Method of treating patients suffering lumbar osteochondrosis with radicular syndrome

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to neurology and physiotherapy, and aims at treating the patients suffering lumbar osteochondrosis with radicular syndrome. With underlying pharmacotherapy, the left-hand and right-hand regions of skin segmental projections of lumbar spinal roots, L5 or L5-S1 are paravertebrally palpated. The painful regions are detected, and transcutaneous electric stimulation of lumbar nerves (TESN) is performed. It is combined with infrared pulse laser therapy (LT). The TESN and LT are combined daily with certain instrumental parametres. One combined procedure of the TESN and LT involves simultaneously identical zones in number 1 to 2 symmetrically; duration of a procedure is 2 to 4 min respectively; the therapeutic course consists of 8 daily procedures.

EFFECT: method allows improving complex treatment rates in the patients suffering lumbar osteochondrosis with radicular syndrome due to pain management in a relatively short time, and cutting time of treatment.

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The invention relates to medicine, in particular, neurology and physiotherapy, and can be used in the treatment of patients with osteochondrosis of the lumbar spine with radicular syndrome.

Known methods of treatment of this pathology with the use of surgical, medical techniques, manual therapy, physical therapy, hirudotherapy, reflexology, physiotherapy, and combinations of these methods.

1. How magnetic therapy of patients with neurological manifestations of lumbar osteochondrosis - EN 2099105 C1 (butchers IG and others 1997), 20.12.97; EN 2267337 C1 (Gerasimenko M. and others 2006), 25.06.04.

2. A method of treating degenerative disc disease of the lumbar spine using ultrasound therapy, phytoprotective and physical therapy - EN 2227008 C1 (Selivanov S. p. and others 2004), 20.04.04.

3. Method of treatment of patients with osteochondrosis of the lumbar spine with the help of electro - EN 2005109679 AND (Malikov A.S. and others 2006), 10.09.06.

4. The method of laser therapy of osteoarthritis of the lumbosacral spine. Bolin V.A. Application of the "Mustang" in the treatment of osteoarthritis: a book published / edited Corr.-Corr. Russian Academy of medical Sciences Prof. Sobakina O.K. - M LLP "Firm Technique". - 2000. - 36 S. Kiryanov CENTURIES, Zhulev NM, Gozalov P.I., Zhulev S.N. The application of laser radiation and magnetic fields in the treatment of neurologically the disease. - SPb.: Publishing house of St. Petersburg maps. - 2002. - 48 S.

5. How lazerorefleksoterapija of osteochondrosis. Bolin VA Laser reflexotherapy. Instructions for use ALT "Moth - R". - M.: NPLC "Technology", 2002. - 34 S.

6. The method of laser therapy of osteoarthritis of the lumbosacral spine and inflammation of the sciatic nerve. Bolin VA, Moskvin SV low-intensity lasers in the treatment of various diseases. - M.: NPLC "Technology", 2004. - 174 C.

The disadvantages of the above methods

How magnetic therapy include only 1 factor of the magnetic field with low induction 10 MT, are cumbersome for staff and the patient, have a long duration of the treatment time of over 20 minutes and a long course of treatment to a maximum of 15 procedures involved experts of different specialties.

The method of ultrasonic therapy, phytoprotective and physical therapy is very cumbersome for staff and the patient, the procedure takes considerable time, accounting for more than 1.5 h, prolonged treatment course of 12 treatments, make use of the experts of different specialties.

The method of electro is invasive and technically challenging, has a greater duration of the treatment time is maximum 30 minutes, make use of the experts of different specialties (preclusive diagnostics, reflexologist, physiotherapist).

Methods of laser therapy include only 1 factor exposure, the maximum duration of the procedure is 6 min long course of treatment - up to 12 treatments.

As a prototype for closest to the technical nature of our chosen method of treatment of patients with neurological complications of degenerative disc disease of the lumbar spine using percutaneous electroneurostimulation "electronics tens-03".

Unlike electroacupuncture (EP) when tens impact is not on the acupuncture points and reflex zones larger area, for example in the region of passage of nerves, areas of pain. Typically, when tens is used pulsed currents with the duration of the rectangular bipolar pulses 0.005 to 0.5 MS and amplitude of the current to 50 mA. The stimulation frequency corresponds to two ranges : "low" (2-4 Hz) and high frequency" (50-200 Hz).

In addition to the analgesic actions, tens has antispasmodic, anti-inflammatory, trophicostimulating and other effects that allows its use not only for pain syndromes, but also in the complex treatment of many diseases. The device CHENS-03 when performing medical procedures used with the zonal electrode having a contact surface in the form of an oval with a diameter of 6 mm and a length of 32 mm, and inside there are 7 electrodes, and circumference - 16 electrodes with a thickness of 1.8 mm with a spherical contact surface Technical description - passport percutaneous electroneurostimulation "electronics tens-03", per. beats. Ministry of health of Russia No. 83/1010-27. Certificate of Gosstandart of Russia No. POCC.RU.AK) V 00026. 195251 Saint-Petersburg, "Biomatter"; Steinherz A.E., White NA Massage for adults and children. - K.: Health, 1994. - 384 S.; General physiotherapy. Ponomarenko G.N. - K.: Kupriyanova OO, 2004. - 384 S.).

For each procedure, you can stimulate no more than 3-4 zones. In the period of exacerbation treatment should be carried out daily, with the improvement through the day, then 2 times a week. The course of treatment is 10-15 procedures. Stimulation zones of influence produce light massaging movements during the first procedure 10-15 minutes with a subsequent increase in exposure time from 3 to 12 treatments to a maximum of 30 min, the last two procedures - 10-15 min. Recommended areas for action for the treatment of neurological complications of lumbar spine reflex area of the lumbosacral spine, the gate area of the sciatic nerve, the area of the branching of the sciatic nerve on the tibial and peroneal nerves, and the area of the flexors and extensors of the foot.

The disadvantages of the prototype

When performing segmental pair is vertebrale tens device CHENS-03 used regular group zonal removable electrodes, located on the housing and intended for transcutaneous electroneurostimulation reflexogenic zones. The area of multielectrode, however, may overlap segmental areas in the paravertebral area segments, which reduces the efficiency of the appliance on the skin segmental projection of these zones. When applying multielectrode electric current is created by an electrical circuit depending on the location surrounding the indifferent electrode. The depth of current flow is not known, since the electric current passes through the path of least electrical resistance, and this is a deep environment intercellular space. Stimulated segmental areas adjacent segments included in the electrical circuit, i.e. there is an effect of the parasitic effects, reducing the specificity of the reflex response. The treatment consists of 10-15 daily procedures, while improving the state - through the day, then 2 times a week, that takes a long period. Pain stopped after about 9-10 procedure.

