Neurological Appearances of
Spinal osteochondrosis is considered a chronic systemic disease of connective tissue which development requires genetic disposition and manifestation - exposure to exo- and endogenous factors. Among the first ones there are numbered physical, chemical and infectious agents, and among the second ones - certain constitutional variants, spinal anomalies, peculiar function of motional system, associated diseases of spine and other organs (V.P.Veselovsky, 1991).
This multi-factor disease first affects intervertebral disc and then other sections of locomotor apparatus and nervous system (O.G.Kogan et al., 1983).
Among the neurological appearances of spinal osteochondrosis vertebrogenic pain syndrome is of greatest importance for adequate evaluation of efficiency of the treatment performed. This syndrome consists of 4 components: muscle pain, fascial-ligamentous pain, joint pain, discogenic pain.
According to the above-mentioned, the conservative treatment of patients with neurological appearances of spinal osteochondrosis should be complex, differential and based on the main pathogenetic mechanisms of disease. The therapeutic measures should be focused on both the vertebral area of affection and extravertebral appearances.
There are 5 main principles of therapy for vertebrogenic diseases of nervous system:
1.exclusion of adverse static-dynamic loads;
2.stimulation of muscle corset;
3.phase and complete exposure;
4.decrease in pain feelings;
5.careful character of therapeutic measures.
The latter 4 principles can be fully realized by methods of regional (local) ozone therapy specially developed for neurological appearances of cervical and lumbar osteochondrosis.
Recommended methods of regional (local) ozone therapy:
· Minor autohaemotherapy with ozone;
· Paravertebral ozone injections;
· Subcutaneous ozone injections into the biologically active points;
· Intramuscular ozone injections into the trigger points.
Ozone therapy was used within the complex treatment including non-steroid anti-inflammatory medicines, vitamins of B group, sedative preparations, therapeutic exercises.
The approximate schema of sanogenetic reactions developed in patients with neurological appearances of spinal osteochondrosis through regional ozone therapy includes:
1.Decrease in the irritation of sinuvertebral nerve ends due to the decreased action of:
a) the discirculatory factor, a decrease in the edema of surrounding tissues;
b) the dislocation factor due to partial restoration of amortization properties of the affected disc, as a result, improvement of its metabolism and activation of trophic influences;
c) the aseptic-inflammatory factor induced by the synthesis of prostaglandins as inflammation mediators and activation of cellular immunity contributing to fast elimination of "foreign" components. As a result, it comes to a significant decrease in afferent flow from periphery to CNS.c) aseptic-inflammatory factor induced by the synthesis of prostaglandins as inflammation f cellular immunity contributing to fast elimination of "foreign" components. As a result, it comes to a significant decrease in afferent flow from periphery to CNS.
2.Actual antinociceptive action of ozone therapy connected with:
a) direct oxidation of algopeptides;
b) a decrease in underoxidated products in spasmodic muscles;
c) an increase in excitability threshold of pain receptor membranes (membrane-stabilizing effect).c) an increase in excitability threshold of pain receptor membranes (membrane-stabilizing effect).
3. Improvement in the function of spinal segmental apparatus manifested as:
a) acceleration of formation of a new motional stereotype;
b) activation of spinal mechanisms of pain control;
c) normalization of vegetative-trophic basis of motional act.c) normalization of vegetative-trophic basis of motional act.
The above-mentioned can be considered a substitution for the use of regional ozone therapy in the complex treatment of patients with neurological appearances of spinal osteochondrosis.