The use of pharmacological blockades in the complex treatment of lumbosacral radiculoischemia in patients with discs hernias of large sizes
Notice bibliographique
Résumé
Introduction . Lumbosacral dorsalgia is widespread and represents an actual problem. The greatest difficulties are noted in the treatment of patients with discs hernias of large size. Local injection therapy is actively used. The development of therapeutic methods in such patients remains relevant. The goal of research is to compare the effectiveness of pharmacological blockade in the complex treatment of spondylogenic lumbosacral radiculoischemia in patients with discs hernias of large size. Materials and methods . A prospective randomized controlled trial was conducted in March-November 2018 at the Neurological Department No. 2 of the Institute of neurology of the Pavlov First Saint Petersburg State Medical University. There were 58 patients with symptoms of lumbosacral radiculoischemia with discs hernias of large sizes. Depending on the used treatment method, the patients were divided into main and control groups. Each patient had 10 sessions of manual therapy lasting 20 minutes each. Sessions were held daily. Preformed physical factors were also used in all the observed patients. Preference was given to low-intensity laser therapy, the number of procedures was 10–15 with an interval on weekends, and the total duration of irradiation was no more than 20 minutes. Additionally, patients in the main group received local injections of diprospan and lidocaine, and patients in the control group received injections without the main substance. The intensity of pain was assessed by visual analog scale during the first day, as well as its intensity by the McGill questionnaire during 14 days. Results . The study included 24 men and 34 women with signs of compression radiculoishemias with discs hernias of large sizes. The level is lumbosacral (LIV–V, LV –SI ). When evaluating the data in the first hours and within 2 weeks, a significant decrease in the severity of pain syndrome was observed in comparison with the initial results in patients of both groups (p<0,05). The obsered data (pain intensity) significantly differed after 2 and 6 hours (p<0,001), as well as during 4, 7, and 8 days (p<0,01). The use of medication blocks with glucocorticoids has a more significant effect compared to the treatment regimen without the main substance (group 2) for 8–9 h (p<0,05) and 7-day treatment period (p<0,01). Conclusion. The medication blockades with glucocorticosteroids included in the complex treatment of patients with spondylogenic radiculoishemias with discs hernias of large sizes have a significantly more significant analgesic effect, while the effect is achieved in a short time. When using local injections with diprospan and lidocaine, the therapeutic effect appears gradually, and it persists for a long time — up to 2 weeks. The recommended number of injections is no more than 3 per course of treatment.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».