UA55914A - Method for treating neurological manifestations of degenerative and dystrophic diseases of lumbar backbone division complicated with hernias of intervertebral disks - Google Patents

Abstract

The method for treating the neurological manifestations of the degenerative and dystrophic diseases of the lumbar backbone division complicated with the hernias of the intervertebral disks comprises physiotherapy and manual therapy. The laser puncture of the lumbar division and the lower limbs is followed by the manual therapy comprising the mobilization with the postisometric relaxation, manipulation and correction at the area of the lumbar division and the lower limbs for 30-40 minutes, 10-12 procedures in total.

Description

The invention relates to the field of medicine, in particular to neurology, namely to methods of treating the human musculoskeletal system.

There is a known method of treating diseases associated with the protrusion of the intervertebral disc and the consequences of fractures (Russian patent Me2086225, MKV-6 Ab1 Me7/00, application 06.05.96, publ. 1997, bull. Mo22), which includes manual influence on the patient's spine in the lying position by stretching the spine around the transverse axis, turning around the sagittal and vertical axis, pressing on the transverse processes occurs synchronously with the patient's exhalation and maximal stretching of the ligamentous-muscular apparatus, after which the patient is shaken in a sitting or standing position.

The disadvantage of this method is that rotation around the sagittal and vertical axes, maximum stretching of the ligamentous-muscular apparatus, and especially shaking can cause complications in the form of even greater compression of the spinal cord hernia.

A known method of combined conservative treatment of herniated intervertebral discs of the lumbar-sacral spine (patent of Ukraine Me37907, MKV-6 Ab1Н23/00, application 05/04/2000, published 05/15/2001, bulletin Me4). The method is used by vibrating the spine and muscle groups of the lower limbs with a frequency of 23 - 26 Hz, an amplitude of 4 mm, with the simultaneous implementation of manual therapy methods on the feet, calf muscles and the spine (combined measures of macrocorrection using only short levers) in combination with the introduction diprospan with novocaine in 1.5 and 10 treatment sessions under the interspinous ligament of the affected segment and the piriformis muscle of the affected side. However, the disadvantage of this method is that the vibration effect on the spine and muscle groups of the lower limbs is of low frequency; methods of manual therapy in the form of macrocorrection with short levers do not include mobilization, manipulation and post-isometric relaxation techniques and are not performed on all segments of the spine; administration of diprospan with novocaine can cause drug allergy and infectious complications.

The invention is based on the task of increasing the effectiveness of treatment of neurological manifestations of degenerative-dystrophic diseases of the lumbar spine, complicated by herniated intervertebral discs due to the combined effect of laser acupuncture and manual therapy on the spine, in particular the lumbar spine and lower limbs.

The task is achieved by using laser puncture on the lumbar region and lower limbs as a physiotherapeutic tool, followed by manual therapy, which includes mobilization with post-isometric relaxation, manipulation and correction of the spine, in particular the lumbar region and lower limbs for 30-40 minutes each , with a course of 10 - 12 sessions.

The claimed method is performed as follows. After a comprehensive examination, laser acupuncture is prescribed with an infrared laser emitter in pulse-continuous mode with a repetition frequency of pulse beams up to 150Hz, a wavelength of 0.89μm, a radiation power of 8W, operated for 1 - S minutes per one body point, total exposure during one session - up to 15 - minutes, affected 10 - 18 biologically active points, with a course of 10 - 12 sessions. In the first 1-2 sessions, generally strengthening points are used, later: local segmental points (in particular, in the area of the projection of the intervertebral disc herniation and in the area of the piriformis muscle on the affected side) and remote corporal points. Immediately after the course of laser acupuncture, manual therapy is applied in a mandatory sequence: mobilization with post-isometric relaxation of the extensors and flexors of the back, piriformis muscle and other muscles of the lower limb, manipulation and correction (if necessary in the 3rd - 5th session).

Patient R., 52 years old, admitted for treatment on October 13, 2000, can serve as an example of a specific application of the claimed method. (medical history Me055321182/867). The diagnosis was established: chronic vertebrogenic lumbosacral radiculitis in the stage of protracted exacerbation with pronounced pain syndrome. Sequestered herniation of the intervertebral disc I 4 - I 5 (10.5 mm), foraminal protrusion of the intervertebral disc I 5 - 51 (Zmm). Static and dynamic disturbances. The patient complained of pain in the lower back and left leg, feeling of numbness in the left leg, difficulty walking due to pain. The pains have been bothering me for about 5 years after significant physical exertion (he works as a carpenter). Aggravation of the disease was noted every year.

He was treated on an outpatient basis with slight improvement. The last exacerbation was a month ago, he was hospitalized. In neurological status: periosteal and tendon reflexes from hands D - 5, alive, from knee and Achilles tendons 5 « D, alive. Soreness during palpation of paravertebral points of the lumbar spine, more pronounced on the left. Laseg's symptom up to an angle of 45" on the left, Matskevich's symptom is positive on the left. Hypoesthesia along the course of the dermatome 1.5 - 51 on the left. Active movements in the lumbar region are painful. Treatment was carried out with laser radiation of the infrared range with a wavelength of 890 nm, pulse repetition frequency up to 150 Hz, radiation power of 8 W. After that, manual therapy was applied: mobilization with postisometric relaxation, manipulation and correction for 4 sessions. A course of laser acupuncture and manual therapy - 10 sessions. Discharged with significant improvement: reflex and sensitive spheres are normal; slight pain when palpating the paravertebral points of the lumbar spine; symptoms Lasega to the corner 70" on the left. The patient was offered a complex of rehabilitation exercises and wearing a supporting corset for 1 month. Examination six months later (March 5, 2001) - the patient has no complaints, the neurological status is normal. Repeat MRI - examination (March 2, 2001): posterior-paramedian herniation of the intervertebral disc with emphasis on the left HA - I 5 - 5 4mm, (reduced by 5.1mm), posterior protrusion of the intervertebral disc 1.5 - 51 -

With, Ohm. There were no relapses.

Thus, the experimental and clinical implementation of this method of treatment in 124 patients at the Department of Reflexology of the Kyiv Medical Academy of Postgraduate Education named after P.L. Shulyk allows us to draw the following conclusions: the action of laser radiation in the infrared range is versatile: analgesic, anti-edematous, regenerative, hemomicrocirculation is enhanced, receptor sensitivity is reduced;

the effect of manual therapy: reduces or eliminates the pathological tone of tense muscles, eliminates the block and provides movement in the vertebral-motor segment, joints of the affected lower limb;

complex use of laser acupuncture and manual therapy potentiates the positive effect on the lumbar spine and muscle groups of the lower limb.

Claims (1)

The method of treatment of neurological manifestations of degenerative-dystrophic diseases of the lumbar spine, complicated by herniated intervertebral discs, which includes the combined effect of physical therapy and manual therapy, which is characterized by the fact that as a physical therapy tool, laser puncture is used in the area of the lumbar spine and lower extremities, followed by manual therapy, which includes mobilization with post-isometric relaxation, manipulation and correction in the area of the spine, in particular the lumbar region and lower limbs for 30-40 minutes, a course of 10-12 sessions.