The objective of the invention is to improve the efficiency of complex treatment of patients with osteochondrosis of the lumbar spine with radicular syndrome at the expense of relieving pain in a shorter time, and reducing treatment time.

The technical result of the present invention is I the ability to accurately access segmental cutaneous projections suffering from nerve roots, ensure electrical safety, the prevention of chocolatecake on vital organs, increasing the specificity of the reflex response to a stimulus, the effect of polarization and the prevention of addiction patients to the effects of combined preformed physical factors, increasing the effectiveness of electrical stimulation segmental zones.

The technical result is achieved by the fact that despite the medication, including nonsteroidal anti-inflammatory drugs (NSAIDs) celebrex, b vitamins (milgamma), diuretics (furosemide), protective agents (ascorbic acid), spend tens and infrared pulsed laser therapy (LT) in the region of the lumbar spine. While tens and hold LT sachetana daily and act on left-hand and right-hand area of skin segmental projections of the roots of the spinal cord lumbar spine L5 and/or L5-S1, painful to palpation paravertebral, retreating in a lateral direction from the spinous processes of the vertebrae at 3 cm, and the impact of each physical exercise factor on one area, daily alternating physical impact factor. When LT plane-parallel attachment No. 2 set on the skin at an angle of 30° to the Central axis of the spine and LT are carried out by stabil the Neu methodology, pulsed power alternately change daily, 8 and 10 W, pulse frequency alternating alternating daily 0.3 and 0.4 kHz, the modulation frequency alternating alternating daily at 10 and 20 Hz. CHENS are carried out with external bipolar electrode consisting of a plastic body of the unit coaxial contacts and a dielectric between them, while the Central contact is made in the form of a rod with a diameter of 0.7 mm, and the radial contact has an inner diameter of 2 mm and an outer diameter of 2.2 mm, and the single pulse has a high amplitude and a low duration pulse with the center contact has a maximum amplitude of-200V, and the amplitude of the radial contact is +30 C. the exposure Time CHENS and LT on one segmental area 1 min stable methods; one combined procedure CHENS and LT are used simultaneously the same zone number from 1 to 2 symmetrically, the procedure amounts to from 2 to 4 min, the treatment consists of 8 daily procedures.

The method is as follows

In the proposed method for the treatment of patients with osteochondrosis of the lumbar spine with radicular syndrome on a background of drug therapy including NSAIDs (celebrex), b vitamins (milgamma), diuretics (furosemide), protective agents (ascorbic who Isleta) use tens-03 with external local bipolar electrode 7 (RF patent for the invention "Electroneurostimulation" EN 2240841 C1, 27.11.2004), consisting of a housing with a compartment for batteries with an electric circuit and removable head zonal electrodes, which when removed reveals two bipolar contact. These contacts connect the bare ends of the two wires of the bipolar electrode.

The operating procedure of the apparatus tens-03.

To check the technical condition of the apparatus, which by turning the switch controller (via "click") in the direction of the sign, turn on the device. Increase the brightness by turning the knob indicates the suitability of the machine to work. After checking the device off. The contacts for the captured area electrodes, visually determining the polarity, connect with stripped from the insulation of the wires of the bipolar electrode. The working surface of the electrode lightly pressed against the skin projection of the segmental areas. Turn the unit on, gradually increasing the strength of the current rotation of the regulator and controlling its brightness indicator is lit, and sensations that occur on the skin under the electrode. Optimum exposure is selected individually depending on skin sensitivity. First impressions of the type of tingling, burning, not turning into painful uncomfortable, are a signal to stop further increase of the current exposure. From this moment achinese timing of exposure. To conduct transcutaneous electroneurostimulation segmental areas of the patient should lie down in a comfortable position, and to release from the service areas of the body necessary for the procedure. For each procedure can be encouraged not more than 4 zones. Procedures carried out daily sachetana with LT, the treatment course of 8 treatments. The exposure time of 1 segmental area is 1 minutes after the procedure smoothly to reduce the impact on and off the device.

Simultaneously with the impact of the tens carry out the effects of therapeutic laser apparatus HELIOS-01 (the Passport. Therapeutic laser device HELIOS-01. The Firm Helmet+. SPb., 2005).

If on the first day of treatment effects CHENS performed on the left-hand region of the lumbar spine, the effect of LT on the right, the next day, the impact of the tens carry on the right-hand region of the lumbar spine, and the impact of LT on the left, that is every alternate day physical impact factor.

The operating procedure of the apparatus HELIOS-01

Turn the unit on by pressing the power button. At the same time on the LCD display will show the parameters of the radiation left over from the previous setting of the apparatus. Pressing the power button you can proceed to set up other preferences. To check the availability of the laser is about radiation apparatus with power indicator laser radiation, which red led indicates normal operation of the emitter. The measurement is carried out at the removed optical instrument and with the label "TEST" on the display. Insert the device into the receiving hole of the meter and press the start button. This will illuminate the green led. To activate the laser apparatus and control indicator power - should illuminate the red led. If the indicator on the meter will flash the green led, it is necessary to change the battery indicator (once in 2 years). The unit is ready for operation. To install the control buttons the desired mode of operation. The device is turned off by selecting the mode indicator to "OFF" and press any of the buttons or the device turns off automatically after 5 minutes of continuous operation.

THEY (peak power, changing daily)8; 10 W;
GPF (pulse frequency,
change daily)0,3; 0,4 kHz;
FM (frequency modulation, changing daily)10; 20 Hz.

The method of laser therapy: contact, static emitter with plane-parallel density of the Oh No. 2 with high transmittance 85 is at an angle of 30° to the surface of the body. (Table 1 - Optical attachments and their transmittance). The exposure time for one field 1 min allowed the exposure time per procedure up to 4 min, which corresponds to 4 fields and laser beam loading dose 0,002-0,005 j/cm21 the procedure and within the parameters of the analgesic effects recommended by the developer of the device (Table 2 - Parameters of laser radiation, for various therapeutic effect). The treatment course consists of 8 daily combined with tens of procedures.

The main features of the proposed method are:

1. Extra carrying infrared pulsed laser therapy (LT), the effect of tens and LT provide sachetana daily and affect skin segmental projection roots of the spinal cord lumbar spine L5 and/or L5-S1, painful to palpation paravertebral, retreating in a lateral direction from the spinous processes of the vertebrae at 3 cm, and tens affect left-hand region of the lumbar spine, and LT - on the opposite, daily alternating physical factors.

