Comparative study of the effectiveness of standard therapy and the complex therapy with inclusion of osteopathic correction, in patients with discogenic S_I radiculopathy

Introduction. Pain in the lumbosacral region is one of the most common causes of disability and seeking medical help. The most pronounced clinical manifestations and a protracted course of pain syndrome are observed in patients with discoradical conflicts. The anatomical and functional features of the segment of the lumbosacral region predispose to persistent compression of the S_I root, which makes it difficult to carry out analgesic therapy, leading the patient to long-term disability or to surgical intervention. Discogenic lesion of the SI root changes the biomechanics of not only the pelvic region and lower limb, but also affects the biomechanics of the whole body. Despite the success in the development of modern approaches to the treatment of this disease, the problem of increasing the effectiveness of treatment of patients with herniated discs of the lumbosacral spine remains relevant. One of the promising directions is the inclusion of methods of osteopathic correction in the complex treatment.

The goal of research — is to substantiate the inclusion of osteopathic correction in the standard therapy of patients with discogenic S_I radiculopathy.

Materials and methods. The study involved 30 patients with discogenic S_I radiculopathy. The two groups were formed by the method of simple randomization: the control group (15 people), whose participants underwent standard conservative treatment, and the experimental group (15 people), whose participants additionally underwent osteopathic correction. At the beginning and at the end of the study, all participants underwent a clinical and neurological examination (including an assessment of the motor function of the muscles innervated by the S_I spinal nerve, an assessment of sensitivity in the zone innervated by the SI spinal nerve, and an assessment of the Achilles reflex), an assessment of the intensity of pain syndrome using a visual analogue scale (VAS), anassessment of life quality by Oswestry Disability Index, and an assessment of osteopathic status. The obtained data were processed by methods of nonparametric statistics.

Results. It was found that the inclusion of osteopathic correction in the standard treatment of patients with discogenic S_I radiculopathy is accompanied by a more pronounced decrease in the number of regional somatic dysfunctions (SD), local SD of the musculoskeletal system and local visceral dysfunctions (the differences are statistically significant, p<0,05). The elimination of regional viscero-somatic and somato-visceral disorders of the L I-L V spinal cord segments, as well as local disorders of the ankle joint, coccyx and muscle-fascial formations of the pelvis, thigh, lower leg and foot is observed. In addition, there is a more pronounced decrease in the intensity of sensitivity disorders in patients and in the intensity of pain.

Conclusion. The obtained results allows to conclude that the inclusion of osteopathic correction in the standard conservative therapy of patients with discogenic S_I radiculopathy contributes to an increase of the treatment effectiveness.

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