scholarly journals Spondyloarthrosis: pathogenesis, clinic, diagnosis and treatment (literature review and own experience)

2020 ◽  
Vol 10 (4) ◽  
pp. 61-73
Author(s):  
Anton V. Yarikov ◽  
A. A. Denisov ◽  
O. A. Perlmutter ◽  
M. Yu. Dokish ◽  
A. G. Sosnin ◽  
...  

8590% of the elderly people are diagnosed with spondyloarthrosis There are various synonyms for this disease in the literature: facet syndrome, facet pain syndrome, arthrosis of the intervertebral joints, zygapophysial joint arthrosis and spondyloarthropathy. The article analyzes the pathogenesis, clinical picture and methods of diagnosis of this disease. Modern types of conservative and surgical treatment are presented. The advantages and disadvantages of the surgical methods for the facet syndrome treatment are analyzed: instrumental denervation (radio frequency, laser, etc.), chemical denervaion and intraarticular administration of drugs. The results of our own clinical work are presented. The facet joint denervation appears to be a productive minimally invasive method of treatment of the reflex forms of spondyloarthrosis. In the early and long-term postoperative period, it leads to a persistent decrease in the intensity of pain and improvement of the quality of life with a low risk of perioperative complications.

2021 ◽  
Author(s):  
Vitaliy E. Potapov ◽  
Vladimir Alekseevich Sorokovikov ◽  
Sergey Nikolaevich Larionov ◽  
Aleksandr Petrovich Zhivotenko

The problem of the pathology of the facet joints of the lumbar spine remains significant and is medical and social due to persistent pain syndrome, high incidence of morbidity and frequent disability outcomes. The complex anatomical and topographic relationships of the facet joints, intervertebral discs and radicular nerves force clinicians to pay attention to the pathology of facet syndrome. A pair of facet joints and an intervertebral disc constitute a functional unit - a "three-component complex" and are interconnected with each other. The article examines the anatomical and morphological features and radiological classifications of degenerative changes in the facet joints, which are currently used in clinical practice. Facet joint pathologies are the most common nosological form of degenerative-dystrophic process (spondyloarthrosis) and a potential source of pain with the formation of instability of the spinal motion segment and the formation of chronic pain syndrome. The features of facet syndrome diagnostics are presented on a clinical example of surgical treatment by means of laser dereception of facet joints.


2019 ◽  
Vol 12 (4) ◽  
pp. 274-281 ◽  
Author(s):  
Yury Viktorovich Ivanov ◽  
Aleksandr Sergeevich Avdeev ◽  
Dmitry Nikolaevich Panchenkov ◽  
Alexander Vyacheslavovich Smirnov ◽  
Dmitry Vasilevich Porkhunov ◽  
...  

Inguinal hernioplasty is one of the most common surgical procedures, but the long-term results of operations leave much to be desired: there are recurrences of hernias, chronic pain syndrome, violation of testicular function in men. A modern review of the literature on the most common surgical methods of treatment of inguinal hernias is presented. Separately, describes the methods of hernioplasty with using local tissue (autodermaplasty) and with the use of mesh implants (allohernioplasty). Material allohernioplasty set out on the basis of their surgical approaches are used: traditional (open) and laparoscopic. Special attention is paid to the necessary properties of the mesh implant, the choice of the method of its fixation. The advantages and disadvantages of the most common methods of hernioplasty are listed. Currently, there is no single standard for inguinal hernioplasty. The choice of the method is based on the experience of the surgeon, technical capabilities and desires of the patient. The most commonly used methods for autoplasty are Desarda and Shouldies, and among allogernioplasty - Liechtenstein technique (traditional surgical access) and laparoscopic methods (transabdominal preperitoneal hernioplasty, total extraperitoneal hernioplasty).


