Evaluation of the effectiveness of therapy in degenerative-dystrophic disk diseases

Abstract

The dominant role during the incidence of degenerative-dystrophic changes of the spinal column in the lesion is pain syndrome of varying intensity. The purpose of this study: to evaluate the effectiveness of conservative methods of treatment of degenerative-dystrophic disk diseases. The retrospective dynamic study included 107 medical records of outpatients, the average age of patients with degenerative-dystrophic disk disease who underwent rehabilitation treatment at Evminov Center for Vertebral Health in the period 2021-2022 was 43.4 ± 4.2. Rehabilitation treatment included personalized kinesitherapy on Evminov Prophylactor (inclined board), Glisson’s Loop, taking non-steroidal anti-inflammatory drugs (NSAIDs) for up to two weeks (appointment depending on the intensity of the pain syndrome) against the background of compliance with the orthopedic regimen and follow-up by a rehabilitologist in dynamics. Depending on the therapy, the examined patients were divided into 3 groups: group I – patients with kinesitherapy, II – kinesitherapy in combination with non-steroidal anti-inflammatory drugs, III – kinesitherapy with Acetaminophen (respectively: 44 (41.1%)); 33 (30.8 %); 30 (28.1%) patients). The duration of taking NSAIDs is 1-2 weeks, and Acetaminophen is 5-7 days. The condition of patients was assessed at the time of the initial visit to Evminov Center and after the first course (3-6 weeks) of rehabilitation measures aimed at decompression of the intervertebral discs. A visual analogue scale was used to measure the intensity of the pain syndrome. According to the results of the study, after 3-6 weeks, there was a positive dynamics of the course in all patients with degenerative-dystrophic disk disease. After 1-2 weeks from the initial visit to the doctor, all patients observed a significant or complete disappearance of pain. Since it is necessary to perform therapeutic exercises on Evminov Prophylactor only until pain appears, and NSAIDs and Acetaminophen block the pain perception threshold, kinesitherapy in groups II and III was carried out in a gentle mode (low-amplitude movements), in contrast to group I. After the end of the course of drug therapy (NSAIDs – up to 2 weeks and Acetaminophen – up to 7 days), patients of both groups increased the range of motion on an inclined board, which is confirmed by measuring the intensity of the pain syndrome with a visual analogue scale at certain time intervals. According to the results of the study, patients who received kinesitherapy started strength exercises 1-2 weeks earlier than in groups II and III. Thus, in the rehabilitation treatment of degenerative-dystrophic disk disease with pain syndrome of varying intensity, it is necessary to include kinesitherapy on Evminov Prophylactor, which, 1-2 weeks earlier than when combined with non-steroidal anti-inflammatory drugs or Acetaminophen, allows to get a positive effect, first of all regarding pain.