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COMMITTEE OF THE RUSSIAN FEDERATION FOR PATENTS AND TRADE MARKS (ROSPATENT). PATENT No.2,005,456 for Invention: METHOD FOR TREATMENT OF SPONDYLOSTEOCHONDROSIS AND PREVENTION OF VERTEBROGENIC DISEASES

Patent owner(s): Bobyr, Anatoli Ivanovich
Country: Russian Federation
Inventor(s): Bobyr, Anatoly Ivanovich
Priority date February 25, 1993
Date filed in Rospatent February 25, 1993
Applications No.93-007046
Date registered in State
register of inventions October 8, 1993
CHAIRMAN OF ROSPATENT

The present invention relates to methods for prevention and treatment of spondylosteochondrosis (vertebral osteochondrosis). The method proposed herein resides in detecting and eliminating or abating local defenses in the muscles of the region of the vertebral column as follows. The presence of the local defense is detected in the paravertebral muscles; depending on the site of the local defense the patient's head or the vertebral portion located proximally to the local defense. Then the patient's body is subjected to jerky tractions in the cranial direction simultaneously with a pressure applied sagittally to the local defense. The forces of the aforementioned traction and pressure are selected to be as follows (P, % of patient's body weight and P1, kg/sq.cm): for children, 5-7; 0.5-3; for females, 7-9; 1-4; and for males, 8-10; 2-6. The prevention and treatment of spondylosteochondrosis is supplemented with stabilizing procedures, which are essentially a complex of autopsychophysical exercises in combination with breathing exercises. According to the proposed method, the pressure applied to the local defense in the sagittal plane may be imparted through a resilient member arranged parallel to the vertebral column.

This invention relates in general to medicine, namely, to neurology and manual therapy. The invention can find application in prevention and treatment of spondylosteochondrosis in children, adults, and patients older that 60, and makes it possible to optimize patient's treatment course and enhance efficacy of both prevention and treatment.

One prior-art method for treating the pain syndrome accompanying functional blockade of the spinal column is known to comprise a complex therapy consisting of horizontal spinal traction and manual therapy procedure, the latter being carried out under load at the instant of spinal traction, (cf. USSR Inventor's Certificate No.1,648,469). The method involves some further techniques and requires, in particular, the use of a traction table..

Another prior-art method for treating spondylosteochondrosis is known to use manual therapy procedure which includes palpation of the spinal column, classical segmental massage of the lumbosacral spine, and mobilization accompanied with manipulations on the blocked PDS, as well as laser puncture, automobilization and autostabilization techniques with the elements of training therapy (cf. USSR Inventor's Certificate No.1,562,998). The method provides for prevention and treatment of spondylosteochondrosis and involves also such techniques as traction, intense segmental massage, and use of expensive equipment. The method discussed before is chosen as the prototype of the herein-proposed one.

The invention is aimed at providing a method for prevention and treatment of spondylosteochondrosis which is instrumental in optimizing patient's therapy, cut down the treatment period, and render the treatment more efficacious.

The method proposed in the present invention is carried into effect as follows. The patient's spinal column is palpated in his/her sitting or standing position to detect the presence of a spasm of the paravertebral muscles, and the local defense. Then the patient is given a brief information about the anatomy of the spinal column, its concern with the human internal organs, as well as some knowledge of manual therapy procedure and fixing the muscular corset which will be carried out in accordance with the proposed method. In addition, the patient is informed that the method is painless, loadless, atraumatic, and complication-free. Next depending on the site of the local defense detected by palpation, the patient's head (when the local defense is found to seat in the cervical spine) or the spinal portion wherein the local defense has been revealed) is fixed in place proximally of the muscle exhibiting the local defense. Then once-through jerky tractions are performed in the cranial direction concurrently with applying a pressure to the local defense in the sagittal plane. The forces of the aforementioned jerky traction and of the pressure applied in the sagittal plane are selected to be as follows (P, % of patient's body weight and P1, kg/sq.cm):

for children	5 - 7	0.5 - 3
for females	7 - 9	1 - 4
for males	8 - 10	2 - 6

The aforestated values of P and P1 are found experimentally and are optimal for the abovelisted age groups of patients. The minimum value of P1 are used for prevention and treatment of osteochondrosis in the region of the cervical vertebrae.

