[Etiopathogenetic substantiation of surgical treatment of neurogenic pain syndromes]. / Etiopatogeneticheskoe obosnovanie khirurgicheskogo lecheniya neirogennykh bolevykh sindromov.

The purpose of the study was to improve classification of neurogenic (neuropathic) pain syndromes. This will make it possible to define the indications for appropriate analgesic surgery for each type of drug-resistant neurogenic pain syndrome. Incorrect management of neurogenic pain syndromes is usually associated with underestimation of pathogenetic prerequisites for its occurrence. Differentiation of compression, deafferentation and mixed neurogenic pain syndromes makes it possible to determine appropriate surgery and avoid tactical errors. Moreover, this approach allows you to save patients from unreasonable long-standing suffering. Patients with chronic pain syndromes often become disabled, sometimes in the prime of life, and isolated from society and family. Therefore, treatment of chronic pain is currently an urgent problem.

[Questionnaire of the Ryzhikh National Medical Research Centre for Coloproctology is a new tool for assessing chronic pelvic pain and pelvic organ dysfunction]. / Oprosnik NMITs koloproktologii imeni A.N. Ryzhikh ­ novyi instrument otsenki khronicheskoi tazovoi boli i narusheniya funktsii tazovykh organov.

The article presents the work of a multidisciplinary team of experts from various fields of medicine to optimize the «Questionnaire for assessing chronic pelvic pain and pelvic organ dysfunction (QCPPD) of the Ryzhikh National Medical Research Centre for Coloproctology¼ for use in clinical practice. The survey of respondents was conducted from June 28 to September 28, 2021. As a result of this survey, by repeatedly making edits and clarifications during communication with respondents, the final version was obtained, which allows assessing the patient's subjective sensations by the nature and localization of pelvic pain, sensitivity disorders and pelvic organ function. The main objective of this Questionnaire is to differentiate patients with neurogenic pain from a huge number of patients with chronic pelvic pain. This aspect will allow a more targeted approach to the diagnosis and pathogenetically justified treatment of patients, including after appropriate instrumental examinations. The work of a multidisciplinary team implies a higher degree of objectification and terminological accuracy of the Questionnaire under discussion. The presented version of the «Questionnaire for assessing chronic pelvic pain and pelvic organ dysfunction (QCPPD) of the Ryzhikh National Medical Research Centre for Coloproctology¼ will be primarily used in coloproctological patients with pelvic pain problems and anal incontinence and obstructive defecation. Further studies will be directed to the clinical evaluation of the results of the work carried out.

[Treatment of spondyloarthrosis and lumbar discopathy by combined minimally invasive techniques].

The study was performed to develop differentiated indications and determination of effectiveness of percutaneous cold plasma nucleoplasty (PCPN) of intervertebral discs combined with percutaneous radiofrequency facet denervation (PRFD) in vertebrogenic pain syndromes. 139 patients surgically treated between 2007 and 2010 were included in this study. In 46 cases PRFD was performed, PCPN in 44 and PCPN of lumbar spine combined with PRFD in 49 cases. Surgical results were assessed on 2--3rd day after surgery and after 6-12 months. Achieved results confirmed that combined technique using PCPN and PRFD in most complicated cases with arthrogenic and discogenic lumbar pain is effective.

[Management of facet pain syndrome in patients treated by microdiscectomy].

Aim of this study was to assess effectiveness of high-frequency denervation of facet joints in facet pain syndrome in patients who underwent microdiscectomy. The analyzed series included 42 patients treated by microdiscectomy 2 to 56 months before minimally invasive manipulation. The control group was made of 50 patients of similar age with facet pain syndrome who did not undergo spinal surgery. Effectiveness of treatment in the main group reached 62% while in the control group it was 82%. VAS score after 6-12 months changed from 7.6 to 3.2 and from 7.9 to 2.2 in control and mail groups, respectively. Conclusions are made about effectiveness of high-frequency denervation of facet joints in patients with failed back surgery syndrome in conditions of their careful selection for this procedure.

[Stimulating electroneuromyography in the diagnosis of neurogenic disorders of the pelvic floor muscles]. / Stimulyatsionnaya elektroneiromiografiya v diagnostike neirogennykh narushenii funktsii myshts tazovogo dna.

The article describes the technology for detecting and studying late phenomenon in stimulating electroneuromyography in order to objectively assess the state of innervation. The standard study of the motor response (M-response), Pudendal nerve terminal motor latency testing (PNTML), using the St. Mark's electrode from the external sphincter and pelvic floor muscles provides information only about efferent innervation at the distal part of the n. pudendus. At the same time, there are sparse reports in the literature on the study of the state of the mixed-fiber pudendal nerve along its entire length from its exit from the intervertebral foramen to the distal part using the St. Mark's electrode, the method is not clearly described, which, accordingly, causes the lack of application of the technique in clinical practice. The authors of this article cite the methodology for studying the late phenomenon in the form of a mixed feedback-reflex in stimulating electroneuromyography, describing the need to consistently use both methods of its registration.