EVALUATION OF THE EFFECTIVENESS OF VARIOUS METHODS OF TREATMENT AT PAIN RELIEF AT PATIENTS WITH LUMBOSACRAL HERNIA: A RETROSPECTIVE STUDY
Introduction: Recently, the need to study the problem of pain syndrome at patients with lumbosacral hernia has increased. Minimally invasive methods of treatment are the safest and most effective at the treatment of spinal diseases for patients with pain syndrome. In Kazakhstan, this issue has not been fully studied and remains relevant for further research.
Aim of the study: To compare the outcomes of various methods of treatment, such as paravertebral blockade, surgical treatment, and RFD (radiofrequency denervation / ablation) to relieve pain at patients with lumbosacral hernia in the neurosurgical department of Emergency Hospital in Semey city.
Materials and methods of research: The retrospective study was carried out on the basis of the neurosurgical department of the Emergency Hospital in Semey city fr om January to October 2020. The object of the study is the medical history of patients with diagnosis M51.1 and M51.8 (ICD). Radiofrequency ablation was performed in the neurosurgical department of the Emergency Hospital in Semey city at the first time in a format of master class. The main method of treatment at patients of the neurosurgery department of the Emergency Hospital in Semey city to remove pain syndrome at disc hernia of the lumbosacral spine is the surgical intervention 80.51 (Extraction of the intervertebral disc) and conservative treatment (paravertebral blockade). To assess the effectiveness of a particular method of treatment, a pain assessment paper-sheet (Wong-Baker grimace scale) is used, where 0 is absence pain, 1-2 is minor pain, 3-4 is moderate pain, 5-6 is tolerable pain, 7-8 is severe pain, 9-10 - unbearable pain.
Results: Of the total number of patients, the lowest pain intensity (0 points) was described by 7.8% (5) patients who belonged to the group wh ere radiofrequency denervation was applied, the remaining 3 patients noted the presence of intermittent pain. Out of 8 patients of the third group (radiofrequency ablation), 2 people note a moderate efficacy of treatment and 6 patients note a significant efficacy after applying of the chosen method of treatment. All 100% of patients of this group refused from analgesics after the treatment.
Conclusions: Our study confirms that RFD (radiofrequency ablation / denervation) is the most effective treatment at pain syndrome at patients with lumbosacral hernia.
Anar K. Ibraimova1, https://orcid.org/0000-0003-1329-8355
Altay S. Kultumanov2, https://orcid.org/0000-0002-7661-2957
Assel Zh. Baibussinova1, http://orcid.org/ 0000-0003-3447-6245
Damir Zh. Bekenov2, https://orcid.org/0000-0002-3779-6239
Assyl A. Shortombayev1, https://orcid.org/0000-0002-1730-5164
1 NCJSC «Semey Medical University» Semey city, Republic of Kazakhstan;
2 CSE on REM (Community State enterprise on right economic management) «Hospital of emergency medical care Semey city» Semey city, Republic of Kazakhstan.
1. Булыщенко Г.Г., Гайворонский А.И., Гайворонский И.В. Морфоскопическая и морфометрическая характеристики межпозвоночных отверстий поясничного отдела позвоночника // Морфология. 2017. № 2. С82-87.
2. Гилязов Д.Р. Оценка эффективности электрофореза с полиминеральными салфетками на основе природной йодобромной воды у пациентов с грыжей межпозвоночных дисков поясничного отдела позвоночника в послеоперационном периоде // Физиотерапия, бальнеология и реабилитация. 2015. № 5. С.18-20.
3. Моржов В.Ф., Моржова Е.В. Применение паравертебральных блокад с дипроспаном в медицинской реабилитации больных с грыжами межпозвоночных дисков // Медико-социальная экспертиза и реабилитация. 2009. № 2. С55
4. Ткачев А.М., Епифанов А.В., Акарачкова Е.С., Гордеева И.Е. Резорбция грыжи межпозвонкового диска: обзор исследований // Фарматека для практикующих врачей. 2020. № 13. С. 42-48 DOI: https: //dx.doi.org/10.18565/pharmateca.2020.13.42-48
5. Шулев Ю.А. Комплексное хирургическое лечение больных с дегенеративными поражениями пояснично-крестцового отдела позвоночника // Вестник хирургии им. И.И.Грекова 2000. 159. № 3. С. 31–36.
