ПУНКЦИОННАЯ ДИАГНОСТИКА И ЛЕЧЕНИЕ ВЕРТЕБРОГЕННОГО РЕФЛЕКТОРНОГО СИНДРОМА ПОЗВОНОЧНЫХ АРТЕРИЙ

Abstract

Objective. To study pathogenic mechanisms of formation of a vertebral artery reflex angiospastic syndrome caused by a combination of cervical degenerative disc disease and spondyloarthrosis, by comparing the efficacy of puncture methods for their treatment. Material and Methods. A prospective randomized controlled study of pathogenesis of vertebrogenic reflex syndrome of the vertebral arteries included 250 patients. Results. The most objective evidence of correlation between vertebral artery reflex syndrome and pathological impulses from the affected intervertebral disc (in degenerative disease) or joint (in spondyloarthrosis) is provided by a puncture diagnostic and treatment manipulation. Pain symptom which is familiar to a patient can be accurately reproduced by a solution injection into the disc or to the joint and instantly eliminated by means of alcohol-novocaine denervation. When clinical and radiographic signs of combination of cervical degenerative disc disease and spondyloarthrosis were identified the puncture diagnostic and treatment manipulations confirmed the dependence of the vertebral artery reflex syndrome mainly on degenerative disc disease in 32.4 % of cases, on spondyloarthrosis - in 6.4 % of cases, and equally on degenerative disc disease and spondyloarthrosis - in 59.6 % of cases. Conclusion. Vertebral artery vertebrogenic reflex syndrome more often depends on a combination of pathological impulses from the intervertebral disc and from the facet joint, so insufficient therapeutic effect of either disc or joint denervation should prompt their combined consecutive application. Hir. Pozvonoc. 2014; (1):78-85.