title: [Ways to optimize the treatment of patients with discogenic-venous lumbosacral radiculomyeloischemia].
abstract: OBJECTIVE
  Treatment of patients with neurological manifestations of degenerative-dystrophic lesions of the spine must be integrated and optimized from the perspective of pathogenesis. Antiedematous therapy is an important moment that takes into account the development of localized swelling affected the spinal structures. We studied the efficacy of L-lysine aescinat in the treatment of patients with discogenic-venous lumbosacral radiculomyelopathy.
  
  
  METHODS
  We analyzed the therapeutic efficacy of antitumor therapy with the drug L-lysine aescinat in 40 patients with discogenic-venous lumbosacral radiculomyelopathy in comparison with a control group of 40 patients treated with conventional therapy in a neurological hospital. The age of the patients ranged from 30 to 60 years. In total, there were 36 (45 %) women and 44 (55%) men. Herniated discs were visualized by MRI in all patients, attention was drawn to the condition of radicular veins of the cauda equina. We assessed muscle strength of lumbosacral myotomes, their trophicity and state of segmental-conductor apparatus sensitivity with the quantitative determination of the time of vibration of a tuning fork.
  
  
  CONCLUSIONS
  The comparison of neurological status dynamics during treatment of inpatients has shown that neurological symptoms reduce more effectively in patients treated with L - lysine aescinat (by 75% during the first 3-5 days) and in a greater number of the patients (77.5% vs 55% in the control group). The authors' experience has shown that venous micro- and macro-circulation disorders play an important role in the pathogenesis of lower lumbar disk hernia. Clinical manifestations of these disorders are segmental and conductive spinal motor disorders in myotomes and sensitivity. Quantitative determination of vibration sensitivity (tuning fork test) is pathognomonic for radiculomyeloischemia. Vein tonics and antiedemics, including L - lysine aescinat as one of the most effective drugs, exert a pathogenetic effect on spondylic and discogenic nervous system disturbances.
authors.affiliation: Neurology and Neurosurgery Chair and Clinic of the First Pavlov State Medical University of St. Petersburg of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
authors.forename: А А
authors.initials: АА
authors.lastname: Skoromets
authors.affiliation: Neurology and Neurosurgery Chair and Clinic of the First Pavlov State Medical University of St. Petersburg of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
authors.forename: Е V
authors.initials: ЕV
authors.lastname: Bubnova
authors.affiliation: Neurology and Neurosurgery Chair and Clinic of the First Pavlov State Medical University of St. Petersburg of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
authors.forename: S М
authors.initials: SМ
authors.lastname: Endalceva
authors.affiliation: Neurology and Neurosurgery Chair and Clinic of the First Pavlov State Medical University of St. Petersburg of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
authors.forename: D S
authors.initials: DS
authors.lastname: Kapitonov
authors.affiliation: Neurology and Neurosurgery Chair and Clinic of the First Pavlov State Medical University of St. Petersburg of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
authors.forename: Т V
authors.initials: ТV
authors.lastname: Lalayan
authors.affiliation: Neurology and Neurosurgery Chair and Clinic of the First Pavlov State Medical University of St. Petersburg of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
authors.forename: S V
authors.initials: SV
authors.lastname: Perfilev
authors.affiliation: Neurology and Neurosurgery Chair and Clinic of the First Pavlov State Medical University of St. Petersburg of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
authors.forename: D G
authors.initials: DG
authors.lastname: Smolko
authors.affiliation: Neurology and Neurosurgery Chair and Clinic of the First Pavlov State Medical University of St. Petersburg of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
authors.forename: А P
authors.initials: АP
authors.lastname: Skoromets
authors.affiliation: Neurology and Neurosurgery Chair and Clinic of the First Pavlov State Medical University of St. Petersburg of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
authors.forename: Т А
authors.initials: ТА
authors.lastname: Skoromets
authors.affiliation: Neurology and Neurosurgery Chair and Clinic of the First Pavlov State Medical University of St. Petersburg of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
authors.forename: О V
authors.initials: ОV
authors.lastname: Sukhatskaya
authors.affiliation: Neurology and Neurosurgery Chair and Clinic of the First Pavlov State Medical University of St. Petersburg of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
authors.forename: А А
authors.initials: АА
authors.lastname: Shmonin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000098:blood supply*; D007405:Intervertebral Disc Displacement / Q000150:complications*; D008161:Lumbosacral Region / Q000098:blood supply; D008239:Lysine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011843:Radiculopathy / Q000188:drug therapy* / Q000209:etiology; D020760:Spinal Cord Ischemia / Q000188:drug therapy* / Q000209:etiology; D014680:Veins / Q000503:physiopathology
chemical_list: D008239:Lysine