6. Chou R., Qaseem A., Snow V. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice // American College of Physicians. 2007. P.478.
7. Deen H.G., Fenton D.S., Lamer T.J. Minimally invasive procedures for disorders of the lumbar spine // Mayo Clin Proc. 2003. 78 (10): 1249. DOI: https://doi.org/10.4065/78.10.1249.
8. Deyo R.A., Loeser J.D., Bigos S.J. Herniated Lumbar Intervertebral Disk // Annals of Internal Medicine. 1990. 112:598-603.
9. Deyo R.A., Tsui-WU, Y.-J. Descriptive Epidemiology of Low-back Pain and Its Related Medical Care in the United States // Spine 12(3). 264–268. doi:10.1097/00007632-198704000-00013
10. Engle A.M., Chen Y., Marascalchi B., Wilkinson I., Abrams W.B., He C., Yao A.L., Adekoya P., Cohen Z.O., Cohen S.P. Lumbosacral Radiculopathy: Inciting Events and Their Association with Epidural Steroid Injection Outcomes // Pain Medicine. 0(0). 2019. 1–11. doi: 10.1093/pm/pnz097
11. Hägg O., Fritzell P., Ekselius L., Nordwall A. Predictors of outcome in fusion surgery for chronic low back pain. A report from the Swedish Lumbar Spine Study // Eur Spine J (2003) 12 :22–33 DOI 10.1007/s00586-002-0465-z
12. Hassenbusch S.J., Portenoy R.K., Cousins M., Buchser E., Deer T.R., Du Pen S.L., Eisenach J., Follett K.A., Hildebrand K.R., Krames E.S., Levy R.M., Palmer P.P., Rathmell J.P., Rauck R.L., Staats P.S., Stearns L., Willis K.D. Polyanalgesic Consensus Conference 2003: An Update on the Management of Pain by Intraspinal Drug Delivery - Report of an Expert Panel // Journal of Pain and Symptom Managemen. 2004. 27(6):540. doi:10.1016/j.jpainsymman.2004.03.001.
13. Hoy D., Bain C., Williams G., March L., Brooks P., Blyth F., Woolf A., Vos T., Buchbinder R. A Systematic Review of the Global Prevalence of Low Back Pain // ARTHRITIS & RHEUMATISM. Vol. 64, No. 6. June 2012. Pp 2028–2037. DOI 10.1002/art.34347
14. Macfarlane G.J., Thomas E., Papageorgiou A.C., Croft P.R., Jayson M.I.V., Silman A.J. Employment and Physical Work Activities as Predictors of Future Low Back Pain // Spine. 1997. 22(10). 1143–1149. doi:10.1097/00007632-199705150-00015
15. Maroon J.C., Kopitnik T.A., Schulhof L.A., Abea A., Wieberger J.E. Diagnosis and microsurgical approach to far-lateral disc herniation in the lumbar spine // J Neurosurg 72:378-382. 1990
16. Oh W.S., Shim J.C. A Randomized Controlled Trial of Radiofrequency Denervation of the Ramus Communicans Nerve for Chronic Discogenic Low Back Pain // Clin J Pain 2004. 20:55–60
17. Pengel L.H.M., Herbert R.D., Maher C.G., Refshauge K.M. Acute low back pain: systematic review of its prognosis // BMJ. 2003. 327(7410). 323–0. doi:10.1136/bmj.327.7410.323
18. Sonne M., Cchristensen K., Hansen S.E., Jensen E.M. Injection of Steroids and Local Anaesthetics as Therapy for Low-back Pain // Scand J Rheumatology. 14: 343-345. 1985.
