Immunodepressants in the complex of treatment of the resistant form of radicular pain syndrome in patients with lumbar osteochondrosis

Objective: to evaluate the effectiveness of intravenous drip infusion of glucocorticoid dexamethasone in the complex of treatment of the resistant form of radicular pain syndrome in patients with lumbar osteochondrosis (LO). Methods. A study included 74 LO patients with a resistant form of pain syndrome. The LO was diagnosed according to H. Hall criteria, which included a thorough clinical-neurological examination, functional-spondylographic examination, computed tomography and magnetic resonance imaging of the lumbar spine. To determine the effectiveness of the treatment, 3 scales were used: 1 - determination of the pain syndrome intensity using the visual analogue scale (VAS); 2 - general assessment of the results of treatment by a doctor; 3 - a quantitative assessment of vertebral syndrome. Patients were divided into two groups: group 1 included 37 patients who received intravenous drip infusions of dexamethasone according to the scheme along with traditional conservative therapy; Group 2 (control group) also consisted of 37patients who received only traditional conservative treatment. Results. The intensity of radicular pain syndrome (according to the VAS) in patients of Group 1 after the end of the course of treatment decreased (on average) by 93.8%, in patients of Group 2 - by 65.6%. The duration of the acute period or exacerbation in the Group 1 was 12.4 days, in the Group 2 - up to 60 days. A general assessment of the results of treatment by a doctor showed that a good effect (2-3 points) was obtained in 37 patients of Group 1; none of the patients had lack of effect and worsening. 34 (92%) patients of the Group 2 had unsatisfactory result (0-1 point). A similar result was obtained in the assessment of vertebral syndrome. Discussion. The analysis of the results of the treatment using appointed scales showed that the intensity of the pain syndrome decreased more rapidly in patients of Group 1, the residual pain syndrome did not develop, the significant effect of the therapy was noted in the majority of patients. In patients of Group 2, the intensity of the pain syndrome decreased slightly. The residual pain syndrome developed. Most patients had a moderate effect of treatment, and the vertebral effect persisted for a long time. Conclusion. Comparative analysis shows that the effectiveness of the therapy with intravenous drip infusions of dexamethasone according to the scheme is an effective way to treat the resistant form of pain syndrome in LO.

immunodepressants, resistant form of pain syndrome