Neurophysiological Factors Associated with Compression and Reflex Mechanisms of Lower Back Pain
- 作者: Barinova I.A.1, Erkhova L.N.1, Zhadnov V.A.2, Zorin R.A.2, Kiryukhina N.N.1, Kosolapov A.A.1, Leonov G.A.2, Burshinov A.O.2
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隶属关系:
- Ryazan Regional Clinical Hospital
- Ryazan State Medical University
- 期: 卷 31, 编号 4 (2023)
- 页面: 593-600
- 栏目: Original study
- ##submission.dateSubmitted##: 01.03.2023
- ##submission.dateAccepted##: 11.07.2023
- ##submission.datePublished##: 22.11.2023
- URL: https://journals.eco-vector.com/pavlovj/article/view/303663
- DOI: https://doi.org/10.17816/PAVLOVJ303663
- ID: 303663
如何引用文章
详细
Introduction: Vertebrogenic pain syndromes (PSs) in the lower back (LB) are among the most common neurological disorders in the population. Currently, clinical, neurophysiological and neuroimaging characteristics are used as predictors of the course and effectiveness of the treatment for vertebrogenic PSs in the LB.
Aim: To identify the neurophysiological factors associated with compression and reflex mechanisms of PSs in the LB for their differentiation in complicated diagnostic cases.
Materials and methods: The study included 73 patients, 43 of them men and 30 women of the mean age 46.5 years. Based on the results of clinical neurological examination and the magnetic resonance imaging data, reflex vertebrogenic PSs (lumboischialgia) were verified in 40 cases, and radiculopathy of L5 and/or S1 (compression vertebrogenic PSs) in 33 cases. The patients underwent stimulation electroneuromyography with record of motor and sensory responses from the lower limbs, of F- and H-response, and examination of heart rate variability.
Results: Logit regression analysis was used to create models permitting to divide patients into groups with different mechanisms of PSs based on the neurophysiological parameters. The first model demonstrated high sensitivity in the identification of predominantly compression vertebrogenic disorders with the independent factors being the mean F-wave latency and the sensory response amplitude. The second model was more sensitive in identification of reflex PSs with the main predictors being the F-response amplitude and heart rate variability parameters.
Conclusion: The identified factors reflect the role of conduction disorders in compression PSs, as well as the involvement of segmental motor neuronal apparatus and autonomic regulatory mechanisms in the reaction in reflex PSs, which are additional sources of information in taking medical decisions in complicated diagnostic cases.
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作者简介
Irina Barinova
Ryazan Regional Clinical Hospital
编辑信件的主要联系方式.
Email: barinova-irina-a2@yandex.ru
ORCID iD: 0000-0001-5384-5208
SPIN 代码: 4545-1196
Postgraduate Student of the Department of Neurology and Neurosurgery
俄罗斯联邦, RyazanLiliya Erkhova
Ryazan Regional Clinical Hospital
Email: shu-lilya1@yandex.ru
ORCID iD: 0009-0005-9097-6799
SPIN 代码: 3737-7064
MD, Cand. Sci. (Med.)
俄罗斯联邦, RyazanVladimir Zhadnov
Ryazan State Medical University
Email: vladimir.zhadnov@mail.ru
ORCID iD: 0000-0002-5973-1196
SPIN 代码: 1632-5083
MD, Dr. Sci. (Med.), Professor
俄罗斯联邦, RyazanRoman Zorin
Ryazan State Medical University
Email: zorin.ra30091980@mail.ru
ORCID iD: 0000-0003-4310-8786
SPIN 代码: 5210-5747
MD, Dr. Sci. (Med.), Associate Professor
俄罗斯联邦, RyazanNadezhda Kiryukhina
Ryazan Regional Clinical Hospital
Email: centerrsc@mail.ru
ORCID iD: 0000-0003-2561-5960
SPIN 代码: 2441-3020
MD, Cand. Sci. (Med.);
俄罗斯联邦, RyazanAndrey Kosolapov
Ryazan Regional Clinical Hospital
Email: kocolapov2@rambler.ru
ORCID iD: 0000-0001-7593-2353
SPIN 代码: 3413-4917
MD, Cand. Sci. (Med.)
