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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
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