METHOD OF CHOOSING THERAPEUTIC APPROACH TO LUMBAR SPONDYLARTHROSIS

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely neurology, neurosurgery and X-ray diagnostics, and may be used for the purpose of choosing a therapeutic approach to lumbar spondylarthrosis. It involves X-ray neuroimaging diagnosis by means of helical computed tomography and/or magnetic resonant tomography. Zygapophysial joints (ZJ) are examined in an axial projection on both sides. Plane angles of the ZJ and a long axis of the body and a width of a joint space (W) on affected and intact sides are determined horizontally. In a sagittal projection, intervertebral foramens are examined on both sides, and also their area is measured on affected and intact sides. The angles of the ZJ and a long axis of the body at the level of degenerative-dystrophic affection (Ran) are related by formula: Ran=Ani:Ana, wherein Ani is the angle of the ZJ and a long axis of the body on intact side, Ana is the angle of the ZJ and a long axis of the body on side of degenerative-dystrophic affection. The normal value is Ran=0.9, the Ran value decreasing by every 0.1 is estimated as 1 point. It is followed by calculating a relation of the areas of the intervertebral foramens at the level of degenerative-dystrophic affection (Rar) by formula: Rar=Ara:Arh wherein Ara is the area of the intervertebral foramen on side of degenerative-dystrophic affection, Arh is the area of the intervertebral foramen on intact side. The normal value is Rar=1.0, the Rar value decreasing by every 0.1 is estimated as 1 point. The normal value W=4 mm, the W value on affected side decreasing by every 0.5 mm is estimated as 1 point. Total score is derived. Total score less than 4 requires conventional therapy, the value within 5 to 14 shows puncture treatment option, and if the value 15 and more, a surgical intervention is performed.;EFFECT: method provides higher clinical effectiveness ensured by optimised choice of the therapeutic approach.;3 ex