[The role of structure-modifying agents in the treatment of back pain].

BACKGROUND: Back pain is currently one of the most urgent problems within pain syndromes. Inadequate treatment of nonspecific back pain, even with a relatively favorable prognosis, leads to its chronicity and decreases the patient's quality of life. The most common cause of vertebrogenic dorsopathies is spinal osteochondrosis. The etiopathogenetic basis of spinal osteochondrosis is degenerative and dystrophic changes in the intervertebral discs involving adjacent vertebrae, joints, and ligaments. Considering the experience of many years of using chondroprotective therapy in clinical practice, we performed an observational study using Ambene Bio to assess the change of pain severity over time in patients with osteochondrosis and back pain. AIM: To study the change in the severity of pain and its components in patients with back pain during therapy with Ambene Bio combined with standard therapy (NSAIDs and muscle relaxants). MATERIALS AND METHODS: Fifty-one patients with chronic lower back pain lasting more than 3 months were included in the study. CONCLUSION: The study results confirmed the high efficacy of Ambene Bio in patients with dorsopathies with an alternating treatment regimen (10 IM injections 2 mL every other day).

[Effect of the direct electric stimulation of the spinal cord in the treatment of neurologic complications of cervical osteochondrosis].

The results of the treatment of 92 patients with neurologic complications of cervical osteochondrosis (26 patients with isolated persistent lesions of roots C4-C7 and 66 patients with the combination of root syndromes and cervical myelopathy) are presented. The combination of direct electric stimulation of the spinal cord with different methods of surgical treatment was used. The efficacy of treatment was assessed with the scale for measuring severity of neurologic complications of cervical osteochondrosis and by electromyographic data before treatment and 1 and 6 months after the surgery. The significantly higher (p<0,05) effect of surgical treatment in the combination with direct electric stimulation of the spinal cord was shown.

Thoracic juxtafacet cyst (JFC) as a rare cause of myelopathy--an additional reference to support the instability theory.

Several causes for the development of a juxtafacet cyst (JFC) of the spine have been discussed, with a focus on instability with overload of the facet joints. In the thoracic spine, JFC is a very rare space-occupying lesion, which can lead to spinal canal stenosis with pain, myelopathic signs and neurological deficits. We report a case of a 70-year-old woman who had a posterolateral fusion of L2 to S1 and, six weeks later a L1 compression fracture. In the following period a thoracolumbar kyphosis has developed. Fourteen months after the fusion procedure a left-sided JFC T11/12 was identified on MRI and CT scans which led to myelopathic symptoms. This was not seen on former MRI scans. After surgical removal of the JFC the myelopathic symptoms were clearly reduced and the woman became pain free. This case report gives a strong support to the hypothesis that spinal instability can lead to overload of the facet joints and result in JFC.

[Use of a diode laser in surgery of intervertebral disks in osteochondrosis of the vertebral column].

The results of surgical treatment of 185 patients with osteochondrosis of the vertebral column were studied during 12 months who, after complex clinico-radial examination, were treated by puncture laser nucleoplasty of intervertebral disks using a diode laser. Stable positive effect was obtained in 84.3% of cases using minimally invasive manipulations.

Anterior C1-2 osteochondroma presenting with dysphagia and sleep apnea.

Spinal osteochondromas are rare, benign tumors of the bone. These tumors can manifest as solitary lesions or as part of a hereditary syndrome. Most spinal osteochondromas occur in the posterior cervical spine and can cause myelopathy or radiculopathy. Osteochondromas of the anterior cervical spine that cause respiratory or swallowing symptoms are rare. We present the unique case of a solitary osteochondroma of the anterior C1 vertebral arch causing obstructive sleep apnea and dysphagia in a 16-year-old female. The patient underwent resection of the tumor via a left anterior transcervical approach to the spine. The patient's symptoms resolved completely after surgery. To our knowledge, this is the first case of a sporadic osteochondroma arising from the anterior arch of the C1 vertebra causing dysphagia and obstructive apnea in a pediatric patient.

[Express-diagnostic of clinical tendency of low-back pains in elderly patients].

Diagnostics of diseases of the lumbar part of spine in elderly and senile people is difficult due to their polyethiologics, similarity of clinical currents accompanied by both pathological and age changes in an organism essentially deforming a clinical picture of a disease. Having used the experience of treatment of 2102 patients with low-back pain, the authors worked out the schemes of differential, thopical and X-ray diagnosis. All that will enable the practice doctors to diagnose the diseases in proper time and to determine the proper way of inquiry and treatment.