2. The parameters LT: when LT plane-parallel attachment No. 2 set on the skin at an angle of 30° to the Central axis of the spine and LT are carried out by the stable method, the pulse is ewnost alternately change daily, 8 and 10 watts, the pulse frequency alternating alternating daily 0.3 and 0.4 kHz, the modulation frequency alternating alternating daily at 10 and 20 Hz.

3. CHENS are carried out with external bipolar electrode consisting of a plastic body of the unit coaxial contacts and a dielectric between them, while the Central contact is made in the form of a rod with a diameter of 0.7 mm, and the radial contact has an inner diameter of 2 mm and an outer diameter of 2.2 mm, and the single pulse has a high amplitude and a low duration pulse with the center contact has a maximum amplitude of 200 V, and the amplitude of the radial contact is +30,

4. The exposure time is in tens and LT on one segmental area 1 min stable methods; one combined procedure CHENS and LT use simultaneously the same zone number from 1 to 2 symmetrically, the procedure amounts to from 2 to 4 min, the treatment consists of 8 daily procedures.

The causal link between distinguishing the essential features and achieve the result:

1. Goal of therapy: to have analgesic, anti-edematous, anti-inflammatory effect. EV Lutsevich et al. (1989), using pulsed semiconductor laser at a wavelength of from 0.84 μm, revealed the following patterns: - when irradiated wounds the dose 0,002-0,005 j/cm 21 the procedure is most pronounced local effects that occur within several days after irradiation in enhancing the reparative processes, the growth of capillaries, increasing the pH of the tissue fluid, reduce swelling and tissue pain syndrome (Use of low-energy lasers in clinical practice. Edited by Prof. Sobakina O.K. - M - 1997. - 302 S. Methodological recommendations on the use of infrared pulsed laser apparatus in the laser therapy. Kozlov V.I., A. Minenkov, Bolin VA, Stupin IV edited by Prof. Sobakina O.K. - SPb. - 2003. - 79 S.

Impact at LT and tens carried out on fields and areas: in the paravertebral area of greatest tenderness to palpation and two symmetric field above and below the zone of pain, receding lateral from the spinous line of the spine at 3 cm, because at this distance the nerve root is available for exposure as an optical factor in LT and tens in the closest reflex area on the surface of the skin.

Combined simultaneous action CHENS and LT has a pronounced anti-edema and analgesic effects in a shorter course of treatment and in most cases patients report cessation or significant decrease in pain after 5 treatments through the synergistic factors.

Daily alternation areas in the effects of (right and left) is necessary to prevent the body adapts to the pressures and optimization of response to stimulus reducing the energy load LT and degree of ionization of the tissue at the chance.

2. Use optical parallel-sided nozzle N2 with a transmittance of 85 in contrast to standard methods, which use a nozzle for General use N1, having a transmittance of 80 (Table 1) and which rasfokusirovka, which reduces the efficiency of laser photostimulation, the mode with fixed parameters and symmetric fields of influence that may cause the addiction to this factor, the emitter is at a 90° angle to the body surface of the patient that does not provide the desired direction of the beam of laser radiation on the anatomical segment suffering from segmental spine. LT by a standard method has a duration of up to 8 min, which may exceed the energy load, reduce the analgesic effect or even increase pain, and takes additional time. In the inventive method, the emitter plane-parallel nozzle N2 with high transmittance 85 is at an angle of 30° to the surface of the body relative to the longitudinal axis of the spine, as this anatomically beam of laser radiation reaches the exit radicular holes are suffering from spine and it has a therapeutic effect.

The selected pulse parameters of the power, the pulse repetition frequency and the modulation frequency is optimal to achieve a positive effect.

3. Bipolar electrode can increase therapeutic properties of this instrument, in particular to selectively stimulate the affected segment of the lumbar spinal cord.

The plastic case provides electrical safety.

Block coaxial contacts and the dielectric between them eliminates uncontrolled tatarstakiye on vital organs.

A Central contact in the form of a rod with a diameter of 0.7 mm, and the radial contact an inner diameter of 2 mm and an outer diameter of 2.2 mm is due to the established experimentally the size of the cutaneous projection of the segmental reflex zones, which have increased conductivity in diameter up to 2 mm Small size of the electrode contacts provide specificity reflex response at the stimulation segmental reflex zones, the reduction effect of the polarization and ionization density of the tissue substrate segmental areas and prevent the spreading of stray currents outside the cutaneous projection of the root segment.

Asymmetrical pulse has a high amplitude and a low duration pulse with the center contact has a maximum amplitude of-200V, and the amplitude of the radial contact extending t is +30V. Given the electric amplitude-frequency characteristics pulse from the device CHENS-03, the degree of polarization is very small, because the effect is short asymmetrical pulse of 2.5 MS with a frequency of message 10 Hz, thereby reducing the number of a patent in the circuit and reducing the density of ionization tissues of root zone. The electrical resistance of the skin when tens is crucial when selecting the amplitude of impact parameters, in this case-200V to +30V asymmetrical pulses. To achieve greater efficiency of treatment you want the selected pulse amplitude was within the "zone efficiency", which has a maximum of 300V. The time of ascent and descent of the curve of the pulse should be less than the "time index" tissues, constituting more than 2.5 MS, as only when they have time to react to the impact. In tens identified the following electrophysiological features of segmental reflex zones: the increased potential in the area and the action potential at the time of receipt "provided" sensations duration from 0.3 to 3.5 MS with the dynamics of the current frequency from 0.5 to 400 Hz. The duration of the pulse from the apparatus tens-03 average of 2.5 MS, and repetition rate 10 Hz data characteristics are placed in electrophysiological parameters reflex, segm ntalnyh zones.

Compared with the reference currents EMF selectively reach the peripheral neural structure of the selected radicular segment.

4. The combined effects of tens and LT 1 min exposure to a single field and 2-4 min of the procedure in contrast to the prototype method, where the exposure time when tens is 10-15 minutes reducing the time of the procedure is achieved through the synergy of its factors, the use of electrodes in tens, using optical attachments and options chosen when LT. Treatment, consisting of 8 procedures sufficient to achieve positive clinical outcomes in contrast to the prototype method, where the course of treatment is 10-15 procedures.

The distinctive set of essential features is new and increases the efficiency of complex treatment of patients with neurological complications of degenerative disc disease of the lumbar spine due to the accurate access segmental cutaneous projections suffering from nerve roots, electrical safety, prevent chocolatecake on vital organs, increasing the specificity of the reflex response to a stimulus, reduce the effects of polarization and prevention of addiction patients to the effects of combined preformed physical factors the Directors, increase the effectiveness of electrical stimulation segmental zones that can cut pain in a shorter time, and to shorten the time of treatment.

Clinical examples of the claimed method

Example 1. And/b No. 5247. Patient P., aged 40, the cook.