19. Tarulli A.W., Raynor E.M. Lumbosacral Radiculopathy // Neurol Clin 25 (2007) 387–405.
20. Tekin I., Mirzai H., Ok G., Erbuyun K., Vatansever D. A Comparison of Conventional and Pulsed Radiofrequency Denervation in the Treatment of Chronic Facet Joint Pain // Clin J Pain 2007. 23:524–529
21. van der Windt DAWM, Simons E., Riphagen II, Ammendolia C., Verhagen A.P., Laslett M., Devillé W., Deyo R.A., Bouter L.M., de Vet HCW, Aertgeerts B. Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain // Cochrane Database of Systematic Reviews 2010, Issue 2. Art. No.: CD007431. DOI: 10.1002/14651858.CD007431.pub2.
22. W. van Wijk R.M.A., Geurts J.W.M., Wynne H.J., Hammink E., Buskens E., Lousberg R., Knape J.T.A., Groen G.J. Radiofrequency Denervation of Lumbar Facet Joints in the Treatment of Chronic Low Back Pain // Clin J Pain 2005. 21:335–344.
References:
1. Bulyshchenko G.G., Gajvoronskij A.I., Gajvoronskij I.V. Morfoskopicheskaya i morfometricheskaya harakteristiki mezhpozvonochnyh otverstij poyasnichnogo otdela pozvonochnika [Morphoscopic and morphometric characteristics of the intervertebral foramens of the lumbar spine]. Morfologiya [Morphology]. 2017. № 2. P2-87. [in Russian]
2. Gilyazov D.R. Ocenka effektivnosti elektroforeza s polimineral'nymi salfetkami na osnove prirodnoj jodobromnoj vody u pacientov s gryzhej mezhpozvonochnyh diskov poyasnichnogo otdela pozvonochnika v posleoperacionnom periode [Evaluation of the efficiency of electrophoresis with polymineral napkins based on natural iodine-bromine water at patients with hernia of intervertebral discs of the lumbar spine in the postoperative period]. Fizioterapiya, bal'neologiya i reabilitaciya [Physiotherapy, balneology and rehabilitation]. 2015. № 5. P.18-20. [in Russian]
3. Morzhov V.F., Morzhova E.V. Primenenie paravertebral'nyh blokad s diprospanom v medicinskoj reabilitacii bol'nyh s gryzhami mezhpozvonochnyh diskov [Application of paravertebral blockade with diprospan at medical rehabilitation of patients with hernia of intervertebral discs]. Mediko-social'naya ekspertiza i reabilitaciya [Medical and social examination and rehabilitation]. 2009. № 2. P55 [in Russian]
4. Tkachev A.M., Epifanov A.V., Akarachkova E.S., Gordeeva I.E. Rezorbciya gryzhi mezhpozvonkovogo diska: obzor issledovanij [Resorption of hernia of intervertebral disc: a review of research]. Farmateka dlya praktikuyushchih vrachei [Pharmateca for medical practitioners.]. 2020. № 13. P. 42-48 DOI: https: //dx.doi.org/10.18565/pharmateca.2020.13.42-48 [in Russian]
5. Shulev Yu. Kompleksnoe hirurgicheskoe lechenie bol'nyh s degenerativnymi porazheniyami poyasnichno-krestcovogo otdela pozvonochnika [Complex surgical treatment of patients with degenerative lesions of the lumbosacral spine]. Vestnik hirurgii im Grekova, [Bulletin of surgery named by I.I. Grekov]. 2000. vol. 159. No 3. P. 31–36. [in Russian]
6. Chou R., Qaseem A., Snow V., Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice. American College of Physicians. 2007. P.478.
7. Deen HG, Fenton DS, Lamer TJ. Minimally invasive procedures for disorders of the lumbar spine. Mayo Clin Proc. 2003. 78 (10) : 1249. DOI: https://doi.org/10.4065/78.10.1249.
8. Deyo R.A., Loeser J.D., Bigos S.J. Herniated Lumbar Intervertebral Disk. Annals of Internal Medicine. 1990. 112:598-603.