2021 ◽  
Author(s):  
Sheng Guo ◽  
Changming Xiao ◽  
Chenglong Wang ◽  
Sen Li

Abstract Background: The prior objective of this study is to discuss individualized puncture path of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of the elderly with severe osteoporotic vertebral compression fractures (OVCFs).Previous studys have compared the clinical efficacy and safety of PVP and PKP. Based on their research results, we will make a further investigation about this two main operations in treating OVCFs and propose a set of original and feasible puncture plan in clinical work, which will improve efficiency and safety of PKP and PVP.Methods: We searched all the articles related to PVP and PKP in treating OVCFs on medicine database. Issues of the selected journals published from 1999 to 2020 were hand-searched by us, including experimental or review articles. Combining conclusions of these researches and clinical cases of our department, we are forged to find more common and preferred treatments for patients with OVCFs under different situations.Results: Most of thees studies revealed that there was no significant difference in relieving the back pain and improving the quality of patients’ life between PVP and PKP surgeries, which generally based on the VAS scores and Oswestry disability index(ODI) scores. However, PKP has a lower rate of bone cement leakage and incidence of adjacent vertebrae fracture than the PVP. Restoring the vertebral height and local kyphotic angle corrections of PKP are much better than that of PVP. On the other hand, more operation time, higher cost and rate of re-surgery of PKP should also be taken into consideration when we make better choice for patients. Therefore, we are forged to find individual methods for patients who are diagnosed as OVCFs.Conclusions: Both the two types of operation can significantly relieve the pain of the patients ,reduce the risk of occurring complication and mortality after OVCFs. There is no so-called best treatment for patients between PVP and PKP. We should take the comprehensive actual conditions into account when choosing surgical methods for patients with OVCFs, which is absolutely vital to us. However, individual puncture path is beneficial for us to make operations including both PKP and PVP.


2020 ◽  
Vol 24 (1) ◽  
pp. 26-33
Author(s):  
V. A. Byvaltsev ◽  
A. A. Kalinin ◽  
M. A. Aliyev ◽  
A. K. Okoneshnikova ◽  
V. V. Shepelev ◽  
...  

Chronic pain in the cervical spine is one of the relevant problems of modern vertebrology. This is due to the polyetiological formation of clinical symptoms and to the variety of surgical techniques, which are often used without taking into account the leading pathomorphological substrate of clinical symptoms. Purpose: To analyze clinical results of surgical treatment of an isolated facet-syndrome of the cervical spine using laser denervation of facet joints (FJ).Material and methods. The study included 234 patients aged in average 58 (53; 67). After provocative tests, an isolated facet-syndrome was diagnosed in them. FJ laser denervation was performed in 2013–2016. A visual analogue pain scale (VAS), neck disability index (NDI), Macnab subjective satisfaction scale and complications were used for analyzing treatment efficacy. The follow-up dynamic observation lasted for 36 months, in average, after the surgery. Results. It has been found out that the technique of laser denervation of cervical FJ is highly effective for treating patients with an isolated facet-syndrome caused by FJ degenerative diseases. Clinical efficacy is supported by a persistent positive dynamics in terms of pain syndrome and functional status at early and late postoperative periods with low risks of perioperative complications.


2019 ◽  
Vol 11 (2S) ◽  
pp. 76-82 ◽  
Author(s):  
O. S. Davydov

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.


Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.


1998 ◽  
Vol 11 (1) ◽  
pp. 113-116
Author(s):  
V. Rucco ◽  
P.-T. Basadonna ◽  
D. Gasparini

We describe a case of low back pain (LBP) secondary to a facet syndrome, with a magnetic resonance image of enlarged zygapophyseal inclusions, which both regressed with manipulative therapy. The role of the lumbar zygapophyseal inclusion in the pain syndrome remains uncertain, because there are no studies on these inclusions in the lumbar facet syndrome. The explanation of the role of manual therapy is also uncertain (adjusting joint subluxations, restoring bony alignment, reducing nuclear protrusion, reducing meniscoid entrapment or extrapment, decompressing facet joints, etc). The diagnosis of classical facet syndrome LBP was made by history-taking and physical examination. The diagnosis of intra-articular enlargements was made by magnetic resonance imaging. The manipulative therapy consisted of manipulations in rotation with the spine placed in kyphosis. Before every manipulation session, spontaneous pain, pain with pressure on the zygapophyseal joint and the range of thoracic and lumbar spine motions were evaluated. After the fourth manipulation session, the patient's pain was alleviated and the enlarged zygapophyseal inclusions were no longer visible. The clinical improvement continued at the controls one and two months after the end of the manipulative therapy. This is the first report of facet syndrome LBP with a magnetic resonance image of enlarged zygapophyseal inclusions which both regressed with manipulative therapy. It is interesting to speculate on the possible mechanisms to explain this outcome, but further studies are needed.


