Treatment Of Dorsopathy Research Articles

The application of information technologies in system of support of decision making in osteopathy

The implementation of information technologies into treatment practice of modern health care significantly increases efficiency of diagnosis and treatment of dorsopathies. The purpose of the study is to develop software module to evaluate post-urological status of patients with spine dorsopathy to optimize diagnostic process and treatment planning. The article describes application of original software module to assess the post-urological status of patients with spine dorsopathy. The proposed software module is designed for objective assessment of post-urological status of patients with spine dorsopathy based on photographic images of examined patient. The most important advantage of software module is built-in forecasting function that is implemented by calculation of severity of pain perceptions and movement disorders using generated regression equations. The possibility to record data obtained during measurements permits to store information in single system. The implementation of software module into clinical practice will contribute to qualitative improvement of diagnostic processes, simplify work of osteopath and reduce the time spent on examination.

General characteristics and features of the use of nonsteroidal anti-inflammatory drugs in the treatment of dorsopathies in clinical practice (literature review)

Back pain ranks first among all non-communicable diseases in terms of the number of years of life lost due to poor health. At the same time, the choice of tactics for the treatment of dorsopathies presents certain difficulties, in particular, the choice of a nonsteroidal anti-inflammatory drug (NSAID), which depends on a number of factors. NSAIDs are effectively used in the treatment of musculoskeletal pain, but they have side effects, which determines the individual characteristics of their use. The article presents an overview of scientific data published in the sources MEDLINE, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Clinical Trials.gov, services for the exchange of research information on the clinical practice of NSAID use. The general characteristics and side effects of NSAIDs in clinical practice are analyzed in order to choose an effective and safe trajectory of their use in the treatment of dorsopathies. In the acute period of dorsopathy, the therapeutic effect should be aimed primarily at reducing pain. At the same time, the use of NSAIDs is necessary and justified, should include a detailed assessment of side effects, duration of use, alternative trajectories of drug and non-drug treatment. Numerous side effects of NSAIDs from the gastrointestinal tract, liver, cardiovascular system, allergic reactions, congenital anomalies in the fetus when using NSAIDs during pregnancy and other undesirable consequences, make it necessary to take the maximum possible measures to minimize adverse reactions and long-term undesirable consequences for the patient. Combined therapeutic effects, including, along with the use of NSAIDs, physiotherapy, physical therapy, massage, reflexotherapy, optimization of motor activity, optimization of posture under static loads, the use of cognitive behavioral therapy methods, is optimal from the standpoint of risk stratification and the expected clinical effect in patients with dorsopathy.

Влияние копинг-стратегий пациентов пожилого и старческого возраста на исходы лечения дегенеративно-дистрофических заболеваний позвоночника

Introduction Dissatisfaction with conservative treatments of various types of dorsopathies results in increased number of surgical interventions to eliminate the accompanying clinical manifestations. Patients' psychosocial characteristics are likely to impact treatment satisfaction, and personality traits as cognitive status, depression, anxiety and coping strategies of the patient have a role. The objective of the study was to assess the impact of the coping strategies of a patient on surgical treatment outcomes in older patients with dorsopathy. Material and methods The study included 149 patients with dorsopathy aged 60 years and over. The patients were divided into 2 groups. The first group (n = 54) consisted of patients with central stenosis of the spinal canal (M48.0) who underwent minimally invasive surgeries without stabilization. The second group included 95 patients with degenerative spondylolisthesis and unstable VMS (M43.1, M53.2). A variety of decompression and stabilization surgical technologies were employed for the patients. Results The majority of patients in the first group ( n = 46, 85 %) obtained satisfactory surgical outcome. Eight patient (15 %) had poor outcome. An inverse, moderate, statistically significant correlation was revealed between maladaptive coping strategies identified with Ways of Coping Questionnaire (distancing, avoidance), Stress Coping Questionnaire (behavioral avoidance of a problem), the Coping Strategy Indicator (avoidance) and surgical outcome. Surgical outcome was rated as satisfactory in 79 (83.2 %) cases and poor in 16 (16.8 %) patients of the second group (n = 95). Patients of the second group showed a greater number of coping strategies having a statistically significant correlation with treatment outcome. Patients with adaptive strategies resulting from decompression and stabilization operations had a more favorable outcome. Maladaptive coping strategies such as confrontation, avoidance and behavioral avoidance of the problem had a negative impact on treatment outcome. Discussion A comprehensive analysis of the questionnaire data showed that the more aggressive the intervention was with the use of fixation constructs, the greater the impact of the patient's coping strategies on the outcome of treatment observed. This relationship was not found in decompression cases with maladaptive strategies being most significant. Conclusion We can conclude about the predictive value of coping strategies based on the impact of the severity of adaptive and maladaptive coping strategies on the outcome and satisfaction with the surgical treatment of dorsopathies in older patients. This factor is essential for the preoperative stage to facilitate personalized treatment options for the complex group of patients.

