Page 76 - Special Issue Modern Trends in Scientific Research and Development, Case of Asia

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process, is noted. Arthrosis in the area of these joints is a and the anterior inner surface of the lower leg. With the
common cause of compression of the vertebral artery. defeat of the LV root, pain in the lower back with irradiation
to the big toe, decreased sensitivity along the outer surface
Some patients have hypermobility (instability), which is of the thigh, lower leg, the middle of the back of the foot, in
manifested by pseudospondylolisthesis (anterior or, more the big toe, and paresis of the extensor of the big toe are
often, posterior) and excessive movement in the spinal noted. Compression of the S1 root leads to pain, decreased
motion segment. The evidence of long-term hypermobility is sensitivity in the area of the outer surface of the thigh, lower
the slope of the anterior-upper corner of the body of the leg and foot to the little toe and fourth toe, loss of the plantar
underlying vertebra and neoarthrosis in the area of contact and Achilles reflexes.
between the articular process and the arch.
Treatment algorithm
Subluxation of the joint according to Kovacs is characterized 1. relief of pain;
on a lateral photograph of the neck by retrospondylolisthesis 2. removal of the inflammatory process;
of the body, a violation of the relationship between the 3. strengthening of metabolic processes;
articular processes in the spinal motion segment (deviation 4. prevention of chronic pain syndrome;
of the posterior superior articular process, sliding of the 5. carrying out a full course of rehabilitation measures;
lower downward), as well as axial opening of the articular 6. prevention of relapse of exacerbations.
gap, superposition of the shadow of the underlying upper
body of the articular process on the shadow overlying Since radiculopathy has a nociceptive component of pain,
vertebra. All this contributes to the trauma of the vertebral prescription of non-steroidal anti-inflammatory drugs
artery when the articular process is close to the deep part of (NSAIDs) and muscle relaxants, which are widely used in
the transverse process. clinical practice, is pathogenetically justified. Taking into
account the presence of a neuropathic component of pain in
Neuroimaging study: magnetic resonance imaging (MRI) of radiculopathy, symptom-modifying drugs with delayed
the spine, which is the most modern, safe method, is action, anticonvulsants or antidepressants from the group of
distinguished by the absence of restrictions in the study selective inhibitors of serotonin and norepinephrine
plane and high image accuracy, which allows you to see in reuptake are also recommended [10, 11].
detail on the display screen, and then on X-ray film, sections
of the spinal column and spinal cord. When prescribing NSAIDs, there is a high risk of developing
side symptoms, and primarily gastropathy. Patients at risk
In chronic radiculopathy, demyelination and degeneration of receive omeprazole. In order to identify safe ways to solve
the spinal nerve develop, leading to hypotrophy or atrophy this problem, numerous clinical studies have been carried
of the innervated muscles and loss of tendon reflexes. The out both in Russia and abroad. It has been proven that in
clinical picture depends on the localization of the root order to reduce the dose and duration of therapy with
involved in the process. The upper cervical roots (CII – CIV), NSAIDs and anticonvulsants, it is justified to include in the
in contrast to the lower ones, are very short, therefore, they course of treatment B vitamins, which are called neurotropic
are squeezed mainly by an osteophyte or a pathologically ones, since they regulate the metabolism of the main
altered ligament. Clinically, depending on the affected root, neurotransmitters and amino acids, stimulate protein
pain and sensory disturbances are noted in the occipital and synthesis and create conditions for more successful nerve
temporal regions, in the neck or shoulder girdle. There are regeneration.
practically no motor disorders in the upper cervical region.
The lower roots are more often affected, since it is the lower Since the pathogenetic mechanisms are edema,
part of the cervical spine that experiences a very large load, inflammation, ischemia, root demyelination and
which creates the preconditions for the formation of degeneration, the drug L-lysine escinate is recommended for
intervertebral hernias. Pain and sensory disturbances spread decongestant purposes (active ingredient: escinalysinate, 1
with radiculopathy of the CV root in the shoulder girdle and ml of concentrated solution contains 1 mg of L-lysine
along the front surface of the proximal part of the shoulder, escinate). The drug is produced in the form of a concentrated
with radiculopathy of the CVI root - from the neck and solution intended for intravenous administration in
scapula to the shoulder girdle along the outer edge of the ampoules of 5 ml No. 10. L-lysine escinate is able to suppress
shoulder, the posterolateral surface of the forearm and the activity of lysosomal hydrolases, which leads to a
lateral surface of the hand to the first or second fingers, with decrease in the rate of degradation of mucopolysaccharides
radiculopathy of the CVII root - along the back surface of the in the connective tissue of the walls of small capillaries. L-
forearm to the third and fourth fingers, with radiculopathy lysine escinate has an analgesic effect, has a decongestant
CVIII root - along the medial surface of the shoulder, forearm (antiexudative) effect. Against the background of treatment,
and hand to the third, fourth or fifth fingers. In the thoracic the tone of the veins increases, the vascular-tissue
region, pain can radiate along the intercostal nerves. permeability decreases, which helps to reduce edema. The
daily dose of the drug for adults is 5-10 ml, which are diluted
In the lumbar region, as well as in the cervical region, the in 50-100 ml of sodium chloride, 0.9% solution for injection,
lower roots are often affected. With the involvement of the and administered intravenously. In the absence of the
three upper lumbar roots (LI, LII, LIII), pain, paresthesias possibility of drip introduction of L-lysine, escinat can be
within the inner and front surfaces of the thigh, groin, lower administered intravenously in a stream very slowly, 5 ml per
abdomen, pubis in the external genitalia are noted. With LIV 15 ml of saline. The maximum daily dose for adults is 20 ml.
lesion, pain and sensory disturbance are localized along the The duration of the drug use is 2–8 days, depending on the
outer anterior thighs, the anterior surface of the knee joint, effectiveness of therapy.

ID: IJTSRD37927 | Special Issue on Modern Trends in Scientific Research and Development, Case of Asia Page 71