Comorbidities in young adults with vertebrogenic pathology and dysplastic phenotype

Людмила  Тибекина; Екатерина Спиричева; Ольга Субботина

doi:10.21638/spbu11.2021.203

Авторы

Людмила Тибекина St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation
Екатерина Спиричева St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation
Ольга Субботина St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation

DOI:

https://doi.org/10.21638/spbu11.2021.203

Аннотация

Pathological changes in the spine are often accompanied by pain syndrome at a young age. However, the significance of comorbid disorders in the formation and course of vertebrogenic pain syndrome has not been studied enough.The objective of the article to clarify the role of comorbid disorders in young adults with unclassified dysplastic phenotype in the formation of vertebrogenic pain syndrome. 61 male patients from 18 to 26 years old with pain syndrome in the spine were examined. Depending on the presence of signs of a dysplastic phenotype the patients were divided into two groups. The first group included 28 patients (median age 22 (21; 23) years), the second group consisted of 33 people (median age 23 (19; 24) years). All patients underwent a comprehensive examination, including neurological and somatic examination, neuroradiological, ultrasound and psychological methods of investigation, also took into account clinical and anamnestic data. Pain syndrome, the state of the autonomic nervous system and the presence of signs of a dysplastic phenotype were assessed using scales and indices. Statistical data processing was performed using the STATISTICA 10.0 program. Differences were considered statistically significant when p < 0.05. According to neuroimaging data, signs of widespread dysplastic and more pronounced scoliotic and kyphoscoliotic changes of the spine, vertebral anomalies, segmental instability were authentically more frequent in patients with the unclassified connective tissue dysplasia phenotype (p<0,05). They had more severe vertebrogenic pain syndrome, which was more intense and long-lasting and was on the background of a greater neurological deficit with autonomic lability and psychopathological disorders, headaches, somatic dysfunction with a prevalence of diseases of the bronchopulmonary system and ENT organs in the control group (p<0.05). Research findings allow us to consider the prevalence of pathological changes in the spine, depressive disorders, somatic and cerebral burden as factors contributing to the formation of pain syndrome in patients with vertebrogenic pathology and connective tissue insufficiency.

Ключевые слова:

young age, pain syndrome, comorbid diseases, connective tissue dysplasia, spine

Скачивания

Данные скачивания пока недоступны.

Библиографические ссылки

References

Podchufarova E. V., Yakhno N. N. Back pain. Moscow: GEOTAR-Media Publ., 2010. 368 p. (In Russian)

Shostak N. A., Pravdyuk N. G., Klimenko A. A., Shemetov D. A., Arinina E. E. Dorsalgia in Young: Peculiarities and Approaches to Treatment. Lechebnoe delo,2009, vol. 1, pp. 45–50. (In Russian)

2Dunn K. M., Hestbaek L., Cassidy J. D. Low back pain across the life course. Best practice & research Clinical rheumatology, 2013, vol. 27, no. 5, pp. 591-600. PMID: 24315141 https://doi.org/10.1016/j.berh. 2013.09.007

Demidov R. O., Lapshina S. A., Yakupova S. P., Mukhina R. G. Connective tissue dysplasia: current approaches to the clinic, diagnosis and treatment. Prakticheskaia meditsina, 2015, vol. 4–2, no. 89,pp. 37–40. (In Russian)

Shirley E. D., DeMaio M., Bodurtha J. Ehlers-danlos syndrome in orthopaedics: etiology, diagnosis, and treatment implications. Sports health, 2012, vol. 4, no. 5, pp. 394–403. PMID: 23016112 https:// doi.org/10.1177/1941738112452385

Stroev Yu. I., Churilov L. P. Systemic pathology of connective tissue. A guide for physicians. St. Petersburg: ELBI-SPb. Publ., 2014. 368 p. (In Russian)

Zemtsovsky E. V., Gorbunova V. N. Once more about hereditary connective tissue disorders and legality of the diagnosis “Connective tissue dysplasia syndrome”. Novye Sankt-Peterburgskie vrachebnye vedomosti, 2013, vol. 4, pp. 42–50. (In Russian)

Kadurina T. I., Gorbunova V. N. Connective tissue dysplasia. St. Petersburg: ELBI-SPb. Publ., 2009. 714 p. (In Russian)

Beighton P. H., Grahame R., Bird H. Hypermobility of joints. London: Springer Science & Business Media, 2011. 204 p. https://doi.org/10.1007/978–1-4471–3633-0

Chukhlovina M. L., Chukhlovin A. A. Diagnosis and treatment of dorsopathy in patients with connective tissue dysplasia. Zhurnal nevrologii i psikhiatrii im. S. S. Korsakova 2017, vol. 117, no. 7, pp. 43–46. https://doi.org/10.17116/jnevro20171177143-46. (In Russian)

Skvortsova A. V., Ivanova I. L. Clinical symptoms of diseases of the nervous system associated with connective tissue dysplasia, in adolescents. Smolenskii meditsinskii al’manakh, 2017, vol. 3, pp. 94–97.(In Russian)

