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Problems of late diagnosis and surgical treatment of single-level herniated intervertebral discs of the lower cervical spine

https://doi.org/10.56618/2071-2693_2024_16_1_8

EDN: AFVBMR

Abstract

INTRODUCTION. The frequency of clinical manifestations of osteochondrosis of the cervical spine reaches 42 % of all clinical symptoms of the peripheral nervous system, and the development of osteochondrosis of the cervical spine does not depend on the professional affiliation of the patient and 80% of patients are affected by the roots of C6 or C7. Therefore, the analysis of clinical manifestations of cervical pain syndrome in patients with herniated intervertebral discs of the cervical spine to find ways to improve the effectiveness of surgical treatment remains relevant.

AIM. To analyze the clinical manifestations of cervical pain syndrome in patients suffering from hernias of the lower cervical spine to improve the results of their surgical treatment.

MATERIALS AND METHODS. The clinical data of 38 patients were evaluated, taking into account the data of the results of neuroimaging of the cervical spine with magnetic resonance imaging (MRI), spiral X-ray computed tomography (CT), questionnaires, as well as according to the examination standard, the severity of pain syndrome according to VAS in the cervical spine and in the upper extremities, the level of quality of life of patients associated with the index of movement restriction in the cervical spine Neck Disability Index (NDI). before the surgical intervention, in the early postoperative period (on day 10) and 6, 12 months after it.

RESULTS. According to the survey, among patients with single-level herniated discs of the cervical spine, women with a previously established diagnosis of osteochondrosis of the cervical spine, with protrusions of the lower cervical discs, who received conservative treatment, living in the city, engaged in sedentary work and intellectual occupation prevailed. In all patients, against the background of conservative treatment, the condition worsened in the fall, with increased pain, during the daytime, radicular pain syndrome was associated with an increase in neurological symptoms of prolapse (hypesthesia, muscle hypotrophy), however, in all cases it was not possible to establish a provoking factor of increased pain syndrome. All patients underwent classic retropharyngeal Clovard access, total microdiscectomy with bilateral foraminotomy, resection of the posterior longitudinal ligament with stabilization by cage and plate. Pain syndrome, assessed on the VAS scale, regressed completely on the 10th day of the postoperative period.

CONCLUSION. To improve the results of neurological deficit recovery after microsurgical removal of herniated intervertebral discs of the cervical spine, it is necessary to carry it out in a timely manner: with increased cervical pain syndrome, as well as the presence of radicular pain syndrome with an increase in neurological symptoms of prolapse.

About the Authors

I. V. Balyazin-Parfenov
Rostov State Medical University
Russian Federation

Balyazin-Parfenov Igor Viktorovich,  

29, Nakhichevansky lane, Rostov-on-Don, 344022.



V. A. Balyazin
Rostov State Medical University
Russian Federation

Balyazin Victor Alexandrovich,

29, Nakhichevansky lane, Rostov-on-Don, 344022.



G. A. Bulguryan
Rostov State Medical University
Russian Federation

Bulguryan Grigory Alexeevich,

29, Nakhichevansky lane, Rostov-on-Don, 344022.



G. P. Zolotykh
Rostov State Medical University
Russian Federation

Zolotykh Gleb Pavlovich,

29, Nakhichevansky lane, Rostov-on-Don, 344022.



S. S. Todorov
Rostov State Medical University
Russian Federation

Todorov Sergey Sergeevich,

29, Nakhichevansky lane, Rostov-on-Don, 344022.



V. Yu. Deribas
Rostov State Medical University
Russian Federation

Deribas Victoriya Yurievna,

29, Nakhichevansky lane, Rostov-on-Don, 344022.



V. G. Efanov
Rostov Regional Clinical Hospital No. 1
Russian Federation

Efanov Vladimir Georgievich,

170, Blagodatnaya str., Rostov-on-Don, 344015.



N. N. Khalyavkin
Rostov Regional Clinical Hospital No. 1
Russian Federation

Khaliavkin Nikolay Nikolaevich,

170, Blagodatnaya str., Rostov-on-Don, 344015.



R. Sh. Abu Avimer
Rostov State Medical University
Russian Federation

Abu Avimer Ramzi Shaban,

29, Nakhichevansky lane, Rostov-on-Don, 344022.