俄罗斯联邦, RyazanGennadiy Leonov
Ryazan State Medical University
Email: lionlion56.leonov@yandex.com
ORCID iD: 0000-0001-5780-1675
SPIN 代码: 5115-3996
MD, Dr. Sci. (Med.), Associate Professor
俄罗斯联邦, RyazanAleksandr Burshinov
Ryazan State Medical University
Email: baomz@mail.ru
ORCID iD: 0009-0001-1708-2642
SPIN 代码: 8792-9686
MD, Dr. Sci. (Med.), Associate Professor
俄罗斯联邦, Ryazan参考
- Csiba L, Zhussupova AS, Likhachev SA, et al. A systematic review of using myorelaxants in treatment of low back pain. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2018;118(12):100–13. (In Russ). doi: 10.17116/jnevro2018118121100
- Khabirov FA. Classification and clinical diagnosis of vertebrogenic pathology. Practical Medicine. 2018;16(10):14–20. (In Russ). doi: 10.32000/2072-1757-2018-10-14-20
- Barrey CY, Le Huec J–C. Chronic low back pain: Revelance of a new classification based on the injury pattern. Orthop Traumatol Surg Res. 2019;105(2):339–46. doi: 10.1016/j.otsr.2018.11.021
- Nijs J, Apeldoorn A, Hallegraeff H, еt al. Low back pain: guidelines for the clinical classification of predominant neuropathic, nociceptive or central sensitization pain. Pain Physician. 2015;18(3):E333–46.
- Erkhova LN, Zhadnov VA. Correlation of neurophysiological characteristics of patients with lumbar vertebral chronic pain syndrome. I. P. Pavlov Russian Medical Biological Herald. 2015;(3):88–93. (In Russ).
- Li W, Gong Y, Liu J, et al. Peripheral and Central Pathological Mechanisms of Chronic Low Back Pain: A Narrative Review. J Pain Resh. 2021;14:1483–94. doi: 10.2147%2FJPR.S306280
- Seliverstova EG, Sinkin MV, Kordonsky AYu, et al. Electrodiagnostic evaluation in differential diagnosis and neurosurgical treatment of radiculopathies caused by spine disorders. Diagnostic value and methodology. Zhurnal Voprosy Neirokhirurgii imeni N.N. Burdenko. 2022;86(2):109–18. (In Russ). doi: 10.17116/neiro202286021109
- Larrson B, Gerdle B, Björk J, et al. Pain Sensitivity and its Relation to Spreading on the Body, Intensity, Frequency and Duration of Pain: A Cross-Sectional Population-based Study (SwePain). Clin J Pain. 2017;33(7):579–87. doi: 10.1097/AJP.0000000000000441
- Cakit BD, Taskin S, Nacir B, et al. Comorbidity of fibromyalgia and cervical myofascial pain syndrome. Clin Rheumatol. 2010;29(4):405–11. doi: 10.1007/s10067-009-1342-5
- Nakajima N, Tani T, Kiyasu K, еt al. Unilateral repetitive tibial nerve stimulation improves neurogenic claudication and bilateral F-wave conduction in central lumbar spinal stenosis. J Orthop Sci. 2018;23(2):282–8. doi: 10.1016/j.jos.2017.12.006
- Gerwin RD. A New Unified Theory of Trigger Point Formation: Failure of Pre- and Post-synaptic Feedback Control Mechanisms. Int J Mol Sci. 2023;24(9):8142. doi: 10.3390/ijms24098142
- Lothe LR, Raven TJL, Sandbaek G, et al. Single-motor-unit discharge characteristics in lumbar multifidus muscle of acute low back pain patients. J Neurophysiol. 2019;122(4):1373–85. doi: 10.1152/jn.00004.2019
- Phuphanich ME, Convery QW, Nanda U, et al. Sympathetic Blocks for Sympathetic Pain. Phys Med Rehabil Clin N Am. 2022;33(2):455–74. doi: 10.1016/j.pmr.2022.02.002
- Parfenov VA, Kalimeeva EYu, Gerasimova ON. Management of patients with acute back pain now and 10 years ago. Neurology, Neuropsychiatry, Psychosomatics. 2019;11(1):66–71. (In Russ). doi: 10.14412/2074-2711-2019-1-66-71
- Zorin RA, Medvedeva YuI, Kurepina IS, et al. The vegetative support of purposeful activity and performance efficiency in healthy people. Nauka Molodykh (Eruditio Juvenium). 2019;7(1):38–45. (In Russ). doi: 10.23888/HMJ20197138-45
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