RU2177300C1 - Method for treating degenerative dystrophy diseases of the vertebral column - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves exposing biologically active points located in the injured vertebral column segment area to laser radiation. Wavelength is equal to or greater than 1.06 mcm. The total power is not greater than 2.5 kW. Contact exposure as single impulse is applied. Medical preparation solutions are administered in those points. EFFECT: stable remission period.

Description

 The invention relates to medicine, namely to traumatology and orthopedics, and can be used for the conservative treatment of patients with degenerative-dystrophic diseases of the spine.

 The problem of choosing a method for the treatment of degenerative-dystrophic diseases of the spine by conservative methods remains unresolved to date. Usually, the success of treatment is noticeable depending on the duration of the remission of the disease, the degree of functional activity of the joint in remission, the duration of disability - disability. Important is the patient's freedom from drug stress during the period of remission.

 A known method of conservative treatment of degenerative-dystrophic diseases of the spine - osteochondrosis, spondylosis (N.V. Kornilov, EG. Gryaznukhin. Traumatological and orthopedic care in the clinic. St. Petersburg. 1994. S. 281) by using acupuncture, laser therapy, magnetotherapy and peril within 2-3 weeks.

 However, relieving pain during an exacerbation period, this treatment does not provide long-term remission, mainly has a symptomatic effect: pathological changes continue in the area of the spinal structures, and the remission that occurs after treatment is always accompanied by drug therapy using non-steroidal anti-inflammatory, analgesic and vascular drugs, which also are known to cause common and local complications. In addition, with insufficiently accurate adherence to the technique of blockade, it is possible to obtain various complications up to death.

 A known method of treating degenerative-dystrophic diseases of the spine (M.A. Berglezov. Degenerative-dystrophic and post-traumatic joint diseases in outpatient practice. Act. Speech. M., - 1993.-P. 21) by paravertebral injection of various drugs: rumalone, arteparone , hydrocortisone, etc., as well as laser therapy and acupuncture.

 However, the known method can cause various complications: in the process of its application, trauma to paravertebral tissues occurs, which subsequently causes various chronic tenso- and myopathies with the formation of myotonic syndrome. The method does not provide drug-free remission after a course of treatment, and the remission itself continues, depending on the stage of the disease, for relatively short periods: from several weeks to a year.

 As the closest analogue, a method has been adopted for the treatment of degenerative and dystrophic diseases of the spine (osteochondrosis) (Pshetakovsky IP Reconstructive treatment of patients with intervertebral osteochondrosis in conditions of MSC and sanatorium-preventorium. Methodical recommendation. Odessa, 1989) by exposure to focused radiation of low-energy biologically active points (BAP) red spectrum lasers - segmental and bracing.

 However, in the known method, the problem of preventing constantly repeated drug-free remission has not been solved, and the low-intensity laser radiation used has a small penetration depth that does not always correspond to the depth of BAP. In this regard, the use of laser irradiation causes a general nonspecific effect rather than an effect directly on the BAP with a clear response to the excitation of biologically active points.

 The objective of the invention is to provide a highly effective method for the treatment of degenerative-dystrophic diseases of the spine, which allows for long-term, stable drug-free and repeated remissions during repeated courses, improvement of the state of intervertebral discs, and prevention of complications associated with anti-inflammatory therapy with known pharmacological drugs.

 The essence of the invention lies in the fact that in a method for the treatment of degenerative dystrophic diseases of the spine, including exposure to biologically active points with focused laser radiation, they affect biologically active spondyl-specific points located in the region of the affected spine with high-energy laser radiation with a wavelength of at least 1.06 microns with a total power of not more than 2.5 kW, contact, with a single impulse to each point, and then solutions of vitamins, lek are introduced into these points aromatic preparations with local anesthetizing, antihistamine and chondroprotective effects. With the defeat of the cervical spine use points - 11V, 21VB, with the defeat of the thoracic region - 12VG, 12V, 16V; lumbar - 23V, 25V, 28V, 32V, 34V on both sides. With a combination of osteochondrosis with the syndrome "shoulder-brush" affect the points 11V, 21VB, 10GI, 14GI, 15GI, 16GI; and with lumbalgia: 23V, 28V, 36V, 57V.

 Using the invention allows to obtain the following technical result.