Author(s):  
V.A. Biletskaya ◽  
◽  
D.V. Lipatov ◽  
M.A. Frolov ◽  
◽  
...  

Today diabetes mellitus (DM) is one of the leading medical and social problems. Its complications lead to terrible concomitant pathologies that qualitatively affect the lives of patients. At the end of 2019, there were more than 463 million people with diabetes in the world and this number is increasing every year. Diabetic retinopathy (DR) is one of the most severe complications of DM on the organ of vision. Secondary neovascular glaucoma (NG) is a manifestation of the end-stage proliferative DR. This is a relatively rare but difficult-to-treat pathology that often leads working-age patients to disability and impaired social adaptation. The main objective of treatment for NG is to compensate for intraocular pressure (IOP), but conservative (drug) therapy is often ineffective. Therefore, doctors are forced to use surgical methods of treatment. At the same time, do not forget about the multiple complications during the operation, as well as in the early and late postoperative periods. A special feature of the course of NG in patients with DM is its combination with the failure of the ligamentous-capsular apparatus of the lens, iris bombage, anterior and posterior synechiae, traction retinal detachment and various hemorrhagic complications. All this allows us to talk about the so-called diabetic glaucoma (DG). Currently, drainage devices have become the standard in the treatment of refractory NG. The effectiveness of such operations according to various sources is about 70-80% of success. Purpose. To assess the condition of patients with DM in the late (10-15 years) postoperative period after performing NG drainage surgery, to analyze the effectiveness of the intervention by studying the dynamics of IOP, the presence or absence of pain syndrome and various intraocular complications. Material and methods. During the period 2006-2020, 150 patients with NG and DM were operated on in the Department of Diabetic Retinopathy of the Federal State Budgetary Institution «Endocrinology Research Centre» of the Ministry of Health of the Russian Federation. Results. In 100% of the postoperative period, the pain syndrome was stopped. And also, in 59.7% of cases, the presence of late complications: vascular thorn, EED, subatrophy and anophthalmos. Conclusion. Despite the presence of complications, drainage surgery in patients with DM continues to be an effective method of choosing surgical treatment for patients with uncompensated NG. Key words: diabetes mellitus; diabetic retinopathy; neovascular glaucoma; drainage surgery.


2020 ◽  
Vol 27 (3) ◽  
pp. 16-26
Author(s):  
Evgenii S. Baykov ◽  
Alexey V. Peleganchuk ◽  
Abdugafur J. Sanginov ◽  
Olga N. Leonova ◽  
Aleksandr V. Krutko

Purpose. Compare the clinical and radiological results of treatment of patients with spinal deformities operated on using the PSO method and corrective fusion in the lumbar spine. Materials and methods. Retrospective monocenter cohort study. The data of 42 patients were analyzed. PSO (group I) was performed in 12 patients; 30 patients had a combination of surgical methods (group II) with mandatory ventral corrective spinal fusion at levels L4-L5, L5-S1. Clinical and radiological parameters were evaluated during hospitalization and at least 1 year later. Results. Postoperative hospitalization in group I 32.5 7.4 days, 27.1 7.4 in group II (p = 0.558758). The duration of the operation in group I was 402.5 55.6 minutes, in group II 526.0 116.2 minutes (p = 0.001124); blood loss 1862.5 454.3 ml versus 1096.0 543.3 ml (p = 0.000171). In both groups, significantly improved clinical and radiological parameters after surgery and after 1 year (p 0.05). In group II, as compared with group I after surgery and more than 1 year: lower back pain according to VAS (p = 0.015424 and p = 0.015424); below ODI after 1 year was (p = 0.000001). In group I, compared with group II after surgery and after 1 year, SVA is less (p = 0.029879 and p = 0.000014), lumbar lordosis is higher (p = 0.045002 and p = 0.024120), LDI is restored more optimally (p = 0.000001 and p = 0.000002), the GAP is lower (p = 0.005845 and p = 0.002639). The ideal Russoly type is restored more often in patients of group II (p = 0,00032). Complications in group I were noted in 12 (100%) patients, in group II in 13 (43.3%) patients (p = 0.001). Conclusions. In multistep surgical treatment compared with PSO, the anterior corrective interbody fusion L4-L5, L5-S1 reliably better and more harmoniously restores the sagittal balance parameters, has significantly lower volume of intraoperative blood loss, fewer perioperative complications and significantly improves the quality of life of patients.


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