Clinical features and complex treatment of vertebral thoracalgia with neurodystrophic signs

Abstract

Objective — to identify the clinical features of vertebral thoracalgia (VT) with neurodystrophic signs and to increase the effectiveness of their complex treatment using manual therapy and kinesiotherapy.Methods and subjects. 247 patients who had VT with neurodystrophic manifestations were under our observation and treatment. The main group included 178 patients with VT (72.1 %) and they were given a complex therapy according to standards and protocols; manual therapy (MT) and kinesiotherapy were applied additionally. The comparison group consisted of 69 patients with VT (27.9 %) who received similar treatment, but without MT.Results. On manual muscle testing results vertebral neurological features were identified in patients with thoracalgia with neurodystrophic manifestations. The nodes of neuroosteofibrosis and neuromiofibrosis as well as functional blocking of the vertebral motor segment (VMS) were determined at several levels in all patients and blocking of additional joints in 90.4 % of patients. As a result of complex treatment with the use of MT in patients from the main group, 108 people (60.7 %) were discharged with significant improvement, 47 (26.4 %) with improvement, in the comparison group, where MT was not used — 22 (31.9 %) and 12 (17.4 %) patients respectively. A slight improvement was observed in 23 patients (12.9 %) from the main group and in 11 (15.9 %) patients from the comparison group. 24 patients (34.8 %) from the comparison group were discharged without improvement. The average treatment periods in the main group were 14.3 ± 1.5 days, and in the comparison group 19.6 ± 2.2 (р < 0.05).Conclusions. In all VT patients with neurodystrophic signs, a manual diagnosis reveals the functional blocks of the thoracic VMS and the nodes of the neuroosteo‑and neuromiofibrosis. At the same time, in 42.6 % of patients, VMS were blocked at several levels, and 90.4 % of patients had blocking of additional joints. The inclusion of MT in the complex treatment significantly increases its effectiveness and reduces the duration of treatment.