Complaints of pain sharp character in the lumbar spine with irradiation to the left foot on the posterolateral surface, aggravated by walking and torso.

The history of this disease. Considers himself sick about 7 years, when first appeared pain in the lumbar spine after heavy lifting. Were outpatients with temporary improvements. Deterioration in the autumn, after exercise and after hypothermia. This exacerbation occurred after lifting heavy, and therefore appealed to hospitalization.

Objectively. Normastenicheskom physique, skin and mucous usual coloration and humidity, lymph nodes and the thyroid gland is not enlarged, BP 130/80 mm RT. Art. Pulse 74 cob min, borders of the heart is not enlarged, the colours, rhythmic, sonorous, abnormal noises that are heard in the lungs vesicular breathing, abnormal noises, palpation of the abdomen painless, physiological functions are normal.

Neurological status. Conscious, oriented in time, place, correct is about answering questions. Percussion of the skull b/painful. The smell is not broken. The field of view of the approximate method is not limited. Pupils D=S, a rounded shape, expression live, even. The mobility of the eyeballs is not limited. Nystagmus, diplopia, no. Palpebral fissure D=S. sensing disturbances in the person not. Palpation of the exit points of the trigeminal nerve b/painful. Face symmetrical. Superciliary, corneal reflexes saved, D=S. Swallowing and foncia not violated. The tongue in the midline. Speech disorders no. Agnosia, apraxia no. Easy pliability of this big toe of the left foot. Muscle tone is normal. Deep reflexes of the upper extremities - average vivacity D=S, knee D<S reduced reflexes Achilles tendon on the left - abs. Hypotension gluteal muscles, calf muscles on the left. Flattened lumbar lordosis, increased thoracic kyphosis. Tenderness to palpation points Valle at the lumbar level, the spinous processes and egotistic ligaments at the level L5-S1. Defans paravertebral muscles at the lumbar level. Limited mobility in the lumbar spine while bending forward and Curling. Coordinatorsee sample performs satisfactorily. In the Romberg sustainable. Hypoesthesia in the segments L5-S1 on the left. (+) the symptoms of tension: Matskevich and Wasserman, (+) symptom Lasaga left with ∠ 25°. Muscle and joint sense saved.

MRI of the lumbar spine: the series MP-tomograms, T1 weighted and T2 in three dimensions is defined by moderate S-shaped scoliosis. Instability in the segment L5-S1 with the offset body L5 posterior to 4 mm, Reduced the height of the intervertebral discs L1-2, L3-S1 with low signal in T2 due to dehydration. The rear protrusion of the disc L1-2, comprimida front of dural camera. Diffuse disc herniation at L3-4, with predominantly medial distribution of sizes up to 6 mm, comprimida dural space. Diffuse disc herniation L4-5 sizes up to 5 mm, comprimida front of dural camera, intervertebral holes and passing the left spine L5. Rear medial hernia of disk L5-S1 size 4.5 mm comprimida front of dural camera. The signal T2 from the cerebrospinal fluid in the sacral Department of dural space increased. Cranial closing plate L5 ravalomana with microsomes. Areas of dystrophic changes of type II in the bodies of L3, L4, L5. In segments L1-S1 is defined by the narrowing of the joint cracks intervertebral joints, lowering the signal from the subchondral departments articular processes, paraartikulyarnye bone growth in the joints of the segments L4-S1, compremise intervertebral holes. MP-pattern of degenerative changes in the lumbar-sacral spine, complicated disk disk herniation with compression of the left spine L5 and p is znakami disorders of CSF dynamics. Common spondylarthrosis.

ENMG. Signs of radiculopathy L5-S1 on the left.

RVG. Signs of increased tonus of arteries of medium and small-caliber left leg and foot, and a moderate difficulty of venous outflow through the veins of these areas.

Diagnosis. Common degenerative changes of the spine. Osteochondrosis of the lumbar spine, acute disk herniation of intervertebral disc with compression of the L5-S1 on the left. Common spondylarthrosis. Vertebrogenic radiculopathy L5-S1 radicular syndrome on the left.

In the complex treatment including NSAIDs (celebrex), b vitamins (milgamma), diuretics (furosemide), protective agents (ascorbic acid), tens and LT expressed pain decreased significantly after 5 combined procedures CHENS and LT.

Example 2. And/b No. 2555. Patient P., 51,, accountant.

Complaints of pain in the lumbar spine with radiating into the right leg on the posterolateral surface, aggravated by walking and torso.

The history of this disease. Considers herself a patient in the course of 3 days, when first appeared pain after lifting heavy, and therefore appealed to hospitalization.

Objectively. Normastenicheskom physique, satisfactory nutrition, skin and mucous usual the paint and humidity, lymph nodes and the thyroid gland is not enlarged, BP 150/90 mm RT. Art. Pulse 82 strike in the mines, borders of the heart is increased to the left by 1.5 cm, several colours are muted, abnormal noises that are heard in the lungs vesicular breathing, abnormal noises, palpation of the abdomen painless, physiological functions are normal.

Neurological status. Conscious, oriented in time, place, correctly answer the questions. Percussion of the skull b/painful. The smell is not broken. The field of view of the approximate method is not limited. Pupils D=S, a rounded shape, expression live, even. The mobility of the eyeballs is not limited. Nystagmus, diplopia, no. Palpebral fissure D=S. sensing disturbances in the person not. Palpation of the exit points of the trigeminal nerve b/painful. Face symmetrical. Superciliary, corneal reflexes saved, D=S. Swallowing and foncia not violated. The tongue in the midline. Speech disorders no. Agnosia, apraxia no. Power paresis no. Muscle tone is normal. Deep reflexes of the upper extremities - average vivacity D=S, knee D=S, a reflex from the right Achilles tendon - abs. Flattened lumbar lordosis, increased thoracic kyphosis. Defans paravertebral muscles at the lumbar level. Flexion in the lumbar spine is limited. Coordinatorsee sample performs satisfactorily. In the Romberg sustainable. With mptom Lasaga (+) to the right with ∠ 20°. Muscle and joint sense saved. Hypoesthesia in the segments L5-S1 on the right.

MRI of the lumbar spine: a series MP-tomograms, T1 weighted and T2 in two projections, the lordosis is straightened. MP-signs of degenerative changes in the lumbar-sacral spine. The height of intervertebral disks Th12-L1, L3-S1 and the signals on T2 is reduced, the signals from the other disks of the investigated area is reduced. Rear middle herniated discTh12-L1 size 4 mm Posterior medial-paramedian disc herniation L4-L5, propagating to the right with compression of the intervertebral foramen, the size of 0.7×1.1 to see the Back midline hernia of disk L5-S1 size 5 mm Dorsal protrusion of the disc L3-L4. The lumen of the spinal canal is narrowed at the level of the hernia, the signal from the structures of the spinal cord (T1 and T2) is not changed. The shape and size of the vertebral bodies usual signs of degenerative changes in the vertebral bodies. Small schmorl's nodule Th11. CONCLUSION: MP picture of degenerative changes in the lumbar-sacral spine, acute disk herniation.

