DIAGNOSIS AND TREATMENT OF SPONDYLOARTHROSIS
Abstract
Controversial data concerning specific syndromes of articulationes zygapophysealis (ZA) arthrosis and clinical value of this disease are still reported by many authors. Spondyloarthrosis, which is known as «facet syndrome» in foreign literature, is associated with spinal osteochondrosis, therefore, its reflex syndromes are often considered by doctors as osteochondrosis symptoms. Compression syndromes of spondyloarthrosis are still not well studied even by specialists in vertebrology because they are not common.
Paracentetic chemical stimulation was performed in the area of clinically urgent ZA in 100 studied patients in order to induce noncompression (reflex) syndromes. Analysis of localization and the character of induced pain reflex syndromes made it possible to rate these syndromes according to classification scheme. Chemical denervation of ZA removed pain reflex syndromes, depending on the pathologic impulse generated from ZA, and validated the results of these treatmentand- diagnostic blockades. In 89% of our patients with reflex syndromes of spondyloarthrosis the results were rated as excellent or very good.
Surgical management of spinal artery compression caused by marginal osteochondrous vegetation of articular processes was found to be effective in 16 patients. Excellent and very good results were found in 8 out of 11 patients following root decompression on cervical level; in 2 patients operated on thoracic level; and in 80 out of 98 patients operated on lumbar level.
When compression syndromes are combined with reflex syndromes of spondyloarthrosis («spondyloarthrosis focus»), then therapeutic measures, besides decompression, stabilization and decompression-stabilization surgical procedures, should involve conservative treatment utilizing paracentetic denervation of articulationes zygapophysealis.
About the Authors
Anatoly Andreyevich Lutsik
Novokuznetsk State Institute of Postgraduate Medicine
Russian Federation
Russian Federation
Egor Borisovich Kolotov
Novokuznetsk State Institute of Postgraduate Medicine
Russian Federation
Russian Federation
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Review
For citations:
Lutsik A.A., Kolotov E.B. DIAGNOSIS AND TREATMENT OF SPONDYLOARTHROSIS. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2004;(1):55-59. (In Russ.)
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