nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2019-2S-76-82nnp-1124Research ArticleREVIEWSОБЗОРЫFacet joint osteoarthritis as a component of non-specific low back painОстеоартрит фасеточных суставов как одна из составляющих неспецифической боли в спинеДавыдовО. С.DavydovO. S.

125315, Москва, ул. Балтийская, 8

8, Baltiyskaya St., Moscow 125315

oleg35_69@mail.ruФГБНУ «Научно-исследовательский институт общей патологии и патофизиологии»РоссияResearch Institute of General Pathology and PathophysiologyRussian Federation201920062019112SСпецвыпуск: боль в спине и конечностях7682Copyright © Davydov O.S., 20192019Давыдов О.С.Davydov O.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1124

Back pain is a significant sociomedical problem due to its high prevalence and negative impact on quality of life. According to the latest data, the pain persists in a considerable number of patients for a year or even several years after its onset, which necessitates the search for a cause of the pain syndrome. The facet syndrome induces pain in 15–66% of cases and is most often due to facet joint osteoarthritis. A comprehensive clinical and diagnostic examination helps one to identify facet joint injury; and targeted pathogenetic and multimodal therapy, including non-steroidal anti-inflammatory drugs, provides complete pain relief in most cases and slows the progression of the disease.

Боль в спине представляет собой значимую медико-социальную проблему из-за высокой распространенности и негативного влияния на качество жизни. Согласно последним данным, у значительного числа пациентов боль сохраняется через год или даже несколько лет от момента возникновения, что определяет необходимость поиска причины болевого синдрома. Фасеточный синдром является причиной боли в 15–66% случаев и наиболее часто обусловлен остеоартритом (остеоартрозом) фасеточных суставов. Комплексное клинико-диагностическое обследование помогает установить поражение фасеточных суставов, а целенаправленная патогенетическая и мультимодальная терапия, включающая нестероидные противовоспалительные препараты, в большинстве случаев обеспечивает полное купирование боли и замедляет прогрессирование заболевания.

неспецифическая боль в спинефасеточный синдромостеоартрит (остеоартроз) фасеточных суставовнестероидные противовоспалительные препаратыэторикоксибnon-specific low back painfacet syndromefacet joints osteoarthritisnonsteroidal anti-inflammatory drugsetoricoxibReferencesHoy D, Bain C, Williams G, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028-37. doi: 10.1002/art.34347Hoy D, Bain C, Williams G, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028-37. doi: 10.1002/art.34347Balague F, Mannion AF, Pellise F, Cedraschi C. Non-specific low back pain. Lancet. 2012; 379:482-91. doi: 10.1016/S0140-6736(11)60610-7Balague F, Mannion AF, Pellise F, Cedraschi C. Non-specific low back pain. Lancet. 2012; 379:482-91. doi: 10.1016/S0140-6736(11)60610-7Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Jun 7. pii: S0140-6736(15)60692-4Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Jun 7. pii: S0140-6736(15)60692-4Матросов ДН, Галушко ЕА, Эрдес ШФ. Эпидемиология болей в нижней части спины в амбулаторной практике. Боль. 2009;4(25):23-8.Matrosov DN, Galushko EA, Erdes ShF. Epidemiology of lower back pain in outpatient practice. Bol'. 2009;4(25):23-8 (In Russ.).