ENMG. Signs of radiculopathy L5-S1 on the right.

RVG. Signs of a moderate increase of a tone of arteries of small and medium caliber at the level of the hips, and a moderate difficulty of venous outflow through the veins of these areas.

Diagnosis. Common degenerative-dystrophic and the changes of the spine. Osteochondrosis of the lumbar spine, acute disk herniation of intervertebral disc with compression of the L5-S1 on the right. Vertebrogenic radiculopathy L5-S1 radicular syndrome on the right.

In the complex treatment including NSAIDs (celebrex), b vitamins (milgamma), diuretics (furosemide), protective agents (ascorbic acid), expressed the pain was gone after 5 combined procedures CHENS and LT.

Example 3. And/b No. 3923. Patient P., 27 HP, engineer.

Complaints of pain in the lumbar spine with irradiation to the left foot on the posterolateral surface, aggravated by walking, long sitting in front of computer and torso.

The history of this disease. Considers himself ill for 4 years, when I first encountered these complaints after hypothermia. Were outpatients with temporary improvements. Yesterday appeared the above symptoms, and therefore appealed to hospitalization.

Objectively. Normastenicheskom physique, skin and mucous usual coloration and humidity, lymph nodes and the thyroid gland is not enlarged, BP 120/80 mm RT. Art. heart rate of 68 beats per min, borders of the heart is not enlarged, the colours of normal, abnormal noises that are heard in the lungs vesicular breathing, abnormal noises, palpation of the abdomen painless, Fiziol the policy of departure in the norm.

Neurological status. Conscious, oriented in time, place, correctly answer the questions. Percussion of the skull b/painful. The smell is not broken. The field of view of the approximate method is not limited. Pupils D=S, a rounded shape, expression live, even. The mobility of the eyeballs is not limited. Nystagmus installation type on both sides. Diplopia no. Palpebral fissure D=S. sensing disturbances in the person not. Palpation of the exit points of the trigeminal nerve painless. Face symmetrical. Superciliary, corneal reflexes saved, D=S. Swallowing and foncia not violated. The tongue in the midline. Speech disorders no. Agnosia, apraxia no. Power paresis no. Muscle tone is normal. Deep reflexes of the upper extremities - average vivacity D=S, knee D≥S, reflexes Achilles tendons average vivacity D≥S. Flattened lumbar lordosis. Defans paravertebral muscles at the lumbar level. Flexion in the lumbar spine is limited. Coordinatorsee sample performs satisfactorily. In the Romberg sustainable. Hypoesthesia on the spine L5-S1 on the left. (+) the symptoms of tension: Matskevich and Wasserman, (+) symptom Lasaga left with ∠ 30°. Muscle and joint sense saved.

MRI of the lumbar spine: MP-signs of degenerative changes in the lumbar-sacral spine, posterolateral protrusion of the disk L5- 1up to 5 mm.

ENMG. Signs of radiculopathy L5-S1 on the left.

RVG. Signs of a moderate increase of a tone of arteries of small and medium caliber at the level of the left leg and foot.

Diagnosis. Common degenerative changes of the lumbar spine, acute disk herniation. Disc herniation L5-S1. Radiculopathy L5-S1 on the left with a radicular syndrome.

In the complex treatment including NSAIDs (celebrex), b vitamins (milgamma), diuretics (furosemide), protective agents (ascorbic acid), tens and LT, expressed the pain was gone after 5 combined procedures CHENS and LT.

Clinical examples of the method prototype

Example 1. And/b No. 4828. Patient S., 31, electrician.

Complaints of pain sharp character in the lumbar spine with radiating into the right leg on the posterolateral surface, aggravated by walking and torso.

The history of this disease. Considers himself ill about 10 years, when first appeared pain in the lumbar spine after heavy lifting. Were outpatients with temporary improvements. Deterioration in the spring and autumn period after hypothermia. This exacerbation occurred after exercise, and therefore appealed to hospitalization.

Objectively. Normastenicheskom telelog the tion, the skin and mucous usual coloration and humidity, lymph nodes and the thyroid gland is not enlarged, BP 120/80 mm Hg heart rate of 78 beats / min, borders of the heart is not enlarged, the colours, rhythmic, sonorous, abnormal noises that are heard in the lungs vesicular breathing, abnormal noises, palpation of the abdomen painless, physiological functions are normal.

Neurological status: conscious, oriented in time, place, correctly answer the questions. Percussion of the skull b/painful. The smell is not broken. The field of view of the approximate method is not limited. Pupils D=S, a rounded shape, expression live, even. The mobility of the eyeballs is not limited. Nystagmus, diplopia, no. Palpebral fissure D=S. sensing disturbances in the person not. Palpation of the exit points of the trigeminal nerve b/painful. Face symmetrical. Superciliary, corneal reflexes saved, D=S. Swallowing and foncia not violated. The tongue in the midline. Speech disorders no. Agnosia, apraxia no. Easy pliability of this big toe of the right foot. Muscle tone is normal. Deep reflexes of the upper extremities - average vivacity D=S, knee D<S reduced reflexes Achilles tendon right abs. Hypotension gluteal muscles on the right gastrocnemius muscle with 2 sides. Flattened lumbar lordosis, increased thoracic kyphosis. Soreness PR is palpation points Valle at the lumbar level, the spinous processes and m/spinous ligaments at levels L4, L5-S1. Defans paravertebral muscles at the lumbar level. Limited mobility in the lumbar spine while bending forward and Curling. Coordinatorsee sample performs satisfactorily. In the Romberg unstable. Hypoesthesia in the segments L5-S1 on the right. (+) the symptoms of tension: Matskevich and Wasserman, (+) symptom Lasaga right with ∠ 30°. Muscle and joint sense saved.

MRI of the lumbar spine: MP-signs of degenerative changes in the lumbar-sacral spine, the circular protrusion of disk L4-L5 to 3.5 mm; dorsal medial hernia of disk L5-S1 to 5.5 mm, deforming posterior longitudinal ligament and comprimida dural bag.

ENMG. Signs of radiculopathy L5-S1 on the right.

RVG. Signs of increased tonus of arteries of medium and small-caliber right leg and foot, and a moderate difficulty of venous outflow through the veins of these areas.

