[The application of physical factors for the rehabilitative treatment of vertebrogenic cerebral dyscirculation].

The present study included 65 patients presenting with vertebrogenic cerebral dyscirculation and degenerative change within the cervical spine in the absence of hemodynamically and/or morphologically significant lesions in brachiocephalic arteries. During the first phase of the study, 39 randomly selected patients underwent traction of the cervical spine following collar zone massage. Moreover, they were instructed to simultaneously wear a soft cervical collar. The analysis of the results of this treatment showed that a combination of physiotherapeutic procedures produces the beneficial effect in the patients with the early manifestation of degenerative processes in the form of cerebral instability. Those suffering more severe anatomical changes in the vertebral column (spondylosis, spondyloarthrosis, spinal disk dislocation) are much less likely to benefit from the proposed treatment. The patients for the second group (n=26) were selected based on the results X-ray examination; they presented with vertebral instability requiring combined physiotherapeutic treatment including collar zone massage, orthotraction therapy, and simultaneous wearing a soft cervical collar. The results of the treatment were assessed from dynamics of clinical manifestations and the results of radioisotope studies of cerebral blood flow. No complications of combined physiotherapy were documented. The effectiveness of orthotraction therapy after preliminary collar zone massage in the patients of group 2 was estimated at 88.5%. Moreover, arterial pressure in the patients with concomitant arterial hypertension was reduced in conjunction with the improvement of venous outflow characteristics.

[Combined rehabilitation treatment of patients with spinal dystrophy using epidural pharmacotherapy]. / Kompleksnoe vosstanovitel'noe lechenie bol'nykh s distroficheskimi zabolevaniiami pozvonochnika s primeneniem épidural'noi farmakoterapii.

The article presents the results of treatment of 70 patients with spinal lumbosacral dystrophy complicated by dislocation of the intervertebral disks. All the patients had long-term history of the disease and exacerbation resistant to conservative treatment. Later, this treatment was changed for epidural long-term local pharmacotherapy (ELLP). The effect of this treatment was assessed by changes in pain syndrome in early and long-term periods, in MRT and CT images. ELLP proved effective as the response reached 83.2%. The maximal 95% response was achieved in combined treatment: ELLP + physio-, balneo-, kinesitherapy, massage. MRT and CT image dynamics show that pathological substrate disappears or significantly decreases in size in 83.4% cases.

[Epidural pharmacotherapy in patients with dystrophic diseases of the lumbosacral spine]. / Epidural'naia farmakoterapiia u patsientov s distroficheskimi zabolevaniiami poiasnichno-kresttsovogo otdela pozvonochnika.

The results of treatment were analyzed in 70 patients with dystrophic diseases of the lumbosacral spine complicated by the displacement of intervertebral disks. All the examinees had a long history and a protracted exacerbation resistant to conservative therapy. Long-term local epidural pharmacotherapy (LTLEP) was used for their treatment. The essence of the method was to employ selective catheterization under X-ray guidance of the epidural space, to bring a catheter directly to a pathological area. Further it was irrigated with drugs many times. The results of treatment were analyzed from changes in the pain syndrome in the early and periods and from the data of repeated studies (magnetic resonance imaging (MRI) and computed tomography (CT)). LTLEP was highly effective, i.e. 84.3% of positive results. Follow-up MRI or CT findings show that the pathological substrate disappears or significantly decreases in sizes in 83.4% of cases. LTLEP is safe: in the study group, there were no complications due to the manipulation itself and after treatment the patients' health status did not deteriorate owing to a therapeutic process. If conservative therapy is inefficient, it may be used as an alternative to conventional and low-invasive neurosurgical operations.

[Epidural long-term local pharmacotherapy in patients with degenerative dystrophic spinal diseases during combined rehabilitation therapy]. / Epidural'naia dlitel'naia lokal'naia farmakoterapiia u bol'nykh s degenerativno-distroficheskimi zabolevaniiami pozvonochnika v komplekse vosstanovitel'noi terapii.

Epidural long-term local pharmacotherapy in degenerative-dystrophic diseases of the lumbar spine proved most effective in combination with rehabilitation procedures. Such combined treatment can be used in cases with long-standing disease resistant to conservative treatment.