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Neurology, Neuropsychiatry, Psychosomatics

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Discogenic lumbosacral radiculopathy

https://doi.org/10.14412/2074-2711-2010-96

Abstract

In most cases, spinal nerve root lesion is due to vertebral causes, such as disk herniation, degenerative changes in the intervertebral joints, and a narrow vertebral canal. The paper considers the pathogenetic mechanisms responsible for the development of discogenic radiculopathy and its associated pain syndrome and main approaches to its diagnosis and treatment. Some attention is given to therapy for neuropathic pain syndrome.

About the Author

E. V. Podchufarova
I.M. Sechenov First Moscow Medical University
Russian Federation


References

1. <div><p>Frymoyer J. Lumbar disc disease: epidemiology. Instr Course Lect 1992;41:217-23.</p><p>Skouen J.S., Brisby H., Otani K. et al. Protein markers in cerebrospinal fluid in experimental nerve root injury. Spine 1999;24:2195-200.</p><p>Heliovaara M., Makela M., Knekt P. et al. Determinants of sciatica and low back pain. Spine 1991;16:608-14.</p><p>Matsui H., Kanamori M., Ishihara H. et al. Familial predisposition for lumbar degenerative disc disease. Spine 1998;23:1029-34.</p><p>Miranda H., Viikari-Juntura E., Martikainen R. et al. Individual factors, occupational loading and physical exercise as predictors of sciatica pain. Spine 2002;27:1002-9.</p><p>Riihimaki H., Tola S., Videman T. et al. Low back pain and occupation. Spine 1989;14:204-9.</p><p>Riihimaki H., Viikari-Juntura E., Moneta G. et al. Incidence of sciatic pain among men in machine operating, dynamic physical work and sedentary work. Spine 1994;19:138-42.</p><p>Goldberg M.S., Scott S.C., Mayo N.E. A review of the association between cigarette smoking and the development of non specific back pain and related outcomes. Spine 2000;25:995-1014.</p><p>Kostova V., Koleva M. Back disorders (low back pain, cervicobrachial and lumbosacral radicular syndromes) and some related risk factors. J Neurol Sci 2001;192:17-25.</p><p>Tarulli A.W. Lumbosacral radiculopathy. Neurol Clin 2007;25(2):387-405.</p><p>Алексеев В.В., Баринов А.Н., Кукушкин М.Л. и др. Боль. Руководство для врачей и студентов. Под ред. Н.Н. Яхно. М.: МедПресс, 2009;302 с.</p><p>Malik K., Benzon H. Low back pain in Benzon: Raj's Practical Management of Pain. 4th ed. Mosby, 2008.</p><p>Попелянский Я.Ю. Ортопедическая неврология. Казань, 1997.</p><p>Смирнов А.Ю. Клиника, диагностика и лечение поясничного стеноза. Нейрохирургия 1999;2:59-64.</p><p>Long D. Surgical treatment for back and neck pain. McMahon: Wall and Melzack's Textbook of Pain, 5th ed. Churchill Livingstone, An Imprint of Elsevier, 2006.</p><p>Черненко О.А., Ахадов Т.А., Яхно Н.Н. Соотношение клинических данных и результатов магнитно-резонансной томографии при болях в пояснице. Неврол журн 1996;2:12-6.</p><p>Gregory D.S., Seto C.K., Wortley G.C. Acute lumbar disk pain: navigating evaluation and treatment choices. Am Fam Physician 2008;78(7):835-42.</p><p>Jarvik J.G., Deyo R.A. Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med 2002;137(7):586-97.</p><p>Jensen T.S., Albert H.B., Soerensen J.S. et al. Natural course of disc morphology in patients with sciatica: an MRI study using a standardized qualitative classification system. Spine 2006;31(14):1605-12.</p><p>Команцев В.Н., Заболотных В.