Diagnosis. Common degenerative changes of the lumbar spine (low back pain, spondylosis deformans). Vertebrogenic radiculopathy L5-S1 radicular syndrome on the right.

In the complex treatment including NSAIDs (celebrex), b vitamins (milgamma), diuretics (furosemide), protective agents (ascorbic acid) and tens expressed the Oli significantly decreased after 9 treatments CHENS.

Example 2. And/b No. 15690. Patient B., 53,, Docker.

Complaints of intense pain searing character with irradiation in both legs, more to the left, decreasing in the supine position.

The history of this disease. Considers himself ill since yesterday, when first appeared pain after an awkward movement and crackle in the back, and therefore appealed to hospitalization.

Objectively. Normastenicheskom physique, increased nutrition, and skin and mucous usual coloration and humidity, lymph nodes and the thyroid gland is not enlarged, BP 140/85 mm Hg heart rate 88 beats / min, borders of the heart is increased to the left by 1 cm, several colours are muted, abnormal noises that are heard in the lungs vesicular breathing, abnormal noises, palpation of the abdomen painless, physiological functions are normal.

Neurological status. Conscious, oriented in time, place, correctly answer the questions. Percussion of the skull b/painful. The smell is not broken. The field of view of the approximate method is not limited. Pupils D=S, a rounded shape, expression live, even. The mobility of the eyeballs is not limited. Nystagmus, diplopia, no. Palpebral fissure D=S. sensing disturbances in the person not. Palpation of the exit points of the trigeminal nerve b/painful. Face symmetrical. Superciliary, corneal re lexi saved, D=S. Swallowing and foncia not violated. The tongue in the midline. Speech disorders no. Agnosia, apraxia no. Power paresis no. Muscle tone is normal. Deep reflexes of the upper extremities - average vivacity D=S, knee D=S, reflexes Achilles tendons average vivacity D=S. Hypertension gluteal muscles on both sides. Flattened lumbar lordosis, increased thoracic kyphosis. Defans rocky density of the paravertebral muscles at the lumbar level. Flexion in the lumbar spine is impossible. Coordinatorsee sample performs satisfactorily. In the Romberg sustainable. The sensitivity on the body of the saved. Symptom Lasaga (+) on two sides with ∠ 25°. Muscle and joint sense saved. Expressed vegetative reactions in the form of hyperhidrosis at the lumbar level.

MRI of the lumbar spine: MP-signs of degenerative changes in the lumbar-sacral spine with the reduction of height of intervertebral disks mainly in segments L3-S1, where the segment L5-S1 is visible to the left posterolateral disc herniation size up to 6.5 mm, deforming dural bag on both sides.

ENMG. Signs of increased activity of peripheral motoneurons dominated newsegments at the level of L4-L5. The decrease in the amplitude of voluntary contraction on the background of previous load at the same level.

RVG. Signs of moderate Uwe is icene tone of arteries of small and medium caliber at the level of the hips, and moderate obstruction of venous outflow through the veins of these areas.

Diagnosis. Common degenerative changes of the lumbar spine. Chronic spondylogenic recurrent radiculopathy L4-L5, L5-S1 with 2 sides, more on the left. Radicular syndrome.

In the complex treatment including NSAIDs (celebrex), b vitamins (milgamma), diuretics (furosemide), protective agents (ascorbic acid) and tens expressed pain decreased significantly after 9 treatments CHENS.

Example 3. And/b No. 8718. Patient L., 51, the driver.

Complaints of paresthesia, pain in the lumbar spine with irradiation to the left leg, worse at night and during physical activity.

The history of this disease. Considers himself ill for 5 years, when I first encountered these complaints after hypothermia and physical activity. Were outpatients with temporary improvements. This morning appeared the above symptoms, and therefore appealed to hospitalization.

Objectively. Normastenicheskom physique, skin and mucous usual coloration and humidity, in addition to the lumbar region and left leg, where there is pallor of the skin, lymph nodes and the thyroid gland is not enlarged, HELL 150/80 mm Hg Pulse 74 cob min, border settability left, 1.5 cm, the colors somewhat muted, abnormal noises in the lungs heard hard breathing, abnormal noises, palpation of the abdomen painless, physiological functions are normal.

Neurological status. Conscious, oriented in time, place, correctly answer the questions. Percussion of the skull b/painful. The smell is not broken. The field of view of the approximate method is not limited. Pupils D=S, a rounded shape, expression live, even. The mobility of the eyeballs is not limited. Nystagmus installation type on both sides. Diplopia no. Palpebral fissure D=S. sensing disturbances in the person not. Palpation of the exit points of the trigeminal nerve b/painful. Face symmetrical. Superciliary, corneal reflexes saved, D=S. Swallowing and foncia not violated. The tongue in the midline. Speech disorders no. Agnosia, apraxia no. Power paresis no. Muscle tone is normal. Deep reflexes of the upper extremities - average vivacity D=S, knee D≥S reflexes Achilles tendons average vivacity D≥S. Flattened lumbar lordosis. Defans paravertebral muscles at the lumbar level. Flexion in the lumbar spine is limited. Coordinatorsee sample performs satisfactorily. In the Romberg sustainable. Paresthesia in the nerve root L5-S1 on the left. Hypoesthesia in the segments L5-S1 on the left. (+) the symptoms of tension: Matskevich and Dejerine, (+) the sympto is Lasaga left with ∠ 20°. Muscle and joint sense saved. Expressed vegetative reactions in the form of lengthening the time of the white spots, asymmetry white and red dermographism, hyperhidrosis at the lumbar level and on the left lower extremity, the local decrease of temperature, the hydrophilic fabrics. Trophic disturbances in the form of hyperkeratosis, thinning, brittle nails.

MRI of the lumbar spine: MP-signs of degenerative changes in the lumbosacral spine, posterior protrusion of the intervertebral discs L3-S1 segment L5-S1 up to 3 mm.

ENMG. Signs of radiculopathy L5-S1 on the left.

RVG. Signs of a significant increase of a tone of arteries of small and medium caliber at the level of the left leg and foot, as well as significant reductions in venous outflow through the veins of these areas. Vasospastic option circulation.

Diagnosis. Common degenerative changes of the lumbar spine. Chronic spondylogenic recurrent radiculopathy L5-S1 on the left. Radicular syndrome, hernia of disk L5-S1.

In the complex treatment including NSAIDs (celebrex), b vitamins (milgamma), diuretics (furosemide), protective agents (ascorbic acid) and tens expressed pain stopped after 10 treatments CHENS.