Thus, the local defense is gradually eliminated or, if impossible, it is reduced in the involved spinal portions. In this case the number of manual therapy procedures and the rate of their application depend on the clinical, anatomical and functional state of the spinal structures involved, on the degree of markedness of the pain syndrome and blocking PDS, as well as the degree of hypertonus of the paravertebral muscles. Local elimination or reduction of the local defense carried out, according to the invention, increases greatly the efficacy of prevention and treatment of spondylosteochondrosis, which is due connection between the local defense, through the spinal cord, to some patient's internal organ or another. Thus, it is by eliminating or reducing the local defense, thereby restoring neurophysical processes in the organs connected to the local defense that one can prevent the disease or relapses of the passed disease, or progress of such a disease and its complication. To fix the muscular corset of the spinal column, prevention and treatment of spondylosteochondrosis are supplemented with stabilizing procedures, which are essentially a complex of autopsychophysical exercises in combination with breathing exercises. Whenever necessary, pressure to the local defense in the sagittal plane may be applied through a resilient member, e.g., an elastic rod whose upper end is held forcelessly to the local defense and which is arranged parallel to the spinal column. The rod length "1" is 12-15 cm, and its diameter "d" can be from 2 to 5 cm. The rod dimensions depend on patient's age, as well as on the conditions of his/her muscular corset. Thus, used for children is a rod 2 cm in diameter and 12 cm long for adults, 5 cm and 15 cm, respectively. To fix the muscular corset, autopsychophysical exercises are performed at an inbreath-holding spell according to the following scheme: fixing either of the temporal head portions, exerting a pressure on said head portion, and simultaneously tensioning the muscles of the body half involved; then the aforementioned operations are performed on the other temporal head portion, which is followed by fixing the frontal head portion, exerting a pressure thereon and tensioning the muscles of anterior body portion and of the abdominal cavity. Next the occipital head portion is fixed, a pressure is exerted thereon and the dorsal muscles are tensioned. When the patient feels a pain during the aforesaid exercises, particular attention should be given to the level of painful sensations on the side of the body contralateral to the painful one. The aforedescribed therapeutic complex is carried out for 5 to 10 days once or twice a day depending on patient's subjective condition. At the same time, it is expedient for prevention purposes and with a view to fixing the muscular corset and maintaining it in that state under modern conditions (that is, ever worsening ecological situation, incomplete nourishment, and so on) to make the aforementioned complex of exercises part of daily morning exercises indispensable for every patient predisposed to or suffering from spondylosteochondronis.

Exemplary case history. Male patient G., 70. Weight, 70 kg, body height, 190 cm. Complained of nausea, diarrhea and the related abdominal pain, as well as of hemorrhoid, feeling fatigue and dorsal discomfort, tinnitus aurium, headache, pain in the right knee joint, and increased arterial pressure. The patient have been suffering for the last 25 years and was many times hospitalized to experience but temporary and partial amelioration. In 1990 a nephrolith was detected in the right kidney by the ultrasonic examination technique. The patient was given outpatient physiotherapeutic treatment, massage, remedial gymnastics, IRT. During the recent time the patient is under dispensary observation for increased arterial pressure and is prescribed to take clophelin.

Objective evidence: the patent features a good bodily structure, AP - 170/100 mm Hg. Motion in the lumbar and thoracic spines is restricted. Lasegue's sign - 60° on the left, 55° on the right. Upon examination and palpation of the spinal column a pronounced local defense is detected on the left at the level of 0CC - Cl- Pronounced local defenses are also detected at the level of C7 - T1 on the right, T4 - T5 on the right, and T12 - L2 on the left. The abdomen is soft and painful in its left ileocecal region; the liver is enlarged and painful on palpation.

Positive Pasternacki's sign on the right. Motion in the right knee joint is restricted due to an elastic neoplasm in the popliteal fossa measuring 4x6 cm, painless on palpation. Two hemorrhoidal plexuses are revealed in the anal region.

Diagnosis: spondylosteochondrosis, urolithiasis, stage II hypertensive vascular disease, hemorrhoid, arthrosis of the knee joint, and hygroma of the right popliteal region.

