Page 73 - Special Issue Modern Trends in Scientific Research and Development, Case of Asia

International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470

Diagnostics The spinal nerve is formed by the fusion of the anterior
For the diagnosis of radiculopathy, the presence of tension axons of peripheral motor neurons that exit through the
symptoms is important. For example, the Lasegue symptom anterior lateral cleft of the spinal cord, the number of which
is characteristic - when you try to raise a straight leg while is equal to the number of spinal cord segments, with the
lying on your back, lower back pain increases. sensory neurons of the spinal cord. After fusion, the spinal
nerve (SMN) includes motor, sensory and autonomic fibers
An MRI or CT scan of the lumbosacral spine is important for and exits the spinal canal through the spinal foramen.
making the correct diagnosis, because only these studies will
allow the attending physician to detect the presence of The roots of the spinal cord lie in the subarachnoid space,
diseases such as intervertebral hernias or other diseases of filled with cerebrospinal fluid, between the arachnoid and
the spine (spondylitis, compression fractures, neoplasms). pia mater, the latter of which is tightly attached to the spinal
cord and fuses with it. SMN can be damaged by osteophyte,
Treatment of radiculopathy protrusion, hernia, surrounding tissues, such as ligaments,
The modern approach to the treatment of acute and chronic muscles, in rare cases by a tumor and other mechanical
pain in radiculopathy of the lumbosacral spine is to use non- factors. For the development of radiculopathy, a provoking
steroidal anti-inflammatory drugs and muscle relaxants. The factor is needed, which can be lifting of weight, violation of a
mechanism of their action: reduction of inflammation, pain motor stereotype, hypothermia, stress, prolonged stay in a
intensity, removal of muscle spasm. Also, during the period fixed, especially vertical, posture, bending, especially
of remission of the disease, physiotherapeutic treatment is forward [1].
carried out (electrophoresis, amplipulse, darsonvalization).
Pain can be caused by irritation or compression of one or,
Radiculopathy resulting from pathological changes in the less commonly, several spinal nerves. The most common risk
spine is one of the most severe forms of neurological factor for radiculopathy is herniated disc. Hernias at the
manifestations of vertebrogenic pathology of the peripheral cervical and lumbar level are quite common. The
nervous system. In the case of compression of the spinal intervertebral disc undergoes dehydration early enough,
root, the duration of disability is significantly increased, and cracks, the outer wall of the annulus fibrosus becomes
expensive examination and treatment are required. With an thinner, stretches, the nucleus pulposus shifts from the
inadequate assessment of the existing symptoms of center to the periphery, which leads to its bulging. This
degeneration, permanent disability with a significant process can lead to localized pain and moderate muscle
neurological deficit can occur. With a high prevalence of low tension. With the further process, the bulging increases by
back pain, symptoms of spinal root compression are several millimeters and a protrusion forms. Clinically, this is
observed in 3-5% of people in the population. The peak manifested not only by local pain, but also by a disorder of
incidence in men is at the age of 40–50 years, in women - sensitivity, asymmetry of tendon reflexes. After rupture of
50–60 years [4–7]. the posterior longitudinal ligament, a hernia or extrusion is
formed, which, depending on the localization, can compress
The leading mechanism of the pathogenesis of the SMN. The median hernia practically does not put
spondylogenicradiculo- and myelopathies is the pressure on the root, paramedian and foraminal (lateral)
compression effect on the arterial and venous vessels of the hernias are significant. Clinically, this is manifested by a
spinal root. Coarser compression leads to mechanical pronounced pain syndrome, sensory and motor disorders in
damage to the fibers. This occurs when space is limited at the area of localization of the corresponding root. However,
the site of the passage of the spinal root in the intervertebral the size of the hernia and the severity of the pain syndrome
foramen - at the level of the lateral pocket (in most cases, do not have a strict interdependence [1, 2].
with a herniated disc). A stenosing effect can also be
observed with calcification of the ligamentous apparatus At the moment, there is no single point of view regarding the
with the formation of osteophytes, hypertrophy of the mechanism of development of compression radiculopathy.
articular facets, or capsular segmental processes. A The direct effect of the compressing agent on the spinal root
combination of these changes is possible, especially with a (SMC), artery or vein, causing the development of an
significant decrease in the height of the intervertebral discs inflammatory reaction with the release of prostaglandin E2,
[7, 8]. interleukins, tumor necrosis factor, nitric oxide and other
substances, is considered as a triggering factor. Venous
Radiculopathy is a medical, social and economic problem discirculatory disorders develop. The pathogenesis of pain
that not only reduces the quality of life, activity and syndrome is quite complicated, it is not only mechanical
performance, but also causes disability of patients. The compression of the MCS, but also ischemic, since the arteries
urgency of this problem is due to the prevalence and and veins of the MCS are subjected to compression. Pain in
duration of the disease. The term "radiculopathy" comes radiculopathy manifests itself sharply, intensely, with
from the Latin words "radicula" and "pathia", which means a lumbago in the extremities and even in the head like
lesion of the spinal nerve. This is not an independent disease cervicocranialgia.
of the peripheral nervous system, but a complex of
symptoms of damage to the spinal nerves, a relatively The pain syndrome is of a mixed nature: nociceptive as a
common pathological condition, typical for an average of 10- result of irritation of peripheral nociceptors of the
15% of people over the age of 45. According to statistics, surrounding tissues, neuropathic - due to damage to the
there is no gender difference - men and women get sick spinal root, psychogenic - with chronic pain. The role of
equally. inflammation, reflex ischemia of the root, hemorrhage in the
root is also not excluded [3]. Violation of venous blood flow
in neurological manifestations of radiculopathy plays a

ID: IJTSRD37926 | Special Issue on Modern Trends in Scientific Research and Development, Case of Asia Page 68