Khaybullina D. Kh. Features of neurologic status in children with dorsopathy associated with connective tissue dysplasia. Prakticheskaia meditsina, 2017, vol. 1.1, no. 102, pp. 134–137. (In Russian)

Martynov A. I., Nechayeva G. I., Akatova Ye. V., Vershinina M. V., Viktorova I. A., Gol’tsova L. G., Gromova O. A., Delov R. A., Drokina O. V., Druk I. V., Dubilei G. S., Ivanova D. S., Ivanova I. L., Kalinina I. Yu., Kononova N. Yu., Kudinova E. G., Lalov Yu. V., Lisichenko O. V., Loginova E. N., Lyalyukova E. A., Maksimov V. N., Nagaeva T. A., Nadei E. V., Moskvina Yu. V., Pervichko E. I., Plotnikova O. V., Ponomareva D. A., Potapov V. V., Ryapolova E. A., Saveleva I. V., Svechnilova N. N., Seleznev A. V., Semenkin A. A., Semenova E. V., Smol’nova T. Yu., Smyalovsky V. E., Tereshchenko Yu. V., Troshin I. Yu. Tyurin A. V., Khusainova R. I., Cukanov A. Yu., Chindareva O. I., Shilova M. A., Shupina M. I., Temnikova E. A. Guidelines of the Russian Scientific Medical Society of Internal Medicine on the diagnosis, treatment and rehabilitation of patients with the connective tissue displasia (first edition). Medicinskii vestnik Severnogo Kavkaza, 2018, vol. 13, no. 1–2, pp. 143–144. (In Russian)

Kraemer J. Intervertebral Disk Diseases. Moscow: MEDpress-inform Publ., 2013. 471 p. (In Russian)

Smith T. O., Jerman E., Easton V., Bacon H., Armon K., Poland F., Macgregor A. J. Do people with benign joint hypermobility syndrome (BJHS) have reduced joint proprioception? A systematic review and meta-analysis. Rheumatology international, 2013, vol. 33, no. 11, pp. 2709–2716. PMID:23728275 https://doi.org/10.1007/s00296-013-2790-4

Henderson Sr. F. C., Austin C., Benzel E., Bolognese P., Ellenbogen R., Francomano C. A., Ireton C., Klinge P., Koby M., Long D., Patel S., Singman E. L., Voermans N. C. Neurological and spinal manifestations of the Ehlers-Danlos syndromes. American journal of medical genetics, Part C, Seminars in medical genetics 2017, vol. 175, no. 1, pp. 195–211. PMID: 28220607 https://doi.org/10.1002/ajmg.c.31549

Di Stefano G., Celletti C., Baron R., Castori M., Di Franco M., La Cesa S., Leone C., Pepe A., Cruccu G., Truini A., Camerota F. Central sensitization as the mechanism underlying pain in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type. European journal of pain (London, England),2016, vol. 20, no. 8, pp. 1319–1325. PMID: 26919608 https://doi.org/10.1002/ejp.856

Joergensen A. C., Lucas R., Hestbaek L., Andersen P. K., Andersen A.-M. N. Early-life programming of pain sensation? Spinal pain in pre-adolescents with pain experience in early life. European Journal of Pediatrics, 2019, vol. 178 (12), pp. 1903–1911. PMID: 31624948 https://doi.org/10.1007/s00431-019-034759

Gusev E. I., Kryzhanovskiy G. N. Dysregulation of the nervous system. Moscow: MIA Publ., 2009. 512 p.(In Russian)

Nevmerzhitskaya K. S., Lvova O. A., Zyuzgina E. A. Revisited the significance of undifferentiated connective tissue displasia in neurological pathology in children. Sistemnaia integratsiia v zdravookhranenii,2009, vol. 3, pp. 31–35. (In Russian)

Ivanova I. L., Kildiyarova R. R. Clinical manifestations of connective tissue dysplasia in adolescents with vertebrogenic diseases of the nervous system. Rossiiskii pediatricheskii zhurnal, 2012, vol. 4,pp. 18–22. (In Russian)

Bulbena A., Gago J., Pailhez G., Sperry L., Fullana M. A., Vilarroya O. Joint hypermobility syndrome is a risk factor trait for anxiety disorders: a 15-year follow-up cohort study. General Hospital Psychiatry,2011, vol. 33, no. 4, pp. 363–370. PMID: 21762833 https://doi.org/10.1016/j.genhosppsych.2011.03.004

Smith T. O., Easton V., Bacon H., Jerman E., Armon K., Poland F., Macgregor A. J. The relationship between benign joint hypermobility syndrome and psychological distress: a systematic review and metaanalysis.Rheumatology, 2014, vol. 53, no. 1, pp.114–122. PMID: 24080253 https://doi.org/10.1093/rheumatology/ket317

Abbakumova L. N., Arsent’ev V. G., Gnusaev S. F., Ivanova I. I., Kadurina T. I., Trisvetova E. L., Chemodanov V. V., Chukhlovina M. L. Multifactorial and hereditary connective tissue disorders in children. Diagnostic algorithms. Management tactics. Russian guidelines. Pediatr, 2016, vol. 7, no. 2, pp. 5–39.https://doi.org/10.17816/PED725-39. (In Russian)