Under our supervision there were 40 patients with osteo what androsa of the lumbar spine with radicular syndrome at the age of 22 to 55 years (mean age 36.3 years). Patients were divided into 2 groups (20 people each), homogeneous clinical picture of the disease, gender and age. Patients of the 1st group (12 men and 8 women) received sachetana segmental tens with an external electrode and LT, and patients of the 2nd group (11 men and 9 women) - segmental CHENS zonal electrodes. The control group consisted of 20 healthy persons.

The results of the MRI scan of the lumbar spine are presented in table 3. All patients complained of pain of varying intensity in the lumbar spine with irradiation in one or both lower limbs and were distributed by the severity of pain before treatment according to the scale of YOUR (table 4). Patients were conducted: magnetic resonance imaging (MRI) before treatment, electroneuromyography (ENMG) peroneal nerve and rheovasography (RVG) lower extremities (before and after treatment). In the control groups of these studies (except MRI) was performed once. All patients underwent medical therapy including NSAIDs, vitamins, diuretics, protective agents according to the standard scheme.

Complete relief of pain of various degrees on the scale and YOUR neurological improvement after 5 treatments occurred in patients in group 1 in 19 people, and in patients 2 groups of only 2. Positively what I clinical trend was observed in the 87.3% of the patients of the 1st group and in 68.2% of patients of the 2nd group. So, persistent treatment effect (according to the follow-up monitoring for more than one year) was observed in 88.4% of the patients of the 1st group and 67,7% of the patients of the 2nd group. Indicators ENMG, RVG presented in table. 5. The dynamics of the severity of pain in patients 2 groups osteochondrosis of the lumbar spine with radicular syndrome before treatment, on day 5 and on day 10 on the scale of YOUR presented in table 6.

The efficiency of this invention consists in the ability to accurately access segmental cutaneous projections suffering from nerve roots, ensuring electrical safety, preventing chocolatecake on vital organs, increasing the specificity of the reflex response to a stimulus, the effect of polarization and the prevention of addiction patients to the effects of combined preformed physical factors, increasing the effectiveness of electrical stimulation segmental zones that can cut pain in a shorter time, and to shorten the time of treatment.

By the present method pain stopped after 5 treatments, and the method prototype - after 9-10 procedures. The course of treatment by the present method consists of 8 daily procedures, and the method-prototype - from 10-15.

The inventive method of treatment can be used in hospital, clinic, doctor's office family practice.

Table 1
Optical attachments and their transmittance
No.The purpose and characteristicsTransmittance, %
1Nozzle for General use.80
2The parallel-sided nozzle for impact on the underlying structure. This nozzle gives a plane-parallel beam.85
3Contact the nozzle to impact the areas of acupuncture, giving a well-focused beam.70
4Diffuser nozzle for handling relatively large areas.75
5Intracavitary nozzle intended for delivery of laser radiation in cavities.35

Table 2
The parameters of the laser) the treatment, for various therapeutic effect
The power densityPulse powerThe exposure timeFm/FcUnit doseQty fieldsThe number of procedures
mW/cm2WminHz/kHzJ/cm2piecespieces
Stimulation of acupuncture points and reflex activation of the functions of organs
0,05-0,52-510-201-6/10,001-0,011-107-12
Stimulation of intracellular regeneration
0,5-13-60,5-520-60/1of 0.01-0.11-57-14
Stimulation of metabol the PCA tissues and organ function
1-104-80,5-580/10,1-11-510-14
Stimulation of immune response
0,5-2,53-60,5-580/1,5of 0.01-0.11-710-12
Stimulation of microcirculation
5-107-101-580/2,50,5-51-1010-12
Stimulation of reparative processes
1-54-80,5-420-80/1-30,05-11-57-20
The reduction in pain sensitivity
1-105-102-580-100/1,5 0,5-51-57-12
Anti-inflammatory action
0,5-14-81-580-100/20,5-51-510-12

Table 3
Data MPT spine in patients with osteochondrosis of the lumbar spine with radicular syndrome
MRI signsThe number of sick people
The straightening of the lumbar lordosis38
Deformation of the guard plates29
Reducing the height of the intervertebral slit34
Sacralization of L5 (transitional vertebra L4)7
Globalizacija S1 (free vertebra L6)5
Narrow spinal canal9
Splitting arc L5 or S1 (spina bifida)8
Spondylolisthesis11
Scoliosis of the spine36
Total40

Table 4
Distribution of patients according to severity of pain before treatment according to the scale of YOUR
The severity of painThe number of sick people
1st group2nd group
Moderate, 1 to 4 points00
Expressed, from 5 to 7 points2020
Pronounced, from 8 to 10 points00

Table 5
Electrophysiological indices ENMG and rvh patients (M±m)
The group of patientsThe speed of conduction of the impulse, m/sIOC ml / 100 cm3
before the treatmentafter the treatmentpbefore the treatmentafter the treatmentp
1st24,1±2,237,1±2,1<0,012,8±0,13,3±0,1<0,05
2nd24,3±1,930,0±1,9>0,052,7±0,13,2±0,1<0,05
Control38,3±1,8--3,6±0,1--

Table 6
Dynamics of severe pain in patients with osteoarthritis of the lumbar spine with radicular syndrome to Le is to be placed, on day 5 and on day 10 of treatment on the scale of YOUR
The group of patientsBefore treatment, pOn day 5, pOn day 10, p
120191
220218

A method of treating patients with osteochondrosis of the lumbar spine with radicular syndrome, which consists in the fact that despite the medication, including nonsteroidal anti - inflammatory drug-celebrex, vitamin b - milgamma, diuretic - furosemide, cartilage - ascorbic acid, paravertebral conduct palpation of the left and right areas of skin segmental projections of the roots of the spinal cord lumbar spine, L5 or L5-S1, reveal the painful area, conduct a percutaneous electrical nerve stimulation (tens) in the region of the lumbar spine, characterized in that it further conduct infrared pulsed laser therapy (LT), with tens and LT carried out sachetana daily and act on left-hand and right-hand area of skin segmental projects the th roots of the spinal cord lumbar spine, L5 or L5-S1, retreating in a lateral direction from the spinous processes of the vertebrae at 3 cm, and the impact of each physical exercise factor on one area, daily alternating physical impact factor; LT plane-parallel attachment No. 2 emitter laser therapeutic apparatus HELIOS-01 is mounted on the skin at an angle of 30° to the Central axis of the spine and LT performed in a stable methodology, modes of operation of the apparatus of the alternate as follows: one day pulse power set of 8 W, a repetition rate of 0.3 kHz, modulation frequency of 10 Hz, the next day pulse power set 10 W the pulse repetition rate of 0.4 kHz, modulation frequency of 20 Hz; enss is performed with the help of a device with a remote local bipolar electrode, which consists of a plastic housing, block coaxial contacts and a dielectric between them, while the Central contact is made in the form of a rod with a diameter of 0.7 mm, and the radial contact has an inner diameter of 2 mm and an outer diameter of 2.2 mm, and an asymmetrical pulse external bipolar electrode has a high amplitude and a low duration pulse with the center contact has a maximum amplitude of -200 V, and the amplitude of the radial contact is +30 V, the exposure time CHENS and LT on one segmentary the zone 1 min stable method; for one combined procedure CHENS and LT use simultaneously the same zone number from 1 to 2 symmetrically, the time of the procedure, respectively, ranges from 2 to 4 min, the treatment consists of 8 daily procedures.