References

1. Тюлькин О. Н., Щедренок В. В., Захматова Т. В. и др. Опыт хирургического лечения стеноза позвоночного канала у пациентов с дегенеративными заболеваниями шейного и поясничного отделов позвоночника // Хирургия позвоночника. 2011. № 4. С. 69–74. [Tyulkin O. N., Shchedrenok V. V., Zakhmatova T. V., Kaurova T. A., Moguchaya O. V. Experience of surgical treatmentfor spinal canal stenosisin patients with degenerativecervical and lumbar spine diseases. Khirurgiya Pozvonochnika. 2011;(4):69–74. (In Russ.)]. https://doi.org/10.14531/ss2011.4.69-74.

2. Хижняк М. В., Педаченко Ю. Е., Танасейчук А. Ф. и др. Ближайшие и отдаленные результаты дифференцированного хирургического лечения пациентов с множественными грыжами шейного отдела позвоночника // Военная медицина. 2017. № 4. С. 50–52. [Hizhnyak M. V., Pedachenko Yu. E., Tanaseychuk A. F., Fuhrman A. N., Bondarchuk Yu. A. The immediate and long-term results of differentiated surgical treatment of patients with multiple hernias of the cervical spine. Voennaya Meditsina. 2017;(4):50–52. (In Russ.)].

3. Абакиров М. Д., Чмутин Г. И., Аль Баварид О. А. и др. Эффективность интервенционной хирургии в лечении хронической боли шейного отдела позвоночника и плечевого сустава // Вестн. РУДН. Сер.: Медицина. 2022. Т. 26, № 2. С. 129–137. [Abakirov M. D., Chmutin G. E., Al-Bawareed O. A., Panin M. A., Alenizi A. A., Petrosyan A. S. et al. Interventional surgery effectiveness in treatment of the cervical spine and shoulder joint chronic pain. RUDN Journal of Medicine. 2022;26(2):129–137. (In Russ.)]. https://doi.org/10.22363/2313-0245-2022-26-2-129-137.

4. Балязин-Парфенов И. В., Басанкин И. В., Балязин В. А. и др. Экспериментальная модель межтелового импланта для стабилизации шейных позвонков после удаления грыжи межпозвонкового диска на основе СКТ-метрических данных (краткий обзор литературы и собственные исследования) с апробацией его в кадаверном эксперименте // Российский нейрохирург. журн. им. проф. А. Л. Поленова. 2023. Т. 15, № 2. С. 6–12. [Balyazin-Parfenov I. V., Basankin I. V., Balyazin V. A., Balyazina E. V., R. Sh. Medvedov R. Sh., Bagaudinov A. B., Gyulzatyan A. A., Tulendinov G. R., Zolotykh G. P., Zibrova L. A., Skoropis A. V. Experimental model of an interbody implant for stabilization of cervical vertebrae after removal of a herniated intervertebral disc based on SCT metric data (a brief review of the literature and our own research) with testing it in a cadaver experiment. Russian Neurosurgical Journal named after Professor A. L. Polenova. 2023;15(2):6–12. (In Russ.)]. Doi: 10.56618/2071-2693_2023_15_2_6.

5. Алейникова И. Б., Гринь А. А., Кайков А. К. Результаты хирургического лечения больных дегенеративно-дистрофическими заболеваниями шейного и поясничного отделов позвоночника с применением динамических имплантатов. Нейрохирургия. 2015. № 4. С. 24–30. [Aleinikova I. B., Grin’ A. A., Kaikov A. K. The treatment outcomes at patients with degenerative dystrofic diseases of cervical and lumbar spine underwent surgery with usage of dynamic spinal implants. Neirokhirurgiya. 2015;(4):24–30. (In Russ.)]. https://doi.org/10.17650/1683-3295-2015-0-4-24-30.

6. Олейник Е. А., Олейник А. А., Беляков Ю. В. и др. Количественное локационное отражение интенсивности болевого синдрома при шейном остеохондрозе // Российский нейрохирург. журн. им. проф. А. Л. Поленова. 2022. Т. 14, № 2. С. 105–107. [Oleynik E. A., Oleynik A. A., Belyakov Yu. V., Oleynik A. D., Orlov A. Yu., Ivanova N. E. Quantitative location reflection of the intensity of pain syndrome in neck osteochondrosis. Rossiiskii neirokhirurgicheskii zhurnal imeni professora A. L. Polenova. 2022;14(2):105–107. (In Russ.)]. EDN: NSPSRE.

7. Некоторые особенности патогенеза течения, диагностики и лечения радикуло- и миелопатичесих синдромов остеохондроза шейного отдела позвоночника (обзор) / А. А. Чехонацкий, Н. Е. Комлева, В. А. Чехонацкий, А. И. Бубашвили // Саратов. науч.-мед. журн. 2020. Т. 16, № 1. С. 64–68. [Chekhonatskiy A. A., Komleva N. E., Chekhonatskiy V. A., Bubashvili A. I. Some features of pathogenesis of the course, diagnosis and treatment of radicular and myelopathic syndromes of cervical osteochondrosis (review). Saratov Journal of Medical Scientific Research. 2020;16(1):64–68. (In Russ.)]. EDN: HZJDKD.

