HYPERBARIC OXYGENATION IN EARLY POSTOPERATIVE PERIOD IN PATIENTS SUFFERED FROM LUMBAR STENOSIS

Objective. To estimate of efficacy of hyperbaric oxygenation in early postoperative period in patients with lumbar degenerative stenosis.

Material and methods. The analysis of treatment outcomes of 20 patients with degenerative lumbar stenosis was conducted. All patients had only neurogenic intermittent claudication in one or both legs as clinical signs of disease. The presence of radicular symptoms at rest and in prone position was the exclusion criteria as well as diabetes mellitus, any concomitant pathology of nervous system and previous spinal operations. The electroneuromyography (ENMG) of lower extremities was performed before operation for all patients. Surgical treatment included decompression of vertebral canal at the level of stenosis with the following stabilization in most of cases. All patients were divided in 2 groups after operation and repeated ENMG was performed in 8 days after operation: I group — 10 patients with routine postoperative conservative treatment (antibiotic and analgesic therapy, medical gymnastics, physiotherapy); II group — 10 patients who underwent routine treatment with combination of 8 sessions of hyperbaric oxygenation (HBO) starting from 1st postoperative day. Patients of both groups were compared according to intensity of neurogenic intermittent claudication before operation and in 8 days after operation estimating the walking distance and pain intensity in leg using Visual Analog Scale (VAS). ENMG data before and in 8 days after operation were also compared. The following nerves were estimated during ENMG: mixed common peroneal nerves, motor tibial nerves and sensory sural nerves. The parameters of M- or S — response (latent time, amplitude), nerve conduction velocity (NCV) and parameters of F-waves (recruitment, amplitude range, latency diapason, F/M correlation) were estimated.

Results. The mean value of pain intensity before operation was 5,2±1,7 scores according to VAS in patients of I group and 5,4±1,9 scores — in patients of II group. The mean walking distance before operation was 370±330 m in I group and 340±310m — in II group. Postoperatively the mean value of pain intensity was 1,8±0,7 scores according to VAS in I group and 1,3±1,4 scores in II group, walking distance — 620±310 m and 610±340 m correspondingly. There were no significant difference in parameters of ENMG in both groups.

Conclusion. The HBO conduction in patients with degenerative lumber stenosis in early postoperative period improves the clinical signs and fastening the rehabilitation however it does not improve the ENMG parameters. 

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