UA7645U - Method for conservative treatment of medial and paramedial hernias of intervertebral disks of sacral-lumbar backbone division - Google Patents

Abstract

The method for the conservative treatment of medial and paramedial hernias of the intervertebral disks of the sacral-lumbar backbone division comprises the manual therapy, namely postisometric relaxation of the muscles, the mobilization, and the manipulation, for example according to the principles of osteopathic school. In the course of the postisometric relaxation of the extensors of the back, in particular of the lumbar backbone division, the patient lies supine with the legs flexed maximally in the knee and hip joints. In the stage of breath-in (7-9 s) with the look directed upwards, the extension of the patient's legs is slightly interfered with the aid of the shoulder girdle. In the stage of breath-out (7-9 s) with the look directed downwards, the shoulder girdle presses the legs of the patient extending the shoulder from the side of the hernial protrusion or in the area of hernial "accent".

Description

Description of the invention

A useful model belongs to medicine, in particular to neurology, vertebrology and manual therapy and can be used for the treatment of medial and paramedian herniated discs of the lumbosacral spine (including sequestered ones).

A method of combined conservative treatment of herniated intervertebral discs of the lumbosacral spine |1) is known. The prototype includes the use of vibration, manual therapy, therapeutic medical blockades in the area of the spine, in particular the lumbosacral spine. However, this method does not take into account the type of herniated intervertebral discs, the use of postisometric muscle relaxation (hereinafter PIRM) is not described.

The closest to this method of treatment is the method of treating patients with medial herniated intervertebral discs of the lumbosacral spine in the Moscow Manual Therapy Center (2). However, the known method of treatment does not take into account when performing PIRM of the back extensors from which side the hernial protrusion 72 | the doctor's position does not allow a full-fledged PIRM. Also, the sizes of intervertebral disc herniations, which depend on the number of procedures and the intensity of the amplitude of movements when performing PIRM, are also not taken into account.

The task of a useful model is to reduce the spasm of the back extensors as much as possible during PIRM, in particular on the side of the hernial protrusion, which makes it possible to more rationally carry out manual therapy techniques (mobilizations, manipulations) that directly eliminate functional blockages, that is, the range of motion in the back is normalized spinal motor segment.

The task is carried out as follows: in the position of the patient on his back with the legs maximally bent in the knee and hip joints during the phase - inhalation of 7-9 seconds. look up, slightly resist the extension of the patient's legs with the shoulder girdle, during the exhalation phase for 7-9 seconds, look down, press on the patient's legs with the shoulder girdle, at the same time pushing the shoulder from the side of the hernial protrusion or where the "accent" of the hernia is.

PIRM of the back extensors is performed, taking into account the severity of the pain syndrome, the type and size of the hernia: in case of protrusions in 2-4 sessions, in case of prolapses (actual hernias) - in 3-5 sessions, in case of sequestered hernias - in 4-6 sessions with a less intense amplitude of movements , and PIRM of the back extensors is performed about 3-5 times in one session.

After maximum stretching of the spasmodic muscles of the back extensors, mobilization and manipulation techniques are performed. Electropuncture is used before manual therapy. "Her

Clinical example:

Patient M., 42 years old, history no. 0953203437/285, complained of pain in the lower back and left leg, ee, feeling of rubbing on the outside of the left leg, deterioration of gait due to pain. Cha

Brief history: sick for about 16 years, after physical exertion. There were exacerbations for 2-3 years. in 1 year 3 o She was treated on an outpatient basis. In the spring of 1999 after physical exertion, the condition worsened. She was treated repeatedly in an inpatient and outpatient setting, there were periods of improvement. The last exacerbation approx. a week ago

Concomitant diseases: chr. cholecystitis "

