Romanenko V. Clinic, diagnostics and treatment of chronic vertebrogenic lumbosacral pain syndromes with neuropathic component

Scientific work is devoted to the study of clinical, neurophysiological and psychological characteristics of patients with chronic vertebrogenic lumbosacral pain syndromes with neuropathic component with or without irradiation of pain in the leg, as well as optimization of diagnostics and treatment. Clinical and neurological characteristics, peculiarities of depression, anxiety, sleep disorders and autonomic dysfunction in patients with chronic vertebrogenic lumbosacral pain syndromes were studied. Its peculiarities depending on the group according to the Quebec task force classification of spinal disorders were found. Ukrainian version of the DN4 questionnaire was validated for the purposes of determination of neuropathic component of low back and leg pain. Nociceptive flexor reflex was studied and its main parameters, by which it is possible to identify presence of neuropathic component of pain, were found. It was shown that the use of amitriptyline in patients with chronic vertebrogenic lumbosacral pain syndromes reduces pain intensity, improves neurophysiological and psychological parameters, quality of life and quality of sleep. System of discriminant equations was developed for determination of neuropathic component of pain. Diagram of the diagnostic signs was developed for determination of the leading mechanism of pain and choice of treatment in patients with chronic vertebrogenic lumbosacral pain syndromes.