Issue: 2015, Vol. 20, No. 4
NERVOUS SYSTEM FUNCTIONAL STATUS IN PATIENTS WITH VERTEBROGENIC LUMBAR CHRONIC PAINFUL SYNDROME
- Keywords
- chronic pain, back, biopsychosocial model of pain, nociceptive pain, neuropathic pain, lumboischial- gia, radicular syndromes, central sensitization, vertebrogenic lumbar painful syndrome
- Abstarct
- Aim - to estimate nervous system functional status in patients with vertebrogenic lumbar chronic painful syndrome.Materials and methods. 100 persons were examined, first group - 40 patients with radicular syndromes, second group - 40 patients with reflectory syndromes, third group - 20 practically healthy individuals who had no complaints for back ache. Organism functional reactivity was evaluated by cardiointervalometry (R.M. Bayevsky method); status of afferent sensor systems - by short-latent somatosensor-induced potentials method; status of spinal nervous centers - by stimulative electroneuromyography.Results. Both groups demonstrated increased centralization degree in cardiac rhythm control, in the group of patients with reflectory syndromes it corresponded to compensated distress; but in the group of patients with radicular syndromes it corresponded to distress which resulted in functional disorders. Moderate tension of regulatory systems was revealed in both groups but in first group the tendency to manifested tension was marked including the tendency to activity rise of sympaticoadrenal & pituitary body-adrenal glands systems. Hyperactivity of somatosensor zone of cerebral hemisphere cortex of corresponding leg projection was revealed in both groups; it might be the indirect sign of central sensitization and the tendency to more expressed hyperactivity of somatosensor cortex zone and its work dizorganization was detected in patients with reflectory syndromes. The decrease of N45 cerebral components amplitudes of short-latent somatosensor-induced potentials was observed and this fact indirectly showed to myelinizated fast conductive fibers disorder. The detected increase of F-waves latent periods pointed to moto neuron excitability reduction and F-waves amplitude decrease - to axon injury.Conclusions: Central sensitization phenomenon was stated in patients with vertebrogenic lumbar chronic painful syndrome and it was more expressed in patients with reflectory syndromes particularly with lumboischialgy.
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