А. Методические основы клинической электронейромиографии. СПб: Лань, 2001;350 с.</p><p>Levin K.H. Electrodiagnostic approach to the patient with suspected radiculopathy. Neurol Clin 2002;20(2):397-421.</p><p>Stafford M.A., Peng P., Hill D.A. Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Brit J Anaesth 2007;99(4):461-73.</p><p>Kelly M. Pain due to pressure on nerves. Spinal tumours and the intervertebral disc. Neurology 1956;6:32-6.</p><p>Lindahl O., Rexed B. Histological changes in spinal nerve roots of operated cases of sciatica. Acta Orthop Scand 1951;20:215-25.</p><p>Благодатский М.Д., Солодун Ю.В. Об аутоиммунном компоненте воспалительных реакций при корешковых синдромах поясничного остеохондроза. Журн неврол и психиатр 1988;4:48-51.</p><p>Болезни нервной системы. Рук-во для врачей. Под ред. Н.Н. Яхно. Т.1. M.: Медицина, 2005;744 с.</p><p>Латышева В.И., Антонов И.П., Борткевич Л.Г. Аутоиммунные механизмы патогенеза неврологических проявлений поясничного остеохондроза. Иммунология 1985;2:80-1.</p><p>Осна А.И., Путинцева Л.С., Атучина C. И. Аутоиммунные реакции в патогенезе остеохондроза позвоночника. Журн невропатол и психиатр 1970;11:1621-5.</p><p>McCarron R.F., Wimpee M.W., Hudkins P.G. et al. The inflammatory effects of nucleus pulposus: a possible element in the pathogenesis of low back pain. Spine 1987;12:760-4.</p><p>Saal J.S., Franson R.C., Dobrow R. et al. High levels of inflammatory phospholipase A2 activity in lumbar disc herniations. Spine 1990;15:674-8.</p><p>Piperno M., le Graverand H., Reboul P. et al. Phospholipase A2 activity in herniated lumbar discs. Spine 1997;22:2061-5.</p><p>Chen C., Cavanaugh J.M., Ozaktay C. et al. Effects of phospholipase A2 on lumbar nerve root structure and function. Spine 1997;22:1057-64.</p><p>Rydevik B.L., Pedowitz R.A., Hargens A.R. et al. Effects of acute, graded compression on spinal nerve root function and structure. An experimental study of the pig cauda equine. Spine 1991;16:487-93.</p><p>Nygaard O.P., Mellgren S.I., Osterud B. The inflammatory properties of contained and noncontained lumbar disc herniation. Spine 1997;22:2484-8.</p><p>Yabuki S., Kikuchi S., Olmarker K. et al. Acute effects ofnucleus pulposus on blood flow and endoneurial fluid pressure in rat dorsal root ganglia. Spine 1998;23:2517-23.</p><p>Brisby H., Olmarker K., Larsson K. et al. Proinflammatory cytokines in cerebrospinal fluid and serum in patients with disc herniation and sciatica. Eur Spine J 2002;11:62-6.</p><p>Burke J.G., Watson R.W.G., McCormack D. et al. Intervertebral discs which cause low back pain secrete high levels of proinflammatory mediators. J Bone Joint Surg Br 2002;84:196-201.</p><p>Takahashi H., Suguro T., Okazima Y. et al. Inflammatory cytokines in the herniated disc of the lumbar spine. Spine 1996;21:218-24.</p><p>Brisby H., Olmarker K., Rosengren L. et al. Markers of nerve tissue injury in the cerebrospinal fluid in patients with lumbar disc herniation and sciatica. Spine 1999;24:742-6.</p><p>Olmarker K., Larsson K. Tumor necrosis factor a and nucleus-pulposus-induced nerve root injury. Spine 1998;23:2538-44.</p><p>Olmarker K., Rydevik B. Selective inhibition of tumor necrosis factor-α prevents nucleus pulposus-induced thrombus formation, intra-neural oedema, and reduction of nerve conduction velocity. Spine 2001;26:863-9.