Modern possibilities of improving the effectiveness of medical treatment of vertebrogenic radicular pain syndrome in degenerativedystrophic diseases of the spine

Abstract

Introduction. The lifetime incidence of radicular pain syndrome in different age groups varies from 12.2 % to 43.0 %. The most common injectable method of pain syndrome treatment is the execution of blockades. Short duration of the analgesic effect of individual types of blockades makes us think about the use of their combination to achieve a better analgesic effect. The aim of the study was to prove the efficacy of nonsurgical correction of painful radicular syndrome using a combination of medication blockades. Materials and methods. Analysis of treatment efficacy of pharmacoresistant vertebrogenic radicular syndrome using paravertebral blockade and combined (epidural + periradicular) blockade was performed. The effectiveness was evaluated by the dynamics of pain syndrome (according to the visual analogue scale of VAS pain) after the blockade, after 3 days, 14 days and 1 month. Results. The 1st group patients' pain level according to VAS after the blockage was 3.5 ± 0.8, 3 days later – 5.6 ± 1.1, 14 days later – 4.8 ± 1.2, 30 days later – 4.2 ± 0.7. The patients in the second group had a pain level of 0 after the blockade, after 3 days – 1.8 ± 0.2, 14 days – 2.1 ± 0.9, 30 days – 1.8 ± 0.5. The patients in the main group had significantly lower VAS after combined blockades (p < 0,05). Discussion The available researches of some methods of injection therapy suggest the strengthening and increase of duration of the analgesic effect when combining some kinds of blockades among themselves. The results of the carried out research show that application of the combined blockades permitted to decrease reliably the level of the residual radicular pain in patients with lumboishyalgia (p < 0,05). Conclusion. The study proves that application of combined blocks in the complex treatment at low efficiency of the standard medical conservative therapy and at absence of indications for surgical treatment allows effectively stopping worsening of radicular pain syndrome in a short time.