Color light therapy in complex treatment of dorsopathies and arthropathies

Color light therapy in complex treatment of dorsopathies and arthropathies

Possibilities of osteopathic correction methods using in the treatment of dorsopathy at the cervicothoracic level

Dorsopathy and associated pain syndromes are among the most common diseases of the musculoskeletal system and connective tissue. Despite the relatively high level of the problem knowledge, the dorsopathies treatment still remains a fairly serious task for clinicians. A combination of medication and non-medication treatment methods is optimal. Some studies have previously demonstrated the clinical efficacy of osteopathic correction methods using in the complex therapy of patients with dorsopathies. The issues of isolated application and mutual compatibility of various non-drug methods have not yet been studied enough. The article describes a case from practice devoted to the isolated use (monotherapy) of osteopathic correction in a patient with dorsopathy, and discusses the features of individual regional somatic dysfunctions identification and filling out an osteopathic conclusion.

Psychovegetative status and neurological symptoms in patients with idiopathic eczema

INTRODUCTION: The study included 68 patients with idiopathic hand eczema.
 RESULTS: Neurological symptoms were detected in 75% of patients; the most frequently recorded symptoms were myodefans (66.1%) and radicular sensory impairment (52.9%). Disorders of the psychoemotional state of patients were manifested by signs of depression in 38.1% of patients and personal and reactive anxiety in 63.8% and 72% of patients, respectively. The prevalence of indicators of depression and reactive anxiety and personal anxiety were found in men and women, respectively. The manifestation of the psychovegetative syndrome was found in 75% of patients. Degenerative-dystrophic changes in the spine were observed in 91.1% of patients, and two or more conditions were observed in 52.9% of the examined patients. The most pronounced changes were observed in C5C7 segments of the spine, and in 57.3% of the patients, these changes were associated with the side of the inflammatory process on the skin.
 CONCLUSION: The obtained data substantiate the correction of the psychovegetative syndrome and treatment of dorsopathy in hand eczema.

The use of osteopathic correction in conjunction with radon baths at the sanatorium-resort stage of rehabilitation of patients with dorsopathy

Introduction. Dorsopathy occurs in 90 % of people throughout life, and is in the first place for the duration of temporary disability in people after 45 years. The sanatorium-resort phase of rehabilitation, including usually physiobalneotherapy, is important in the treatment of dorsopathy. Radon therapy is one of the physiobalneotherapy types. However the effectiveness of radon monotherapy is not more than 25–38 % for various forms of dorsopathy. Therefore a combination of balneotherapy with additional methods of infl uencing on the organism is used in modern balneology to increase the effectiveness of therapy and to ensure the achievement of a positive treatment result in a shorter time without pathological balneoreaction and exacerbation. Osteopathic correction can be considered as such an additional method of infl uencing on the organism, because it triggers a cascade of regulatory reactions at the local, regional and global levels, and these reactions have a cumulative and prolonged effect.The goal of research — to substantiate the possibility of osteopathic correction using in conjunction with radon baths at the sanatorium-resort stage of rehabilitation in patients suffering from dorsopathy.Materials and methods. The study involved women aged 25 to 60 years, with a diagnosis of dorsopathy, taking radon therapy. Using the method of simple randomization with a random number generator, the main group (30 people who received radon therapy and osteopathic correction, OC), and the control group (30 people who received only radon therapy) were allocated. At the beginning and the end of treatment the osteopathic status examination of each patient was conducted in parallel with the study of their reactive anxiety level, assessed according to the Spielberger–Hanin scale, the body′s resistance to hypoxia, assessed in the Stange test by the length of breath-holding after inspiration, and the adaptive capacity of the circulatory system, assessed by Coefficient of adaptation L. Kh. Garkavi. The results were processed using nonparametric statistics.Results. It was found that if OC was included in radon balneotherapy, the state of patients suffering from dorsopathy improves statistically significantly (p<0,0001) by the following indicators: the total number of somatic dysfunctions in patients and the number of regional dysfunctions decreased, the level of reactive anxiety decreased, the body′s resistance to hypoxia increased, the adaptive potential of the circulatory system increased. The changes of all indicators in the main group receiving OC in addition to radon therapy were significantly more pronounced than in the control group receiving only radon therapy (p≤0,0001).Conclusion. The results obtained during this study allow recommending the use of osteopathic correction to enhance the effect of the sanatorium-resort treatment.