</p><p>Onda A., Yabuki S., Kikuchi S. Effects of neutralizing antibodies to tumor necrosis factor-alpha on nucleus pulposus-induced abnormal nociresponses in rat dorsal horn neurons. Spine 2003;28:967-72.</p><p>Karppinen J., Korhonen T., Malmivaara A. et al. Tumor necrosis factor-α monoclonal antibody, infliximab, used to manage severe sciatica. Spine 2003;28:750-4.</p><p>Myers R., Olmarker K. Pathogenesis of sciatic pain: role of herniated nucleus pulposus and deformation of spinal nerve root and dorsal root ganglio. Pain 1998;78:99-105.</p><p>Глауров А.Г. Нарушения венозного кровообращения и методы его коррекции при вертеброгенных радикулярных синдромах. Сосудистые заболевания нервной системы. М., 1986; с. 33-4.</p><p>Yoshizawa H., Crock H. Blood supply of lumbosacral vertebrae, spinal cord, nerve roots and ganglia. Clinical anatomy and management of low back pain. Ed. by Giles L., Singer K. Butterworth/Heinemann, 1997; p. 134-55.</p><p>Миронов С.П., Ветрилэ С.Т., Крупаткин А.И. и др. Микрогемоциркуляция нервных корешков и твердой мозговой оболочки до и после дискэктомии при поясничных болях. Вестн травматол и ортопед 2006;3:57-61.</p><p>Peul W.C., van Houwelingen H.C., van den Hout W.B. The Hague Spine Intervention Prognostic Study Group et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med 2007;356(22):2245-56.</p><p>Markova T., Dhillon B.S., Martin S.I. Treatment of Acute Sciatica. American Family Physician 2007;75(1):99-100.</p><p>Weinstein J.N., Tosteson T.D., Lurie J.D. et al. Surgical vs Nonoperative Treatment for Lumbar Disk Herniation: The Spine Patient Outcomes Research Trial (SPORT): A Randomized Trial. JAMA 2006;296(20):2441-50.</p><p>Алексеев В.В. Дифференциальная диагностика и лечение болей в пояснице. РМЖ 2002;10:533-7.</p><p>Jordan J., Shawver M.T., Weinstein J. Herniated lumbar disc. Clin Evid 2004; 11:1477-92.</p><p>Neuropathic pain: the pharmacological management of neuropathic pain in adults in non-specialist settings The National Institute for Health and Clinical Excellence (NICE) guidance. 2010 http://www.nice.org.uk/guidance.</p><p>Baron R., Binder A. How neuropathic is sciatica? The mixed pain concept Orthopade 2004;33(5):568-75.</p><p>Левин О.С., Мосейкин И.А. Эффективность габапентина при дискогенной пояснично-крестцовой радикулопатии. Журн неврол и психиатр 2009;12:60-5.</p><p>Данилов А.Б., Жаркова Т.Р. Невропатический компонент при радикулопатии: диагностика и лечение. Боль 2009;4:33-7.</p><p>Grice G.R., Mertens M.K. Gabapentin as a potential option for treatment of sciatica. Pharmacotherapy 2008;28(3):397-402.</p><p>Yildirim K., Deniz O., Gureser G. et al. Gabapentin monotherapy in patients with chronic radiculopathy: The efficacy and impact on life quality. J Back and Musculoskeletal Rehabilitation 2009;22:17-20.</p><p>Heran M.K., Smith A.D., Legiehn G.M. Spinal injection procedures: a review of concepts, controversies, and complications. Radiol Clin North Am 2008;46(3):487-514.</p><p>Lavelle W.F. Interventional techniques for back pain. Clin Geriatr Med 2008;24(2):345-68.</p><p>Чурюканов М.В., Черненко О.А. Эпидуральное введение глюкокортикостероидов при люмбоишиалгии: механизмы действия, оценка эффективности. Боль 2007;14(5):46-52.</p><p>Saal J.A. Natural history and nonoperative treatment of lumbar disc herniation. Spine 1996;21(24S):2-9.</p></div><br />


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ISSN 2074-2711 (Print)
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