Яхно НН, Кукушкин МЛ, Чурюканов МВ, Сыровегин АВ. Результаты открытого мультицентрового исследования «МЕРИДИАН» по оценке распространенности болевых синдромов в амбулаторной практике и терапевтических предпочтений врачей. Российский журнал боли. 2012;3(36-37):10-4.Yakhno NN, Kukushkin ML, Churyukanov MV, Syrovegin AV. The results of the open multicenter study «MERIDIAN» to assess the prevalence of pain syndromes in outpatient practice and therapeutic preferences of doctors. Rossiiskii Zhurnal Boli. 2012;3(36-37):10-4 (In Russ.).Knaggs R. Low back pain clinical guidelines: similarities and divergent views across the pond. Br J Pain. 2017 May;11(2):70. doi: 10.1177/2049463717701809Knaggs R. Low back pain clinical guidelines: similarities and divergent views across the pond. Br J Pain. 2017 May;11(2):70. doi: 10.1177/2049463717701809Mehling WE, Gopisetty V, Bartmess E, et al. The prognosis of acute low back pain in primary care in the United States: a 2-year prospective cohort study. Spine (Phila Pa 1976). 2012 Apr 15;37(8):678-84. doi: 10.1097/BRS.0b013e318230ab20Mehling WE, Gopisetty V, Bartmess E, et al. The prognosis of acute low back pain in primary care in the United States: a 2-year prospective cohort study. Spine (Phila Pa 1976). 2012 Apr 15;37(8):678-84. doi: 10.1097/BRS.0b013e318230ab20Itz CJ, Geurts JW, van Kleef M, Nelemans P. Clinical course of non-specific low back pain: a systematic review of prospective cohort studies set in primary care. Eur J Pain. 2013 Jan;17(1): 5-15. doi: 10.1002/j.1532-2149.2012.00170.xItz CJ, Geurts JW, van Kleef M, Nelemans P. Clinical course of non-specific low back pain: a systematic review of prospective cohort studies set in primary care. Eur J Pain. 2013 Jan;17(1): 5-15. doi: 10.1002/j.1532-2149.2012.00170.xFreburger JK, Holmes GM, Agans RP, et al. The rising prevalence of chronic low back pain. Arch Intern Med. 2009 Feb 9;169(3):251-8. doi: 10.1001/archinternmed.2008.543Freburger JK, Holmes GM, Agans RP, et al. The rising prevalence of chronic low back pain. Arch Intern Med. 2009 Feb 9;169(3):251-8. doi: 10.1001/archinternmed.2008.543Manchikanti L, Pampati VS, Fellows B, et al. Prevalence of lumbar facet joint pain in chronic low back pain. Pain Physician. 1999;2:59-64.Manchikanti L, Pampati VS, Fellows B, et al. Prevalence of lumbar facet joint pain in chronic low back pain. Pain Physician. 1999;2:59-64.Schwarzer AC, Wang S, Bogduk N, et al. Prevalence and clinical features of lumbar zygapophysial joint pain: A study in an Australian population with chronic low back pain. Am Rheum Dis. 1995;54:100-6. doi: 10.1136/ard.54.2.100Schwarzer AC, Wang S, Bogduk N, et al. Prevalence and clinical features of lumbar zygapophysial joint pain: A study in an Australian population with chronic low back pain. Am Rheum Dis. 1995;54:100-6. doi: 10.1136/ard.54.2.100Bogduk N. Lumbar Facet Syndrome. In: Steven D. Waldman SD, ed. Pain Management. Philadelphia: W.B. Saunders; 2007. P. 769-76.Bogduk N. Lumbar Facet Syndrome. In: Steven D. Waldman SD, ed. Pain Management. Philadelphia: W.B. Saunders; 2007. P. 769-76.Varlotta GP, Lefkowitz TR, Schweitzer M, et al. The lumbar facet joint: a review of current knowledge: part 1: anatomy, biomechanics, and grading. Skeletal Radiol. 2011;40(1):13-23. doi: 10.1007/s00256-010-0983-4Varlotta GP, Lefkowitz TR, Schweitzer M, et al. The lumbar facet joint: a review of current knowledge: part 1: anatomy, biomechanics, and grading. Skeletal Radiol. 