nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2024-2-101-107nnp-2238Research ArticleREVIEWSОБЗОРЫInterventional diagnosis and treatment methods of discogenic and musculoskeletal low back painИнтервенционные методы диагностики и лечения дискогенной и скелетно-мышечной поясничной болиhttps://orcid.org/0000-0001-5765-3158ПташниковД. А.PtashnikovD. A.

кафедра травматологии, ортопедии и военно-полевой хирургии 

195427, Санкт-Петербург, ул. акад. Байкова, 8; 195067, Санкт-Петербург, Пискаревский просп., 47

Department of Traumatology, Orthopedics and Military Surgery 

8, Akademika Baykova St., St. Petersburg 195427; 47, Piskarevskiy Prosp., St. Petersburg 195067

drptashnikov@yandex.ruhttps://orcid.org/0000-0003-0475-4830ВолковИ. В.VolkovI. V.

195271, Санкт-Петербург, просп. Мечникова, 27

27, Mechnikov Prosp., St. Petersburg 195271

ЛимЕ. Н.LimE. N.

220100, Ургенч, ул. Аль-Хорезми, 96А

96A, Al-Horezmi St., Urgench 220100

НорматовС. Г.NormatovS. G.

220100, Ургенч, ул. Аль-Хорезми, 96А

96A, Al-Horezmi St., Urgench 220100

ЧанСу ЛиChanSu Lee

кафедра нервных болезней и нейрохирургии Института клинической медицины им. Н.В. Склифосовского 

 119021, Москва, ул. Россолимо, 11, стр. 1

Department of Nervous Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine 

11, Rossolimo St., Build. 1, Moscow 119021

ФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии им. Р.Р. Вредена» Минздрава России; ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава РоссииРоссияRussian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden; North-Western State Medical University named after I.I. Mechnikov, Ministry of Health of RussiaRussian FederationЧУЗ «Клиническая больница РЖД-Медицина»РоссияClinical Hospital RZD-MedicineRussian FederationКлиника SurgemedУзбекистанSurgemed ClinicUzbekistanФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian Federation202424042024162101107Copyright © Ptashnikov D.A., Volkov I.V., Lim E.N., Normatov S.G., Chan S.L., 20242024Пташников Д.А., Волков И.В., Лим Е.Н., Норматов С.Г., Чан С.Л.Ptashnikov D.A., Volkov I.V., Lim E.N., Normatov S.G., Chan S.L.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/2238

Low back pain (lumbar pain) is one of the most common causes of disability in the population. In cases where conservative treatment of discogenic or musculoskeletal low back pain does not have a positive effect, interventional methods of diagnosis and treatment are used, which are developing actively on the background of rapid technological progress. Being on the border of interdisciplinary interaction, interventional methods can significantly shorten the duration of conservative therapy and, in many cases, avoid surgical decompressive interventions, which are associated with a considerable risk of complications. The methods, efficacy and safety of epidural administration of glucocorticoids for discogenic radiculopathy and lumbar stenosis as well as the methods of radiofrequency denervation for musculoskeletal pain due to the facet joints and the sacroiliac joint involvement are discussed. The possibilities of drug therapy for musculoskeletal pain of the lumbar spine, and combination of non-steroidal anti-inflammatory drugs and a vitamin B complex, are discussed.

Поясничная боль (боль в нижней части спины) является одной из наиболее частых причин нетрудоспособности населения. В тех случаях, когда консервативная терапия дискогенной или скелетно-мышечной поясничной боли не дает положительного эффекта, используются интервенционные методы диагностики и лечения, которые стали активно развиваться на фоне бурного прогресса технологий. Находясь на границе междисциплинарного взаимодействия, интервенционные методы, с одной стороны, позволяют существенно сократить длительность консервативной терапии, а с другой – избежать во многих случаях хирургических декомпрессивных операций, характеризующихся существенным риском осложнений. Обсуждаются методы, эффективность и безопасность эпидурального введения глюкокортикоидов при дискогенной радикулопатии, поясничном стенозе, а также методы радиочастотной денервации при скелетно-мышечной боли, вызванной поражением фасеточных суставов и крестцово-подвздошного сочленения. Анализируются возможности лекарственной терапии скелетно-мышечной поясничной боли, комбинации нестероидных противовоспалительных препаратов и комплекса витаминов группы В. Ключевые слова: поя

поясничная дискогенная радикулопатияпоясничная скелетно-мышечная больболь в нижней части спиныинтервенционное лечениеэпидуральные блокадынуклеопластикарадиочастотная денервациявитамины группы ВМильгаммаlumbar discogenic radiculopathylumbar musculoskeletal painlow back paininterventional treatmentepidural blocksnucleoplastyradiofrequency denervationB vitaminsMilgammaReferencesHoy D, Bain C, Williams G, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012 Jun;64(6):2028-37. doi: 10.1002/art.34347. Epub 2012 Jan 9.Hoy D, Bain C, Williams G, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012 Jun;64(6):2028-37. doi: 10.1002/art.34347. Epub 2012 Jan 9.Evans L, O'Donohoe T, Morokoff A, Drummond K. The role of spinal surgery in the treatment of low back pain. Med J Aust. 2023 Jan 16;218(1):40-5. doi: 10.5694/mja2.51788. Epub 2022 Dec 11.Evans L, O'Donohoe T, Morokoff A, Drummond K. 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The authors declare that there are no conflicts of interest present.