The combination of referred pain syndromes because of spondyloarthrosis with non-compressive cervical and lumbar syndroms

Objective: to improve the treatment outcomes at patients with degenerative-dystrophic spinal disease through the examination of the clinical features of discogenic referred pain syndromes caused by spondyloarthrosis or intervertebral discs pathology and to develop the methods for their differential diagnosis and multimodality treatment. Materials and methods: the step-by-step denervation of intervertebral discs and facet joints (FJs) on the cervical and lumbar levels was performed at 127 patients including in two main groups in order to differentiate the noncompressive signs because of spondyloarthrosis or intervertebral discs pathology. The visual analogous scale (VAS) and Macnab scale were used to evaluate the treatment outcomes. Results: The analysis of reproduced referred pain syndromes allowed including them into classification scheme and confirmed that referred pain syndromes were caused by pathologic impulses aroused from intervertebral discs and from FJs. The chemical denervation of facet joints eliminated referred pain syndromes associated with pathologic impulse radiated from facet joints, and denervation (dereception) of intervertebral discs eliminated discogenic referred pain syndromes. The follow-up examination in 6-12 months revealed the more excellent and good outcomes according to Macnab scale (81,5% and 76,2% for cervical and lumbar spine respectively) in the main group while comparing with the control group. Conclusion: The conduction of step-by-step denervation (dereception) of intervertebral discs and facet joints allows diagnosing all referred pain syndromes and achieving the good conservative treatment outcomes at patients with degenerative-dystrophic spinal disease.

спондилоартроз, фасеточный синдром, дискогенные боли, радиочастотная нейротомия или денервация, spondyloarthrosis, facet syndrome, discogenic referred pain syndromes, radiofrequency neurotomy or denervation

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