2011;40(1):13-23. doi: 10.1007/s00256-010-0983-4Igarashi A, Kikuchi S, Konno S, Olmarker K. Inflammatory cytokines released from the facet joint tissue in degenerative lumbar spinal disorders. Spine (Phila Pa 1976). 2004 Oct 1;29(19):2091-5. doi: 10.1097/01.brs.0000141265.55411.30Igarashi A, Kikuchi S, Konno S, Olmarker K. Inflammatory cytokines released from the facet joint tissue in degenerative lumbar spinal disorders. Spine (Phila Pa 1976). 2004 Oct 1;29(19):2091-5. doi: 10.1097/01.brs.0000141265.55411.30Genevay S, Finckh A, Payer M, et al. Elevated levels of tumor necrosis factor-alpha in periradicular fat tissue in patients with radiculopathy from herniated disc. Spine (Phila Pa 1976). 2008 Sep 1;33(19):2041-6. doi: 10.1097/BRS.0b013e318183bb86Genevay S, Finckh A, Payer M, et al. Elevated levels of tumor necrosis factor-alpha in periradicular fat tissue in patients with radiculopathy from herniated disc. Spine (Phila Pa 1976). 2008 Sep 1;33(19):2041-6. doi: 10.1097/BRS.0b013e318183bb86Gellhorn AC, Katz JN, Suri P. Osteoarthritis of the spine: the facet joints. Nat Rev Rheumatol. 2013 Apr;9(4):216-24. doi: 10.1038/nrrheum.2012.199Gellhorn AC, Katz JN, Suri P. Osteoarthritis of the spine: the facet joints. Nat Rev Rheumatol. 2013 Apr;9(4):216-24. doi: 10.1038/nrrheum.2012.199Воробьева ОВ. Фасеточный синдром как причина боли в спине. Эффективная фармакотерапия. 2012;(1):4-9.Vorob'eva OV. Facet syndrome as a cause of back pain. Effektivnaya Farmakoterapiya. 2012;(1):4-9 (In Russ.).Давыдов ОС, Павлова ЛВ, Жуков ЕВ. Фасеточный синдром. Врач. 2015;(10):8-14.Davydov OS, Pavlova LV, Zhukov EV. Facet Syndrome. Vrach. 2015;(10):8-14 (In Russ.).Van Kleef M, Vanelderen P, Cohen SP, et al. Pain originating from the lumbar facet joints. Pain Pract. 2010;10:459-69. doi: 10.1111/j.1533-2500.2010.00393.xVan Kleef M, Vanelderen P, Cohen SP, et al. Pain originating from the lumbar facet joints. Pain Pract. 2010;10:459-69. doi: 10.1111/j.1533-2500.2010.00393.xDwyer A, Aprill C, Bogduk N. Cervical zygapophyseal joint pain patterns. I: A study in normal volunteers. Spine (Phila Pa 1976). 1990 Jun;15(6):453-7. doi: 10.1097/00007632-199006000-00004Dwyer A, Aprill C, Bogduk N. Cervical zygapophyseal joint pain patterns. I: A study in normal volunteers. Spine (Phila Pa 1976). 1990 Jun;15(6):453-7. doi: 10.1097/00007632-199006000-00004Парфенов ВА, Исайкин АИ. Боли в поясничной области. Москва; 2018. 200 с.Parfenov VA, Isaikin AI. Boli v poyasnichnoi oblasti [Pain in the lumbar region]. Moscow; 2018. 200 p. (In Russ.).Diez-Ulloa MA, Almira Suarez EL, Otero Fernandez M, et al. Lordosis manoeuvre in the diagnosis of lumbar facet syndrome. Rev Esp Cir Ortop Traumatol. 2016 Jul-Aug;60(4):221-6.Diez-Ulloa MA, Almira Suarez EL, Otero Fernandez M, et al. Lordosis manoeuvre in the diagnosis of lumbar facet syndrome. Rev Esp Cir Ortop Traumatol. 2016 Jul-Aug;60(4):221-6.Gomez Vega JC, Acevedo-Gonzalez JC. Clinical diagnosis scale for pain lumbar of facet origin: systematic review of literature and pilot study. Neurocirugia (Astur). 2018 Jun 14. pii: S1130-1473(18)30051-4Gomez Vega JC, Acevedo-Gonzalez JC. Clinical diagnosis scale for pain lumbar of facet origin: systematic review of literature and pilot study. Neurocirugia (Astur). 2018 Jun 14. pii: S1130-1473(18)30051-4Kalichman L, Li L, Kim D, et al. Facet joint osteoarthritis and low back pain in the community-based population. Spine (Phila Pa 1976). 2008;33:2560-5. doi: 10.1097/BRS.0b013e318184ef95Kalichman L, Li L, Kim D, et al. Facet joint osteoarthritis and low back pain in the community-based population. Spine (Phila Pa 1976). 