 The method is highly effective. It allows in almost 100% of cases to prevent the development of complications, tissue trauma, aggravation of degenerative-dystrophic processes in the intervertebral discs, nearby joints and tissues. Provides persistent, long-term, drug-free remission with repeated courses of treatment. Using the method reduces the level of disability, improves the "quality of life" of patients, especially in the case of the late stages of the pathological process.

 Using the method has practically no contraindications. A contraindication can only be individual intolerance to the drugs used for introduction into biologically active spondyl-specific points (BASST).

 The authors first established the following.

 The system of acupuncture zones is a part of the body’s biological self-regulation apparatus and performs the task of maintaining its optimal energy level in accordance with changing external and internal conditions, those BASST are energy exchange zones. Under the influence of irradiation with a highly active neodymium laser, their electrical conductivity changes. We have developed and theoretically justified a new scheme for the conservative treatment of degenerative spinal diseases with the use of basic drugs, taking into account the nature and localization of the pathological process. A comparative study of various methods of conservative treatment of degenerative spinal diseases based on injections of various drugs showed a significant potentiation of the action of drugs introduced into BASST and an acceleration of the clinical effect with preliminary laser irradiation of the points. Under the influence of laser irradiation with a power of up to 0.5 - 0.6 kW in a periodic mode with a break between pulses of 1-2 s with a total power per session at points of 2-2.5 kW, a significant potentiation of the action of drugs introduced into BASST was noted, and acceleration of the manifestation of the clinical effect: on average 3-5 days after the start of treatment, the pain syndrome is stopped, the functions of the affected segment improve, including muscle tension, a feeling of stiffness, and when involved in the pathology of the limbs (pl hand-brush, lumbalgia, sciatica) the function of the interested limb improves accordingly. The positive effect of the laser with the above parameters is ensured by the depth of light penetration, which allows BASST to be brought into an excited state and to improve the response of points to drugs. Irradiation of BAAST activates the oxidative system with an antioxidant effect in the area of the affected segment, which in turn leads to a shortening of the phases of inflammation, and therefore accelerates the process of stopping the whole process.

 The method is as follows.

 Biologically active spondyl-specific points located in the area of the affected spine are exposed to high-energy laser radiation with a wavelength of at least 1.06 microns with a total power of not more than 2.5 kW contact, a single pulse per point, and then a solution is injected at these points vitamins and drugs with local anesthetic, antihistamine and chondroprotective effects. With symptoms of involvement in the pathological process of the upper or lower limb with a combination of osteochondrosis with shoulder-brush syndrome or the phenomena of lumbalgia and sciatica affect additional points.

To do this, determine the location of biologically active spondyl-specific points (BASST) in accordance with the anatomical landmarks. For example, point 11V is located on both sides of the spine 1.5 cuns outward from the spinous process. To identify the point, draw a horizontal line through the spinous process and retreat from it 1.5 cun outwards. 12V is located at the intersection of a horizontal line drawn through the top of the spinous process of the 2 thoracic vertebrae 1.5 cunus outward from the process. In case of damage to the lumbar spine involving the sciatic nerve or irritation of the nerve roots, various combinations of points are possible depending on the localization of the pain syndrome. But be sure to use a 23V point in each case. BASST is combined as follows: 23V and 25V, or 23V, 28V and 34V (at the clinic of interest of the sacrum), or 23V and 34V on both sides. With exacerbation due to lumbalgia, sciatica 23V, 28V, on both sides, 36V and 57V. When exacerbating the pathology of the cervical spine in combination with the "shoulder-brush" syndrome, the points are combined as follows: always use the 11V 21VB points on both sides and add combinations every other day 10GI, 16GI and 14GI, 15GI from the side of the syndrome. For physical impact, use the domestic laser neodymium device "Good Light" or the imported "SHARPLAN" Nd: YAG LAZER SYSTEM or other laser devices with the indicated parameters. The apparatus is tuned to a pulsed exposure mode using a point light guide, which makes it possible to focus the laser radiation flux. Having brought the fiber directly to the surface of the segment, first the previously found biologically active points are sequentially irradiated with a high-energy neodymium laser with a power density of 0.5 kW per point, after which they are injected into the same BASST. Puncture points are made at an angle of 90 ^o to the surface of the skin, the depth of introduction of the needle is an average of 1 inch.

