Concept of a complex therapy in restorative treatment of discogenic lumbosacral radiculopathies.

Анотація

Currently, the treatment of lumbosacral radiculopathy (LSR) is an urgent problem due to the frequent chronic pain syndrome, the lack of a unified methodological approach to the recommendations, taking into account the pathological characteristics of the compressed root.  The purpose of the work is the development of the concept of a comprehensive etiopathogenetic treatment of acute lumbosacral radiculopathy. 100 patients, divided into two groups were examined (the main – 45 people, the control – 55 people). Each group was divided into subgroups depending on the treatment received (basic and complex). Basic therapy included treatment according to European and American recommendations. Complex treatment consisted of a combination of basic therapy and vibrotraction postisometric muscle relaxation (PIMR) with biomechanical stimulation of the paravertebral muscles. Treatment control was based on the analysis of the neurological and neuroorthopaedic status, severity of a pain syndrome using a 5-point verbal scale, PainDETECT questionnaire, the muscle syndrome index, as well as quantative sensory testing. The stages of the study were chosen taking into account the pathological stages of the disease: 1-7 days and 30 days. When analyzing the results of ELISA to IgG for urogenital infections in 46.7% of patients of the main group and 47.3% of the control, urogenital chronic infections were detected, while in the main group mycoplasmic and ureaplasmic infections were more common, and in the control group patients mostly had chlamydial infection. When antibacterial drugs were included in the treatment, the most pronounced regression of the pain syndrome was determined. Thus, it was found that the use of vibrotractional postisometric relaxation with biomechanical stimulation of the paravertebral muscles in combination with the use of NSAIDs is aimed at quickly removing the muscular-tonic and compression symtoms during 10-14 days (p<0.05), and the further use of neurotropic therapy led not only to a persistent analgesic effect, but also contributed to the improvement of the biomechanical indicators of the spine (p<0.05), positively affecting the motor activity.