Preview

Translational Medicine

Advanced search

Translational methods for the treatment of chronic back pain

https://doi.org/10.18705/2311-4495-2022-9-4-5-12

Abstract

Background. Up to 83 % of the working population has a high level of social adaptation disorder due to the pain in the lumbosacral spine. The development of translational approaches in the treatment of degenerative diseases of the spine is becoming increasingly important. The key methods in the differentiated approach to the treatment are laser vaporization of the intervertebral disc and radiofrequency denervation of the facet joints in the case when the pain syndrome is facet-like.
Objective. To evaluate the effectiveness of a differentiated approach in the use of minimally invasive surgical methods in patients with discogenic and vertebrogenic pain syndrome based on an analysis of the immediate results of treatment.
Design and methods. A retrospective analysis of examination and treatment data of 101 patients with degenerative-dystrophic diseases of the lumbar spine, accompanied by pain, was carried out. In 29 (28.7 %) patients, laser vaporization of the intervertebral disc was performed; in 72 (71.3 %) cases, radiofrequency denervation of the facet joints of the lumbosacral spine was used.
Results. Positive outcomes after laser vaporization were observed in 27 patients. A positive result was noted in 67 patients after radiofrequency destruction of the sinuvertebral nerve.
Conclusions. Differentiated use of minimally invasive puncture methods for the treatment of osteochondrosis of the spine and adequate selection of patients for these procedures often lead to the positive result.

About the Authors

A. V. Gorodnina
Polenov Russian Research Institute of Neurosurgery, branch of Almazov National Medical Research Centre
Russian Federation

Angelina V. Gorodnina,  junior researcher 

Mayakovsky st., 12, St. Petersburg, 191014 



A. V. Ivanenko
Polenov Russian Research Institute of Neurosurgery, branch of Almazov National Medical Research Centre
Russian Federation

Andrey V.Ivanenko, MD, Associate Professor, Department of Neurosurgery 

Saint Petersburg



References

1. Shcherbuk YuA, Parfenov VE, Svistov D.V. et al. Practical neurosurgery. Saint Petersburg: Gippocrat, 2002. p.648 In Russian [Щербук Ю.А., Парфенов В.Е., Свистов Д.В. и др. Практическая нейрохирургия. Санкт-Петербург: Гиппократ, 2002. с.648.]

2. Shchedrenok VV, Ivanenko AV, Sebelev KI et al. Minimally ivasive surgery of degenerative diseases of the spine. Vestnik khirurgii im. I.I. Grekova. 2010; 169(2):102– 104. In Russian [Щедренок В.В., Иваненко А.В., Себелев К.И. и др. Малоинвазивная хирургия дегенеративных заболеваний позвоночника. Вестник хирургии им. И.И. Грекова. — 2010; 169(2):102–104]

3. Ivanchenko V.N., Gromov M.S., Ninel V.G. et al. Minimally invasive surgeryfor treatment of discogenic pain syndrome in patients with lumbar degenerative disease. Hirurgiâ pozvonočnika=Spine Surgery. 2010; 3:48-51. In Russian [Иванченко В.Н., Громов М.С., Нинель В.Г. и др. Малоинвазивная хирургия в лечении дискогенных болевых синдромов у пациентов с поясничным остеохондрозом. «Хирургия позвоночника». 2010; 3:48- 51.] DOI: 10.14531/ss2010.3.48-51

4. Gorodnina AV, Meredzhi AM, Ivanenko AV et al. Minimally invasive neurosurgery of lumbar disc herniations. Russian Neurosurgical Journal. 2020; 12(3): 5-11 In Russian [Городнина А.В., Мереджи А.М., Иваненко А.В и др. Малоинвазивная нейрохирургия межпозвонковых грыж поясничного отдела позвоночника. Российский нейрохирургический журнал им. профессора А.Л. Поленова. 2020; 12(3): 5-11]

5. Belyakov YuV, Merzhoyev AM, Orlov AYu et al. Comparative analysis of percutaneus endoscopic interlaminar discectomy and microdiscectomy in patients with overweight. Russian Neurosurgical Journal. 2020; 12(1):12-15. In Russian [Беляков Ю.В., Мереджи А.М., Орлов А.Ю. и др. Сравнительный анализ чрезкожной эндоскопической интерламинарной дискэктоми и микродискэктомии у пациентов с избыточной массой тела. Российский нейрохирургический журнал им. профессора А.Л. Поленова. 2020; 12(1):12-15]

6. Meredzhi AM, Orlov AYu, Nazarov AS et al. Percutaneous endoscopic transforaminal and interlaminar lumbar discectomy for cranially migrated disc hernia. Hirurgiâ pozvonočnika=Spine Surgery. 2020;17(3):81-90. In Russian [Мереджи А.М., Орлов А.Ю., Назаров А.С. и др. Перкутанное эндоскопическое трансфораминальное и интерламинарное удаление грыж поясничного отдела позвоночника с краниальной миграцией//Хирургия позвоночника. 2020; 17(3):81-90] DOI: 10.14531/ss2020.3.81-90.