 

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FIELD: medicine.

SUBSTANCE: invention refers to medicine also can be used for treating vast purulent wounds of soft tissues. That is ensured by exposure of a wound surface to high-energy semiconductor lasing after opening of a suppurative focus and detritus evacuation. Then the wound is irrigated with an antiseptic and exposed to defocused CO2-laser beam of power 20 Wt, light spot diametre 1 cm in the continuous mode. On the 2 day after the beginning of treatment, provided no secondary necroses observed, a session of photodynamic therapy follows. Herewith, the wound surface is coated with Photoditazine modified gel of methyl hydroxyethyl cellulose esters containing 0.5-1.5% dimethylglucamine salt of chlorine E6. Before applications, gel is mixed with 25% aqueous polyethylene oxide in the volumetric ratio gel: polyethylene oxide 10:2-3. Then it is exposed to semiconductor lasing of wave length 0.66±0.03 mcm, power density 0.5 to 1.0 Wt/cm2 and energy density 20 J/cm2. If detecting the signs secondary necrosis, before photodynamic therapy, the wound is processed with defocused CO2-laser beam one more time. Another session of photodynamic therapy is required, when on the 2nd day after photodynamic therapy, perifocal inflammatory manifestations remain in the wound.

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3 cl, 2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, ophthalmology, and can be used for treating latent subretinal neovascular membranes. That is ensured by introduction of the vascular endothelial growth factor inhibitor ranibizumab in dosage 0.3-0.5 mg transsclerally in the posterior vitreous body. In 5-7 days after reduction of neovessel permeability and tissue oedema, a neovascular membrane is sized by fluorescent angiography. Further, the photosensitiser Verteporfin 0.08-0.1 mg/kg is administered. In 15 min, the neovessels within SNM borders are exposed to a diode laser of wave length 689 nm at power density 500-600 mWt/cm2 for 83-100 seconds in total dosage to 50 J/cm2.

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FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to gynecology and concerns the integrated treatment of tuboperitoneal infertility. That is ensured by low-intensity infrared lasing at power 150 Wt, wave length 0.89 mcm of the inguinal lymph nodes and a skin projection of the lumbosacral plexus. The exposure time is 1 min for each region for 1st session. Thereafter, the exposure time is increased to 3 minutes during 10 sessions. It is combined with local intraendometrial introduction of an antibacterial agent and an immunomodulator. Besides the treatment involves a number of plasmapheresis sessions and introduction of nonsteroidal anti-inflammatory drugs, antioxidants, desensitisers, and vaginal sanitation.

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FIELD: medicine.

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2 tbl, 3 ex

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2 ex

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1 tbl, 1 ex

FIELD: medicine.

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2 ex, 9 tbl

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3 cl, 5 dwg

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1 ex, 1 dwg

FIELD: medicine.

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23 cl, 2 dwg

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1 ex, 1 dwg

FIELD: medicine.

SUBSTANCE: group of inventions concerns apparatuses and methods of treating to decrease a body perimetre, first of all to reduce cellulitis and/or depot fat in a treated region. The treatment system involves an ultrasonic apparatus for ultrasonic wave transmission to the required treated region and an electric stimulation apparatus for the required treated region simultaneously with ultrasonic wave transmission. The method of treating consists in ultrasonic wave transmission to the required treated region and electric stimulation thereof, with electric stimulation being interferential stimulation.

EFFECT: application of the inventions allows improving clinical effectiveness for cellulitis.

68 cl, 7 dwg

FIELD: medicine.

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1 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: invention is related to medicine and aims at treating the children with posttraumatic limb injures in postoperative period. The patient is exposed to low-frequency (1-2 Hz) pulse currents supplied to the patient's body from the device "Lymphavision" with using 2 electrodes placed along the greatest perimetre around an injury area with respect to the lymph flow ducts. The exposure requires current strength 3 to 15 mA prescribed individually for each patient to sensation of distinctive slight visible muscular reductions. The exposure time is 8-10 min for a course of 6-10 daily procedures.

EFFECT: method provides antiinflammatory action, reduced pain syndrome, relieved spasm of peripheral arteries, normalised venous outflow, improved supply and regeneration of postoperative tissues, reduced sclerosing and fibrosis of tissues.

3 ex

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SUBSTANCE: after orthodontic treatment with non-removable Edgewise equipment amplipulsetherapy. Amplipulsetherapy includes second type of work. Current with frequency 5000 Hz modulated on amplitude within the limits from 10 to 150 Hz with alternation of sending current and pauses, duration of current and pauses sendings being discrete from 1 to 6 s. Procedure duration constitutes 15 min. Course of treatment includes 10 sessions which are performed every second day.

EFFECT: application of invention restores functional activity of chewing group of muscles and synchronises their work in adult patients with central occlusion.

3 tbl, 1 ex, 3 dwg

FIELD: medicine.

SUBSTANCE: invention concerns medicine, namely - surgery. The method involves physiotherapeutic treatment preceding knee joint replacement. It implies mechanical pneumatic compression of lower limbs in combination with the electrostimulation device "Lymphavision". The electrostimulation involves application of the electrodes on the anteromedial surface of the lower one-third of shin and on the medial surface of the upper one-third of hip. The course includes 7 sessions. The operation is followed with limb elevation within 7 days and physiotherapeutic treatment. Herewith, knee joint region is galvanised. The electrodes are applied transversely, with medial and lateral surfaces from patella. The sessions are performed daily.

EFFECT: method improves clinical effectiveness ensured by rapid reduction of hemarthrosis and improvements of lymphatic and venous outflow within knee joint.

1 ex, 6 tbl

FIELD: medical engineering.

SUBSTANCE: device has programmable unit for producing output impulses having analog-to-digital signal converter connected to radio frequency communication unit having external programming and feeding unit and connected to wire electrode for supplying stimulation impulses to organs and tissues and biosensor units of respiratory and cardiovascular system parameters and autonomous power supply source. Electrostimulator envelope is manufactured from porous biologically inert silicon material containing carbon biosensors in the pores.

EFFECT: enhanced effectiveness of stimulation; long service life; operation safety.

4 dwg

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