 The nature of the process is determined: the presence or absence of signs of synovitis. In the presence of synovitis, an antihistamine, a local anesthetic (novocaine or its analogues), vitamin B12, and chondroprotectors are used. In BASST, the corresponding localization of the exacerbation of the pathological process, previously irradiated with a neodymium laser, is introduced the above mixture of drugs in the average therapeutic dose, distributed in equal proportions to all active points. Procedures are performed daily. A 1-2 day break in the middle of the course is possible. In total, 10-14 procedures per course. A comprehensive conservative treatment is carried out using physiotherapy, general strengthening medication. The proposed method completely eliminates the use of steroid hormonal drugs. The criterion of remission is the normalization of biochemical blood tests: seromucoid level, as well as the clinical results of the treatment: the function of the affected segments of the spine, concomitant lesions of the limbs, the normalization of autonomic reactions, the absence of pain, etc. allowing the patient to do without oral medications.

 The method was applied in 41 patients with degenerative-dystrophic diseases of the spine in the city hospital of the city of St. Russ and 15 GKB of Moscow. Of these, between the ages of 37 and 63, there were 22 women and 19 men. As a result, the method provided a positive clinical result, namely that the pain syndrome was stopped on day 3-4, the functional range of movements in the spine and limbs significantly increased by day 5-6, the feeling of stiffness passed, and the severity of vegetative reactions decreased. For a year or more, headaches were not noted. Remission ranged from a year to ten years. None of the patients experienced complications as a result of the treatment.

 Clinical examples.

 Example 1. Patient M. 51 was treated for exacerbation of osteochondrosis of the lumbar spine with radicular syndrome. The patient complained of pain in the lumbar spine with radiation to the right gluteal region and along the posterior surface of the lower limb. The "antalgic posture" was detected, the feeling of "weakness" in the leg. A decrease in pain and tactile sensitivity along the posterior surface of the thigh and lower leg, atrophy, and impaired reflexes were objectively determined. X-ray revealed a decrease in the height of the discs, bone spikes, changes in the structure of the vertebrae, signs of instability of the spine, Schmorl's hernia L4-L5 of the lumbar vertebrae. Treatment started: for 11 days, BASST therapy was carried out: points 23V (at the intersection of the horizontal line drawn through the top of the spinous process L2 of the lumbar vertebra and the vertical line along the edge of the paravertebral muscles), 25V (the intersection of the horizontal line through the middle of the spinous process L4 and the vertical line along the edge of the paravertebral muscle) on both sides, 36V (in the center of the gluteal fold) and 38V (in the corner formed by the medial edge of the biceps muscle and the lateral edge of the semi-membranous muscle 1 cun above the popliteal fold) about radiated with a neodymium laser with a power of 0.6 kW per point. After irradiation of the point, a portion of the cocktail from the preparations was introduced into it: rumalon, suprastin, vitamin B12, lidocaine. At the same time, measures were taken: exercise therapy, the introduction of nicotinic acid and aloe parenterally N 10. On day 3, the pain was significantly reduced, gait improved. By the end of treatment, the feeling of "weakness" in the leg disappeared. Two weeks later, the patient returned to his previous work. Remission for more than four years.

 Example 2. Patient C., 46 years old, was outpatient for exacerbation of cervical osteochondrosis. Pain in the cervical spine, headache, stiff neck and shoulder muscles, functional torticollis were noted. On radiographs of the cervical spine - a decrease in the height of the discs, smoothing of the cervical lordosis, signs of instability in the region of C3-C4. The patient underwent therapy according to the indicated scheme: laser therapy at points 11V (1.5 cuns outwards from the spinous process Th1 of the thoracic vertebra) and 21VB (middle of the trapezius muscle: the apex of the vertical line through the papilla until crossing with the trapezius muscle) and the introduction of rumalone, lidocaine and Vitamin B12 N 10. Exercise therapy, massage-relaxation, nicotinic acid and aloe vera parenterally. Reception Actovegin, aerovita. The course is two weeks. The condition has improved dramatically. Headache disappeared for 3-4 sessions. Pain and stiffness in the cervical spine and shoulder girdles passed on the 5-6th session. Therapy is continued to consolidate the result. The patient began to work again. Remission three years to the present.

Claims (1)

 A method for the treatment of degenerative-dystrophic diseases of the spine, including exposure to biologically active points with focused laser radiation, characterized in that they affect biologically active points located in the affected area of the spine with high-energy laser radiation with a wavelength of at least 1.06 μm with a total power of not more than 2.5 kW, contact, with a single impulse to each point, and then solutions of vitamins, drugs with local anesthesia are introduced into these points esthetic, antihistamine and chondroprotective effect.