2008;33:2560-5. doi: 10.1097/BRS.0b013e318184ef95Saal JS. General principles of diagnostic testing as related to painful lumbar spine disorders: a critical appraisal of current diagnostic techniques. Spine (Phila. Pa. 1976). 2002;27(22):2538-45. doi: 10.1097/00007632-200211150-00027Saal JS. General principles of diagnostic testing as related to painful lumbar spine disorders: a critical appraisal of current diagnostic techniques. Spine (Phila. Pa. 1976). 2002;27(22):2538-45. doi: 10.1097/00007632-200211150-00027Chou R, Hashimoto R, Friedly J, et al. Pain Management Injection Therapies for Low Back Pain [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Mar. AHRQ Technology Assessments.Chou R, Hashimoto R, Friedly J, et al. Pain Management Injection Therapies for Low Back Pain [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Mar. AHRQ Technology Assessments.Qaseem А, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-30. doi: 10.7326/M16-2367Qaseem А, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-30. doi: 10.7326/M16-2367Парфенов ВА, Яхно НН, Кукушкин МЛ и др. Острая неспецифическая (скелетномышечная) поясничная боль. Рекомендации Российского общества по изучению боли. Неврология, нейропсихиатрия, психосоматика. 2018;10(2):4-11. doi: 10.14412/2074-2711-2018-2-4-11Parfenov VA, Yakhno NN, Kukushkin ML, et al. Acute nonspecific (musculoskeletal) low back pain. Guidelines of the Russian Society for the Study of Pain (RSSP). Nevrologiya, Neiropsikhiatriya, Psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2):4-11 (In Russ.). doi: 10.14412/2074-2711-2018-2-4-11Насонов ЕЛ, Яхно НН, Каратеев АЕ и др. Общие принципы лечения скелетно-мышечной боли: междисциплинарный консенсус. Научно-практическая ревматология. 2016; 54(3):247-65. doi: 10.14412/1995-4484-2016-247-265Nasonov EL, Yakhno NN, Karateev AE, et al. General principles of treatment for musculoskeletal pain: Interdisciplinary consensus. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2016;54(3):247-265 (In Russ.). doi: 10.14412/1995-4484-2016-247-265Roelofs PD, Deyo RA, Koes BW, et al. Nonsteroidal anti-inflammatory drugs for low back pain: an updated Cochrane review. Spine (Phila Pa 1976). 2008;33:1766-74. doi: 10.1097/BRS.0b013e31817e69d3Roelofs PD, Deyo RA, Koes BW, et al. Nonsteroidal anti-inflammatory drugs for low back pain: an updated Cochrane review. Spine (Phila Pa 1976). 2008;33:1766-74. doi: 10.1097/BRS.0b013e31817e69d3De Vecchis R, Baldi C, Di Biase G, et al. Cardiovascular risk associated with celecoxib or etoricoxib: a meta-analysis of randomized controlled trials which adopted comparison with placebo or naproxen. Minerva Cardioangiol. 2014 Dec;62(6):437-48.De Vecchis R, Baldi C, Di Biase G, et al. Cardiovascular risk associated with celecoxib or etoricoxib: a meta-analysis of randomized controlled trials which adopted comparison with placebo or naproxen. Minerva Cardioangiol. 