Typically, the blockade of the spine herniated prescribed to patients with pronounced pain syndrome. The technique of treatment is that for severe pain a person receives an injection of the designated drug at the site of inflammation a certain section of the spine. It can be paravertebral muscles or exit points of spinal nerves. The site of injection and type of drug the doctor selects individually.
This treatment is carried out after a thorough examination and not all patients assigned. If you have some side disease, this procedure is invalid or does not give the desired result. There are a number of contraindications to the use of drug exposure on the nervous system when herniated.
Technically a blockade is a complex and crucial procedure. So the doctor, injections must have high professional qualifications. Incorrect actions may lead to irreversible consequences. In the process of drug administration is important to the direction of movement of the needle, the infusion rate, the accuracy of the puncture, the safety of adjacent vessels and tissue, the correct choice of medication. The result of a medical error can become a disability.
Types of drug blockade
The reason for the development of herniated discs can be the trauma, wounds, diseases of the internal organs or nervous system. Among the risk factors of tumor in the area of the cervical, thoracic or lumbar area, sedentary lifestyle, sedentary work, violation of metabolism. Aggravation of herniated discs is expressed in severe pain manifesting at different parts of the spine. It can be lumbosacral, neck, shoulders, between shoulder blades.
Depending on the severity of the patient’s condition and the localization of painful lesions selected one of the two main types of closures. They differ from each other by place and method of drug administration. When transforaminal blockade drug is administered in the area of exits from the intervertebral foramen of the spinal cord nerves. When intralaminar type needle is directed between the vertebral processes in the midline.
Injections are divided into 3 categories:
- anesthetic agents (procaine, lidocaine);
- anti-inflammatory agents (corticosteroids);
- mixed formulations.
For quick pain relief anesthetic medicines are used. Widely used procaine blockade in osteochondrosis. The condition of the patient after the procedure is improved immediately due to the direct effects of anesthetic drugs on nerve endings and fibers. Therefore, in severe pain in the lower back or in the cervical such manipulation is assigned to provide emergency assistance. For repeated treatment to eliminate spasms, swelling, inflammation used mixed compositions.
The model differences are related to the nature and time of exposure on nervous tissue. The effectiveness of treatment provide mechanisms such as:
- pharmacological properties of the components;
- reflex effects on all levels of the nervous system;
- the maximum concentration of the drug in the pathological focus.
The effectiveness of the method of anesthesia and the treatment depends on the stage of the disease, the competence of the medical staff, the individual characteristics of the patient and his General condition. Special requirements apply to equipment intended to conduct a preliminary diagnosis.
Modern methods of anesthesia
Modern medicine uses various methods of influence on the pain centers in the intervertebral space of the cervical and lumbar. An example of effective short term pain relief can serve as a cervical vagosimpaticescoy blockade. This successful methodology has been developed by A. V. Vishnevsky. It is relevant after receiving multiple fractures to the ribs, injuries in the thoracic, postoperative pneumonia, respiratory tract burns.
When the procedure is over the point of insertion of the needle is the right sternocleidomastoid muscle of the neck. The first injection is done by multiple sequential injections of small volumes of anesthetic (2-3 ml). This ensures painless course of the subsequent procedure. After carrying out aspiration of the sample to enter from 30 to 60 ml of anesthetic solution.
The scientist has also developed a method of manipulating the layers of fat in which is an injection in the lumbar region, it is soft fabric. This temporary anesthesia is effective in injuries of the abdominal organs and burn shocks.
Short-term local anesthesia is carried out to prepare the main procedure. The doctor needs with maximum precision to determine the location of inflammation and the points where it is advisable to enter the shot. This purpose is performed paravertebral (translated from Latin – «around the spine») manipulation. First, the doctor probes his skin and reveals the most painful place. Then he takes a fine needle and injecting the Novocain subcutaneously, pre-treating the local area with an alcoholic solution of iodine.
Further, using a long needle injected the necessary preparations already at the desired depth, almost to the bone. It allows you to block the affected nerve roots, causing pain to the patient. Paravertebral injection is carried out in the bulk of cases.
Pain during exacerbation of herniated discs can be easily confused with symptoms of other diseases: a feeling of tightness in the thoracic spine is often mistaken for angina, aching pain in the lower back – renal colic or inflammation of the appendages.
Indications and contraindications
The introduction of drugs into the spinal area procedure, assigned by the attending physician after examination. Indications for the examination are based on the data obtained through research techniques MRI (magnetic resonance) and CT (computed tomography). Additional methods include examination and questioning of the patient, palpation of the inflamed hearth. A shot of novocaine or mixed funds to the appropriate Department of the spine is prescribed for patients with such factors.
Some patients such manipulation is prohibited because of health status or individual characteristics of the organism. Contraindications include:
- cardiovascular, renal, hepatic failure;
- diseases of the Central nervous system;
- individual intolerance to the components of the injected compositions;
- low blood pressure;
- inflammatory processes in the body or the affected area.
For certain categories of patients is necessary to choose an alternative method of pain relief and effective treatment. They administered an intravenous infusion of painkillers and the pills.
How is it treated
For the procedure you need to use the fluoroscope. The procedure is carried out for 2 hours, then 2-3 hours the patient’s condition is watched by the doctors. Possible complications at this time: discomfort in lower back, weakness, numbness of the limbs.
|Preliminary preparation.||Disinfection of the skin, palpation and local anesthesia. The patient lies on side with knees bent and summarizing them to the stomach.|
|The first stage.||Needle 60 mm made a puncture. Before the introduction of the drug liquid is drawn off. The doctor injects the contrast agent and observe its distribution in the vertebra. When it detects blood in the syringe, changing the angle of insertion of the needle. The presence of cerebrospinal fluid – a signal to end the manipulation.|
|Second stage.||Directly administered the drug a total volume of 30-60 ml.|
After 3-4 hours in the absence of side effects eat. Driving a car is only valid for 12 hours after the last injection. Practice shows that as a result of this manipulation complications are extremely rare, and the patient’s condition significantly improved.
Numerous statistical studies confirm high efficacy of drug blockade as a method of treatment of herniated discs.