedures.

To control the results of treatment, an MRI study was performed twice for patients: when determining the indications for hernias of the cervical intervertebral discs and at the end of treatment to monitor the results of treatment.

Clinical example

Patient T., 40 years old, diagnosis: C3-4 intervertebral disc herniation, marked radicular syndrome, upper limb polyneuropathy. Consultation of a neurosurgeon is recommended in order to determine indications for surgical treatment. The patient turned to the vertebral neurological center. MRI examination: dorsal hernia MTD S3-4 3 mm (paramedian left-sided) (figure 2). The patient was given a course of treatment in accordance with the claimed method. As a result of the treatment, the subjective condition of the patient improved significantly. When the control MRI study conducted after the course of treatment (20 days after the first MRI study, 15 days after treatment) (figure 3), signs of hernial protrusion MPD C3-4 are not registered.

During 2005-2008 and parts of 2009 using the proposed method were treated 382 patients with hernias of cervical MTD aged 18 to 67 years. When contacting all patients, neuroimaging studies were performed: MRI or computed tomography, ultrasound examination of the cervical spine with an assessment of the state of MTD for the detection of hernias. As a result of the treatment, in the majority of patients - 316 (82.7%), a stable, pronounced (confirmed by further dynamic studies) positive result was achieved. In other patients, the severity of the positive effect was less, or the treatment effect lasted less time and required an additional course of treatment.

The treatment of a large group of patients did not reveal cases of deterioration in the condition of patients, both clinical and morpho-functional.

Thus, the use of the proposed method allows for the treatment of patients with hernias of cervical MTD. The result of this treatment is the elimination of pain, a decrease in the volume of hernial protrusion, the restoration of radicular conduction.

Claims (1)

A method for the treatment of hernias of the cervical intervertebral discs, including the administration of a medication analgesic blockade, characterized in that, in combination with the blockade, drug interstitial electrophoresis of the injection site of the anesthetic with the drug Karipain is carried out with a current strength of 4-7 mA, the duration of the procedure is 10-12 minutes daily, for a course of treatment 12-15 procedures.

Images