2014 Dec;62(6):437-48.Ramey D, Watson D, Yu C, et al. The incidence of upper gastrointestinal adverse events in clinical trials of etoricoxib vs. non-selective NSAIDs: an updated combined analysis. Curr Med Res Opin. 2005;21(5):715-22. doi: 10.1185/030079905X43686Ramey D, Watson D, Yu C, et al. The incidence of upper gastrointestinal adverse events in clinical trials of etoricoxib vs. non-selective NSAIDs: an updated combined analysis. Curr Med Res Opin. 2005;21(5):715-22. doi: 10.1185/030079905X43686Malmstrom K, Sapre A, Couglin H, et al. Etoricoxib in acute pain associated with dental surgery: a randomized, double-blind, placeboand active comparator-controlled dose-ranging study. Clin Ther. 2004 May;26(5):667-79. doi: 10.1016/S0149-2918(04)90067-7Malmstrom K, Sapre A, Couglin H, et al. Etoricoxib in acute pain associated with dental surgery: a randomized, double-blind, placeboand active comparator-controlled dose-ranging study. Clin Ther. 2004 May;26(5):667-79. doi: 10.1016/S0149-2918(04)90067-7Moore R, Moore O, Derry S, et al. Responder analysis for pain relief and numbers needed to treat in a meta-analysis of etoricoxib osteoarthritis trials: bridging a gap between clinical trials and clinical practice. Ann Rheum Dis. 2010;69:374-9. doi: 10.1136/ard.2009.107805Moore R, Moore O, Derry S, et al. Responder analysis for pain relief and numbers needed to treat in a meta-analysis of etoricoxib osteoarthritis trials: bridging a gap between clinical trials and clinical practice. Ann Rheum Dis. 2010;69:374-9. doi: 10.1136/ard.2009.107805Jung SY, Jang EJ, Nam SW, et al. Comparative Effectiveness of Oral Pharmacologic Interventions for Knee Osteoarthritis: A Network Meta-analysis, 2018. Modern Rheumatol. 2018;28(6). doi: 10.1080/14397595.2018.1439694Jung SY, Jang EJ, Nam SW, et al. Comparative Effectiveness of Oral Pharmacologic Interventions for Knee Osteoarthritis: A Network Meta-analysis, 2018. Modern Rheumatol. 2018;28(6). doi: 10.1080/14397595.2018.1439694Arendt-Nielsen L, Egsgaard LL, Petersen KK. Evidence for a central mode of action for etoricoxib (COX-2 inhibitor) in patients with painful knee osteoarthritis. Pain. 2016 Aug;157(8):1634-44. doi: 10.1097/j.pain.0000000000000562Arendt-Nielsen L, Egsgaard LL, Petersen KK. Evidence for a central mode of action for etoricoxib (COX-2 inhibitor) in patients with painful knee osteoarthritis. Pain. 2016 Aug;157(8):1634-44. doi: 10.1097/j.pain.0000000000000562Moss P, Benson HAE, Will R, Wright A. Fourteen days of etoricoxib 60 mg improves pain, hyperalgesia and physical function in individuals with knee osteoarthritis: a randomized controlled trial. Osteoarthritis Cartilage. 2017 Nov;25(11):1781-91. doi: 10.1016/j.joca.2017.07.009Moss P, Benson HAE, Will R, Wright A. Fourteen days of etoricoxib 60 mg improves pain, hyperalgesia and physical function in individuals with knee osteoarthritis: a randomized controlled trial. Osteoarthritis Cartilage. 2017 Nov;25(11):1781-91. doi: 10.1016/j.joca.2017.07.009Sharma L. Osteoarthritis year in review 2015: clinical. Osteoarthritis Cartilage. 2016 Jan;24(1):36-48. doi: 10.1016/j.joca.2015.07.026Sharma L. Osteoarthritis year in review 2015: clinical. Osteoarthritis Cartilage. 2016 Jan;24(1):36-48. doi: 10.1016/j.joca.2015.07.026Cohen SP, Huang JH, Brummett C. Facet joint pain – advances in patient selection and treatment. Nat Rev Rheumatol. 2013;9(2):101- 16. doi: 10.1038/nrrheum.2012.198Cohen SP, Huang JH, Brummett C. Facet joint pain – advances in patient selection and treatment. Nat Rev Rheumatol. 2013;9(2):101- 16. doi: 10.1038/nrrheum.2012.198Manchikanti L, Helm S, Singh V. An algorithmic approach for clinical management of chronic spinal pain. Pain Physician. 2009;12(4): 225-64.Manchikanti L, Helm S, Singh V. An algorithmic approach for clinical management of chronic spinal pain. Pain Physician. 2009;12(4): 225-64.

The authors declare that there are no conflicts of interest present.