9. Deyo, R. A., Tsui-WU, Y.-J. Descriptive Epidemiology of Low-back Pain and Its Related Medical Care in the United States. Spine 12(3). 264–268. doi:10.1097/00007632-198704000-00013
10. Engle A.M., Chen Y., Marascalchi B., Wilkinson I., Abrams W.B., He C., Yao A.L., Adekoya P., Cohen Z.O., Cohen S.P. Lumbosacral Radiculopathy: Inciting Events and Their Association with Epidural Steroid Injection Outcomes. Pain Medicine. 0(0). 2019. 1–11. doi: 10.1093/pm/pnz097
11. Hägg O., Fritzell P., Ekselius L., Nordwall A. Predictors of outcome in fusion surgery for chronic low back pain. A report from the Swedish Lumbar Spine Study. Eur Spine J. 2003. 12 :22–33 DOI 10.1007/s00586-002-0465-z
12. Hassenbusch S.J., Portenoy R.K., Cousins M., Buchser E., Deer T.R., Du Pen S.L., Eisenach J., Follett K.A., Hildebrand K.R., Krames E.S., Levy R.M., Palmer P.P., Rathmell J.P., Rauck R.L., Staats P.S., Stearns L., Willis K.D. Polyanalgesic Consensus Conference 2003: An Update on the Management of Pain by Intraspinal Drug Delivery—Report of an Expert Panel. Journal of Pain and Symptom Managemen. 2004. 27(6):540. doi:10.1016/j.jpainsymman.2004.03.001.
13. Hoy D., Bain C., Williams G., March L., Brooks P., Blyth F., Woolf A., Vos T., Buchbinder R. A Systematic Review of the Global Prevalence of Low Back Pain. Arthritis & Rheumatism. Vol. 64, No. 6. June 2012. Pp 2028–2037. DOI 10.1002/art.34347
14. Macfarlane G.J., Thomas E., Papageorgiou A.C., Croft P.R., Jayson M.I.V., Silman, A. J. (1997). Employment and Physical Work Activities as Predictors of Future Low Back Pain. Spine. 22(10). 1143–1149. doi:10.1097/00007632-199705150-00015
15. Maroon J.C., Kopitnik T.A., Schulhof L.A., Abea A., Wieberger J.E. Diagnosis and microsurgical approach to far-lateral disc herniation in the lumbar spine. J Neurosurg 72:378-382. 1990
16. Oh W.S., Shim J.C. A Randomized Controlled Trial of Radiofrequency Denervation of the Ramus Communicans Nerve for Chronic Discogenic Low Back Pain. Clin J Pain. 2004. 20:55–60
17. Pengel, L. H. M., Herbert R.D., Maher C.G., Refshauge K.M. (2003). Acute low back pain: systematic review of its prognosis. BMJ. 327(7410). 323–0. doi:10.1136/bmj.327.7410.323
18. Sonne M., Cchristensen K., Hansen S.E., Jensen E.M. Injection of Steroids and Local Anaesthetics as Therapy for Low-back Pain. Scand J Rheumatology, 14: 343-345. 1985.
19. Tarulli A.W., Raynor E.M. Lumbosacral Radiculopathy. Neurol Clin. 25 (2007) 387–405.
20. Tekin I., Mirzai H., Ok G., Erbuyun K., Vatansever D. A Comparison of Conventional and Pulsed Radiofrequency Denervation in the Treatment of Chronic Facet Joint Pain. Clin J Pain 2007. 23:524–529
21. van der Windt DAWM, Simons E., Riphagen II, Ammendolia C., Verhagen A.P., Laslett M., Devillé W., Deyo R.A., Bouter L.M., de Vet HCW, Aertgeerts B. Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 2. Art. No.: CD007431. DOI: 10.1002/14651858.CD007431.pub2.
22. W. van Wijk R.M.A., Geurts J.W.M., Wynne H.J., Hammink E., Buskens E., Lousberg R., Knape J.T.A., Groen G.J. Radiofrequency Denervation of Lumbar Facet Joints in the Treatment of Chronic Low Back Pain. Clin J Pain. 2005. 21:335–344.
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Ibraimova A.K., Kultumanov A.S., Baibussinova A.Zh., Bekenov D.Zh., Shortombayev A.A. Evaluation of the effectiveness of various methods of treatment at pain relief at patients with lumbosacral hernia: a retrospective study // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 3, pp. 118-126. doi 10.34689/SH.2021.23.3.012Related publications:
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