7. Choy DS. Percutaneous laser disc decompression. New York, USA, 2003; p.239. DOI: 10.1007/b97255

8. Choy DS, Case RB, Fielding W et al. Percutaneous laser nucleolysis of lumbar disks. N Engl J Med. 1987; 317(12):771-772. DOI: 10.1056/NEJM198709173171217.

9. Shpagin MV, Yarikov AV, Nazmeev IA et al. The experience of denervation of facet joints in the lumbar spine. Hirurgiâ pozvonočnika=Spine Surgery. 2019; 16(1):57-62. In Russian [Шпагин М.В., Яриков А.В., Назмеев И.А. и др. Опыт денервации дугоотростчатых суставов поясничного отдела позвоночника. Хирургия позвоночника. 2019; 16(1):57-62] DOI: 10.14531/ss2019.1.57-62

10. Gorbunov AV, Koshkareva ZV, Zhivzenko AP et al. The effectiveness of laser vaporization in the treatment of intervertebral hernias of the lumbar spine. Acta Biomedica Scientifica (East Siberian Biomedical Journal). 2020; 5(2):43-48 In Russian [Горбунов А.В., Кошкарева З.В., Животенко А.П. и др. Эффективность лазерной вапоризации при лечении межпозвонковых грыж поясничного отдела позвоночник. Acta Biomedica Scientifica (East Siberian Biomedical Journal). 2020;5(2):43-48] DOI: 10.29413/ABS.2020-5.2.7

11. Kurenkov E.L., Makarova V.V. Normal Anatomy of Human Intervertebral Disc. Journal of Anatomy and Histopathology. 2017;6(3):117-128. In Russian [Куренков Е.Л., Макарова В.В. Нормальная анатомия межпозвонкового диска у человека. Журнал анатомии и гистопатологии. 2017;6(3):117-128] DOI: 10.18499/2225-7357-2017-6-3-117-128

12. Shutov MV, Khovryakov AV, Belyaev AN. Morphological changes in the intervertebral disc during laser vaporization in the experiment. Modern problems of science and education. Surgery. 2011; 5:39-44. In Russian [Шутов М.В., Ховряков А.В., Беляев А.Н. Морфологические изменения в межпозвонковом диске при проведении лазерной вапоризации в эксперименте// Современные проблемы науки и образования. 2011; 5:39-44]

13. Chudnovsky VM, Ivanenko AV, Yusupov VI et al. Analysis of acoustic-hydrodynamic phenomena of laser puncture treatment of degenerative diseases of the intervertebral discs Russian Neurosurgical Journal. 2011; 3(2):52 In Russian [Чудновский В.М., Иваненко А.В., Юсупов В.И. и др. Анализ акустогидродинамических явлений лазерного пункционного лечения дегенеративных заболеваний межпозвонковых дисков. Российский нейрохирургический журнал им. профессора А.Л. Поленова. 2011; 3(2):52]

14. Cohen SP, Doshi TL, Constantinescu OC et al. Effectiveness of Lumbar Facet Joint Blocks and Predictive Value before Radiofrequency Denervation: The Facet Treatment Study (FACTS), a Randomized, Controlled Clinical Trial. Anesthesiology. 2018; 129(3):517-535. DOI: 10.1097/ALN.0000000000002274.

15. Erbas YC, Pusat S, Erdogan E. Percutaneous Laser Disc Decompression: Retrospective Analysis of 197 Cases and Review of The Literature. Turk Neurosurg. 2015; 25(5):766-770. DOI: 10.5137/1019-5149.JTN.14692-15.2.


Review

For citations:


Gorodnina A.V., Ivanenko A.V. Translational methods for the treatment of chronic back pain. Translational Medicine. 2022;9(4):5-12. (In Russ.) https://doi.org/10.18705/2311-4495-2022-9-4-5-12

Views: 460


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2311-4495 (Print)
ISSN 2410-5155 (Online)