Role of radiologic imaging complex in morpho-pathogenetic approach to sanatorium resort intensity regimen selection in patients with dorsopathies

At the present time for sanatorium treatment of dorsopathies no morpho-pathogenetic principles are based on severity of degenerative spine changes. The choice of treatment modalities is provided according only to clinical signs and the fact of degenerative spine disease presence, in spite of limitations and contradictions to some resort procedures because of their mechanisms and peculiarities of therapeutic effects. Materials and methods. Comparison of complex imaging examination and sanatorium resort intensity regimen medical appointments of 952 patients with dorsopathies was provided depending on morphological pattern and severity of degenerative spine changes. Case histories, sanatorium medical outpatient cards and the results of radiologic imaging (computed tomography, magnetic resonance imaging, spondylography and osteodensitom-etry) were analyzed. Results. Three groups of sanatorium resort therapeutic action intensity (maximal, 376 patients; limited, 493 patients; and minimal, 83 patients) for patients with dorsopathies were established. The most significant morphological criteria of patient distribution into appropriate groups were established, such as bone mineral density state, the presence and severity of spinal osteoarthrosis and spondylolisthesis, vertebral-motor segment stability or instability, vertebral body hemangiomas. The size of intervertebral disc extrusions and grade of disc height decreasing played a secondary role. The value of spondylography, computed tomography, magnetic resonance imaging and dual-energy radioabsorptiometry in determination of these criteria is presented, as far as in imaging algorithm of examination of patients with dorsopathies on the pre-sanatorium stage, with calculation of computed tomography and magnetic resonance imaging sensitivity, specificity and accuracy. Discussion. Forming morpho-pathogenetic approach to sanatorium resort treatment of dorsopathy demands essential application of modern radiologic imaging modalities. The presence, type and severity of degenerative spine morphological changes must be as fundamental as clinical and neurological pattern, affecting sanatorium resort intensity regimen selection and treatment modalities and schemes. In basic cases most advisable radiologic imaging pre-sanatorium examination modality should be computed tomography, but others are also necessary to use when concretely indicated.

Role of antioxidant therapy in treatment of dorsopathy with vertebral artery syndrome

Fifty patients with cervical dorsopathy with the spinal artery syndrome were studied using clinical scales (neurological deficit, psychoemotional disturbances) and laboratory methods (parameters of oxidant stress). The correlations between the oxidant stress and the dynamics of neurological syndromes and psychoemotional disturbances as well as the efficacy and safety of their treatment with antioxidants were determined.

Efficacy of combined use of muscle relaxants and topical forms of NSAIDs in anti-pain therapy of cervicalgia and cervicobihalgia

A clinical study of the use of tolperisone (Kalmyrex) in combination with the topical form of meloxicam (Amelotex) in the treatment of dorsopathies was conducted. The feasibility of combining muscle relaxants with topical NSAIDs in the treatment of acute pain syndromes with static-dynamic and musculo-tonic changes in vertebral pathology was demonstrated.

Сочетанное лечение дорсопатий пояснично-крестцового отдела позвоночника

Сочетанное лечение дорсопатий пояснично-крестцового отдела позвоночника

Diagnosis and treatment of dorsopathy in patients with connective tissue dysplasia

To study the pathogenesis, clinical manifestations and treatment of dorsopathy in patients with connective tissue dysplasia. Thirty-six patients, aged from 18 to 45 years, with lumbar-sacral radiculopathies associated with connective tissue dysplasia were examined. Detailed neurological examination, X-ray visualization and MRI of lumbosacral spine section, electromyographic assessment were performed. A five-point scale of neuro-vertebrological symptoms, the Numerical Rating Scale (NRS) and the Roland-Morris Low Back Pain and Disability Questionnaire were used. The results contained own data on the pathogenesis, clinical manifestations and treatment of dorsopathies in connective tissue dysplasias. Inclusion of long-acting pentoxifylline (vasonite) in the combined therapy in patients with dorsopathy associated with connective tissue dysplasia had a positive effect on disease course, decreased pain intensity and improved life activities.

Epidural steroid injections for the treatment of dorsopathy

Spondylogenic (discogenic) nerve root syndromes often do not respond well to treatment. There are frequent side effects or drug intolerability, and only short periods of pain relief can be achieved. Thus, patients are not receptive to medication. A group of 40 patients with different clinical symptoms of pain syndrome were investigated in a prospective, double blind, randomized study. The study comprised three stages: recruitment of patients, which was followed by treatment (14 day duration), and outcome evaluation. The patients were divided into two groups: group 1 received epidural steroid injections (nerve blocks) and group 2 received non-steroid treatment, while both groups received manual (musculoskeletal) therapy (58 patients in total). Intensity and quality of the pain were evaluated throughout the therapeutic period. The results indicate that epidural steroid injections in chronic pain of discogenic etiology are highly effective.