A new approachs to the treatment of рain syndrome in lumbar-sacral spine
Keywords:рain syndrome, lumbar spine, degenerative-dystrophic diseases, herniated discs, epidural injections
Background. The lumbar spine pain remains one of the most pressing medical and social problems. The purpose of the study was to assess the efficacy of the combined use of transforaminal and caudal epidural blockades for treatment of the lumbar spine pain syndrome due to the degenerative-dystrophic changes of the spine. Materials and methods. The study included 228 (85 males, 143 females) patients aged 52.07 ± 13.95 years with lumbar spine pain due to the degenerative-dystrophic changes. Among them, 114 patients received transforaminal epidural blockade and 114 — caudal epidural blockade. Results. The positive therapeutic effect was registered in 150 (65.8 %) patients. The rest 78 patients presented with a recurrent pain syndrome of up to 5 or more points on VAS underwent repeated procedures with a total number of up to four within 4 to 14 days after the first blockade. They were divided into three groups. Group 1 included the patients who received transforaminal epidural blockade (n = 26); group II consisted of the patients who received caudal epidural blockades (n = 26) and group 3 involved the patients undergone the combined use of transforaminal and caudal epidural blockades (n = 26). At starting therapeutic intervention, after hour 1, week 3, and month 3 after the injections, lumbar spine pain intensity, tension sign (straight leg raising test), lumbar mobility and the quality of life (the Oswestry Disability Index) were assessed for all groups. Conclusions. The combined use of transforaminal and caudal epidural blockades is a more effective method for treatment of the lumbar spine pain syndrome and is associated with a positive dynamic in the quality of life of a patient. The transforaminal or caudal epidural blockades only were effective during the short term.
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Copyright (c) 2019 G.S. Moskovko, O.I. Datsyuk, Ya.V. Nikitchuk, A.V. Kostiuchenko, N.V. Titarenko
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