Neurological status: cranial nerves without features. Periosteal and tendon reflexes from the hands Sh- 0-5, alive, knee reflexes 0-5, alive, Achilles reflexes 5-0, reduced. Soreness during palpation of the paravertebral points of the lumbar spine. St. Lasega (t) on the left 7202; village of Wasserman (F) from both sides; village of Matskevicha (t) on the left. Hypoesthesia along the course of dermatome 1 5-51 on the left. "from Examination: magnetic resonance imaging (hereinafter MRI) - protrusion of the intervertebral discs I13-I4-Zmm, 174-I5-4mm, sequestered herniation of the intervertebral disc I15-51-99mm, spondylography (osteochondrosis of the lumbar spine), acupuncture diagnosis according to Nakatan (increase in the level of indicators of the physiological corridor), blood analysis and 75 urine (without peculiarities). Treatment: manual therapy Мо10-12, electropuncture Мо10, drug therapy and As a result of the treatment, an improvement in the general condition, reduction of pain syndrome, improvement ( Ge) of neurological and vertebrological symptoms, during MRI - examination (protrusion of m/x disc 15-51-4, mmm), improvement of indicators during diagnosis according to Nakatan (indicators within the physiological corridor). t Treatment sessions are carried out 10-12 times. in the exceptional majority of cases, with prolapses, 1 course of SL 50 treatment was carried out. In case of sequestered hernias, a narrow vertebral canal, severe pain syndrome, a repeat course of treatment is prescribed after 1 month, with a mandatory mandatory performance of therapeutic physical exercises, wearing a supporting corset.

The results of research were conducted in 78 patients with discogenic radiculitis with medial hernias - 41 patients (52,65), of which prolapses - 43,695, sequestered prolapses - 8,995; paramedian hernias - 37 patients (47.76),

Among them, prolapses - 7.79 Uo, sequestered prolapses - 39,790.

Patients are examined at the end of the course of treatment in order to determine the effectiveness of the treatment method

MRI, spondylography, acupuncture diagnosis according to Nakatana), dynamics of pain syndrome, changes in neurological and vertebral symptoms.

As a result of the treatment, an improvement in the general condition was noted, a change in neurological symptoms (60 codeine and Achilles reflexes increased, the intensity of tension symptoms decreased, hypoesthesia in the innervation zone of certain nerve roots, tonic muscle tension), a change in vertebral symptoms (scoliosis decreased, limited movement in the spine , functional blockades of segments I 4-54, tenderness of paravertebral points, Valle's points), change in the size of the hernia during MRI - examination.

The effectiveness of the treatment was noted in patients with medial herniated intervertebral discs of the lumbosacral spine - 75965, with paramedian herniated intervertebral discs of the lumbosacral spine - 58965.

Thus, the proposed method is effective in the treatment of patients with medial and paramedian herniated discs of the lumbosacral spine.

References: 1. Patent of Ukraine Mo37907, M class. Ab1Н1/00, АЕ1ТН23/00 "Method of combined conservative treatment of herniated intervertebral discs of the lumbosacral spine" / Shulga O.M., Dzyak L.A., Shulga O.O. 2. Sitel A.B. Manual therapy. Guide for doctors. - M.: Izdattsentr, 1998. - 304 p.

Claims (2)

The formula of the invention 1. The method of conservative treatment of medial and paramedian herniations of the intervertebral discs of the lumbosacral spine, which includes manual exposure by the method of manual therapy: postisometric muscle relaxation (hereinafter PIRM), mobilization and manipulation (for example, the osteopathic school), which is distinguished by the fact that during PIRM of the back extensors, in particular of the lumbar spine, in the position of the patient on his back with the legs maximally bent in the knee and hip joints during the inhalation phase - 7-9 sec. exhalation phase - 7-9 seconds, look down, press the patient's legs with the shoulder girdle, at the same time extending the shoulder from the side To the hernial protrusion or where the "accent" of the hernia is. 2. The method according to claim 1, which differs in that PIRM of the back extensors is performed, taking into account the severity of the pain syndrome, the type and size of the hernia, namely in the case of protrusions - in 2-4 sessions, in the case of prolapses (actually hernias) - in 3-5 sessions , with sequestered hernias - in 4-6 sessions with a less intense amplitude of movements, and PIRM of the back extensors is performed about 3-5 times in one session. stump " stv " : : - - Official bulletin "Industrial Property". Book 1 "Inventions, useful models, topographies of integrated microcircuits", 2005, M 7, 15.07.2005. State Department of Intellectual Property of the Ministry of Education and Science of Ukraine. IF) « (Se) in . and? -i (o) sh» sl So 60 b5