V.K. KALABANOV'S METHOD FOR CHOOSING MANUAL THERAPEUTIC APPROACH TO NEUROLOGICAL MANIFESTATIONS OF HERNIATED OR PROTRUDED LUMBAR DISKS

摘要

FIELD: medicine.;SUBSTANCE: invention refers to manual therapy (MT) and is effective for treating the patients suffering aggravated and regressive herniated and protruded (prolapsed) lumbar disks. A lumbar blocking direction is examined, and a MT approach based on the free motion is preferred. A neurologic examination aims at detecting extravertebral syndromes (EVS) anatomically associated with the lumbar (LP), sacral (SP) or both plexuses; muscular fixation of the lower extremities (LE) and the sanogenesis-related muscular fixation in the involved lumbar motor segments and the muscular fixation of thoracic (TS) and cervical (CS) spines are interrelated. If observing the EVS in both LEs, the MT techniques are applied to both LEs, whereas the EVS anatomically associated with the LP require the mobilisation technique to be used, which is post-activation traction (PAT), or the relaxation techniques representing the post-isometric relaxation (PIR), post-reciprocal relaxation (PRR) involving the CS and femoral flexors, adductors and rotators on the LE, and the TS and LS on the flexed spine and LE. The EVS anatomically associated with the SP is relieved by performing the PAT or PIR, the PRR on the CS, femoral flexors, adductors and rotators, foot extensors or flexors on the LE, and on the TS and LS on the flexed spine and LE. If observing the EVS anatomically associated with both the LP, and the SP, there are performed PAT or PIR, the PRR on the CS, femoral flexors and adductors, femoral flexors, adductors and rotators, foot extensors or flexors on the LE, and on the TS and LS in the neutral position of the spine and LE. The LE is first exposed at the level of muscular groups interrelated with more manifested, and then with less manifested EVS. The PAT or PIR, PRR on the CS is completed by manipulations from both sides, and on the LE by pressing myofascial trigger points of the LE and lumbus, on the pelvis by the mobilisation and manipulations on the sacroiliac joints, on the TS by the manipulations, and on the LS by the skin mobilisation. The procedure is completed by performing the manipulations on the intact lumbar motor segments from both sides. The lumbar manipulations are performed if observing no herniated disk sequestration, with a hernia localised no more than 1 cm deep.;EFFECT: method provides choosing the MT approach more accurately and objectively depending on the EVS anatomically associated with the LP, SP with maintaining the sanogenesis-related muscular fixation of the lumbar motor segments, improving the venous blood and lymph outflow from the LE and spine by activating a muscular-venous pump of the LE and a dural-muscular-venous-lymphatic pump of the spine, preventing the hernia enlargement and sequestration, and reducing the length of treatment.;20 dwg, 3 ex