The patient was given treatment with the use of the herein-proposed method. Before treatment the attending physician told the patient about the anatomy of the spinal column, its concern with the internal organs, causes of the pathology and their effect on human organism, as well as some knowledge of the essence of manual therapy procedure and fixing the muscular corset, while drawing patient's attraction to the fact that the method is painless, atraumatic, and complication-free, since the values of the respective forces P and PI with which jerky body tractions are performed and a pressure to the local defense is applied in the sagittal plane have been selected proceeding from the body weight, age, diagnosis, and constitutional capabilities of the patient, as well as from the site of the local defense, to be as follows: P = 7 kg (10% of the body weight equal to 70 kg), P! = 6 kg and 2 kg (for the cervical vertebrae). In order to localize the pressure PI applied to the local defense and with a view to providing comfort for the patient, the doctor made use of an elastic rod 5 cm in diameter and 15 cm in length, having preliminarily wrapped it in a terry towel with 15-cm long ends dangling loosely for fixing the rod on the patient's back. Then the doctor palpated the patient in the vertical (standing) position. As a result, there were revealed the local defenses at the following levels: T12 - L2 on the left; T4 - T5 and C7 - T1 on the right; and 0CC - C1 on the left. Palpation was performed beginning with the sacrolumbar spine. Mobilizing manipulations were also carried out from below upwards, i.e., starting at level of T12 - L2. Then the doctor, having let the patient sit down, fixed forcelessly the upper rod end on the local defense at the T12 - L2 level of the spine on the left, (with the rod arranged parallel to the spine column), using his own abdominal wall and the dangling towel end. Next the doctor fixed the patient's body above the T12 - L2 level by encompassing it from the back (that is, having pulled it towards himself, as it were, and slightly raised) and squatted together with the patient. Then there were performed once-through jerky tractions in the cranial direction and a pressure was applied consecutively to the local defenses in the sagittal plane at the T12 - L2 level on the left and the T4 -T5 and C7 - T1 levels on the right, said pressure being exerted by virtue of the doctor's abdominal tension applied through the elastic rod. Thereupon the aforementioned procedures were effected with respect to the local defenses disposed at the 0CC -C1 level on the left, wherein for convenience the doctor made use of, e.g., his left thumb as an elastic member, putting it forcelessly on the local defense. Further on the doctor fixed the patient's head above the 0CC - Cl level by encompassing it with his other hand and putting the head forcelessly onto his breast ((that is, having pulled it towards himself, as it were, and smoothly raised) and squatted together with the patient. Then there were performed sharply once-through jerky tractions of the body and a pressure was applied in the sagittal plane. In three days all the procedures described before were repeated. Concurrently with the treatment given the patient performed daily the aforementioned autopsychophysical exercises at an inbreath-holding spell two times a day according to the aforedescribed scheme. As a result, abdominal pain disappeared, dorsal pain abated, dizziness and lumbar pain subsided.

Objective evidence: local defenses at the 0CC - C1 level on the left and at the C7 - T1 level on the right were eliminated completely, and those at the T4 - T5 level on the right and at the T12 - L2 level on the left got but hardly palpable, though painless.

In this respect the patient was recommended to continue the complex of stabilizing procedures for the next 30 days and then to carry out one more course of prevention and treatment of spondylosteochondrosis. The patient presented himself at the appointed time and reported that his subjective well-being ameliorated drastically after the first visit to the doctor, the renal calculus came out which was confirmed by the ultrasonic examination findings. The hemorrhoidal plexuses resorbed, the hygromatous tumor in the popliteal fossa diminished, the arterial pressure persisted at the level of 150/90 mm Hg, though the patient took no antidepressants.

A total of 130 patients were treated, using the herein-proposed method, the age bracket of the patients being as follows: children aged from 5 to 12, 21; adolescents aged from 13 to 20, 12; adults aged from 21 to 30, 20; from 31 to 40, 18; from 41 to 50, 38; from 51 to 60, 17; and above 60, 4 patients. The patients of the first four age groups developed a considerable improvement, 35 patients of the age group 41-50 exhibited a considerable improvement, in two patients an improvement was observed, and the condition of one patient remained invariable. In the age group 51-60 a considerable improvement was observed in 13 patients, an improvement, in four patients; among them an exacerbation was observed in one patient but in three days his condition became normal. In the patients older than 60 two of them displayed a considerable improvement and in one patient an improvement was observed, though an exacerbation occurred in him after the treatment course which lasted two days, whereupon his condition normalized.


CLAIMS

1. A method for treatment of spondylosteochondrosis and prevention of vertebrogenic diseases by detecting a local defense of the dorsal muscles, followed by performing, for its elimination or abatement, an intermittent distraction of the affected spinal portion and applying a pressure to the pathologically changed muscles, with subsequent remedial gymnastics aimed at overcoming the resistance offered by part of the trunk muscles, CHARACTERIZED in that the spine portion involved or the patient's head is fixed proximally to the muscle affected by local defense, whereupon a pressure is applied thereto in the sagittal plane concurrently with jerky tractions in the cranial directions performed with the following force (in kg/sq.cra): for child patients, 0.5 to 3; for female patients, 1 to 4; for male patients, 2 to 6; (in percent of body weight): for child patients, 5 to 7; for female patients, 7 to 9; for male patients, 8 to 10. Thereupon with the patient holding breath at inspiring his temporal head portions are alternately fixed and the muscles of the respective trunk half are tensioned, after which the frontal head portion is fixed and the thoracic and abdominal muscles are tensioned, and then the occipital head portion is fixed and the dorsal muscles are tensioned; while so doing, the patient's attention is concentrated at the sensation in the region contralateral to the painful one; the complex of the exercises is repeated daily.
   
   
2. A method as set forth in claim 1, CHARACTERIZED in that the pressure applied to the points of muscular defense in the sagittal plane is exerted through an elastic member, preferably through an elastic rod whose upper end is fixed forcelessly on the point of muscular defense, and the rod is arranged parallel to the spine column.

(56) USSR Inventor's Certificate No.1,562,998. Cl. A 61 H 1/00