8. Басанкин И. B., Гюльзатян А. А., Малахов С. Б. и др. Ганглиозная киста желтой связки шейного отдела позвоночника: редкая причина миелопатического синдрома. Клиническое наблюдение и обзор литературы // Нейрохирургия. 2023. Т. 25, № 3. С. 88–92. [Basankin I. V., Gyulzatyan A. A., Malakhov S. B., Didenko V. G., Tomina M. I., Gritsaev I. E. Ligamentum flavum ganglion cyst of the cervical spine: a rare cause of myelopathy. Clinical observation and literature review. Russian journal of neurosurgery. 2023;25(3):88-92. (In Russ.)]. DOI: 10.17650/1683-3295-2023-25-3-88-92. EDN: UHTQUJ.

9. Taso М., Sommernes J. H., Kolstad F., Sundseth J., Bjorland S., Pripp А. Н. et al. A randomised controlled trial comparing the effectiveness of surgical and nonsurgical treatment for cervical radiculopathy. BMC Musculoskeletal Disorders. 2020;21(1):171. https://doi.org/10.1186/s12891-020-3188-6.

10. Порханов В. А., Басанкин И. В., Афаунов А. А. и др. Пути оптимизации оказания вертебрологической помощи в крупном регионе Российской Федерации // Хирургия позвоночника. 2020. Т. 17, № 4. С. 94–101. [Porkhanov V. A., Basankin I. V., Afaunov A. A., Kuzmenko A. V., Giulzatyan A. A. Ways to optimize providing of spine healthcare in a large region of the Russian Federation. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2020;17(4):94–101. (In Russ.)]. Doi: 10.14531/ss2020.4.94-101. EDN: XVPFQW.

11. Беляев Д. А., Мануковский В. А., Тюликов К. В. и др. Клинический случаи успешного лечения вывиха шейного позвонка // Неотложная хирургия им. И. И. Джанелидзе. 2021. № S2. С. 9–10. [Belyaev D. A., Manukovskii V. A., Tyulikov K. V., Tamaev T. I., Karasenko P. P. Klinicheskii sluchai uspeshnogo lecheniya vyvikha sheinogo pozvonka. Nneotlozhnaya khirurgiya im. I. I. Dzhanelidze. 2021;S2:9–10. (In Russ.)]. EDN: SNDYZV.

12. Mazas S., Benzakour A., Castelain J.-E., Damade C., Ghailanе S., Gille O. Cervical disc herniation: which surgery?. International Orthopaedics. 2019;(43):761–766. https://doi.org/10.1007/s00264-018-4221-3.

13. Гринь А. А., Касаткин Д. С. Факторы риска и методы профилактики хирургических осложнений шейного спондилодеза // Клин. практика. 2017. № 2. С. 56–59. [Grin A. A., Kasatkin D. S. Complications of cervical spine surgery. risk factors and preventive strategies. Klinicheskaya praktika. 2017;(2):56–59. (In Russ.)]. EDN: VTHGLR.

14. Charalampidis A., Hejrati N., Ramakonar H., Kalsi P. S., Massicotte E. M., Fehlings M. G. Clinical outcomes and revision rates following four‑level anterior cervical discectomy and fusion. Scientific Reports. 2022;12(1):5339. https://doi.org/10.1038/s41598-022-09389-1.

15. Encarnacion M. De J., Castillo R. E. B., Matos Y., Bernard E., Enelis B., Oleinikov B. et al. EasyGO-assisted microsurgical anterior cervical decompression: technical report and literature review. Neurologia i Neurochirurgia Polska – Polish Journal of Neurology and Neurosurgery. 2022;56(3):281–284. https://doi.org/10.5603/PJNNS.a2022.0027.


Review

For citations:


Balyazin-Parfenov I.V., Balyazin V.A., Bulguryan G.A., Zolotykh G.P., Todorov S.S., Deribas V.Yu., Efanov V.G., Khalyavkin N.N., Abu Avimer R.Sh. Problems of late diagnosis and surgical treatment of single-level herniated intervertebral discs of the lower cervical spine. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2024;16(1):8-17. (In Russ.) https://doi.org/10.56618/2071-2693_2024_16_1_8. EDN: AFVBMR

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