The use of pharmacological blockades in the complex treatment of lumbosacral radiculoischemia in patients with discs hernias of large sizes
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".