Khvisuk A. Hip-Spine syndrome (pathogenesis, diagnosis, principles of treatment)

Object of investigation - Hip-spine syndrome (HSS). Purpose. To justify combination of hip joint and lumbar spine Pathologies resalted in the unified Hip-Spine syndrome on the basis of informational, analytical, clinical and laboratory investigations; to develop complex system of its diagnostics and treatment. Methods - clinical, laboratory, instrumental and statistical ones. New conceptual and methodological approach to the problem of joint pain accounting interaction intraarticular pathogene-ses factors of joint diseases with extraarticular, primarily, vertebral, ones. The advisability of integration of different nosological forms and pathogenic situations expressed in hip-spine pain and dysfunctions is proved. Metabolic, biomechanical, reflexive and algic peculiarities of HSS are determinated. The role of intra/extraarticular and vertebral factors in HSS genesis, including its clinical manifestations is stated. On the basis of interaction of the above factors three pathogenic mechanisms of HSS development are defined. The system of complex HSS diagnostics, including expert biomechanics and biochemical systems, diagnostic blocades algorythm, MRI diagnostic method of lumbar discs lability, Doppler-sonography investigations of blood circulations in hip area are developed. The system of curative measures directed to reduce pain, eliminate inflammatory and autoimmune change, improve tissues trophism, restore support and motor function is developed. The method of the soft redressment for the hip joint contractures, complex blockade for the lumbosacral spinal part are offered as well as the method of local injection therapy for muscular trigger points using ozone-oxygen mixture is offered. The blockade technique for n.n. obturatorius and external hip skin nerve and lumbar plexus is improved. Multifactor system for evaluating functional conditions of Hip-spine syndrome patients is worked out. In the course of treatment we obtained a per-sistent pain decrease in all the patients, lowering degree of functional disorders manifestation - in 84,0% of patients. The results of the above investigations are used in clinical practice in the Institute of Spine and Joint Pathology named after prof. Sytenko, and Kharkov clinic №7, Sumy regional hospital, Ukrainian institute of Neurology and Psychiatric, in the departments of traumatology and orthopedics of Kharkov Postgraduate Academy and Kharkov Medical University. Traumatology and orthopedics