Dorsopathy ( Latin dorsum - back, patia - pathology or other Greek πάθος - disease) is a term that unites a group of diseases of the musculoskeletal system and connective tissue , the main manifestation of which is pain not of the visceral etiology , often in the back or neck , sometimes with irradiation in the trunk, head or limbs. In accordance with the WHO adopted and approved in Russia [1] international classification of diseases ( ICD-10 ) [2] , dorsopathies include various degenerative-dystrophic , inflammatory, post-traumatic, hereditary, as well as other biomechanical changes in the spinal column , accompanied by pain and violation of his mobility. The influence of pathogenetic factors in dorsopathies is complex, depending on age-related changes and other individual characteristics of human development. Dorsopathies are usually divided into three main groups: deforming dorsopathies, spondylopathies, and dorsalgia [3] . The most common variants of dorsopathies are degenerative-dystrophic changes [4] in the form of: osteochondrosis of the spine ( M42 ); spondylosis ( M47 ); spondylarthrosis; facet joint syndrome ; pain syndromes of various localization ( cervicalgia , cervicobrachialgia , cervicocranialgia , thoracalgia , lumbalgia , lumbar ischialgia , etc.); muscle-tonic disorders ( piriformis syndrome, obturator canal syndrome, scapular muscle syndrome, scalene syndrome , etc.). As well as lesions of the intervertebral discs ( M51, M52 ) in the form of hernias and protrusions , resulting in the introduction of tissue of a pathologically altered disc into the lumen of the spinal canal to develop discosis [5] , as well as narrowing of the spinal canal itself (as a result of inflammatory or degenerative processes), accompanied vertebrobasilar-neurological disorders ( radiculopathy , sciatica , sciatica , lumbago , etc.) and facilitates a more pronounced compression disorders (neuropathy, myelopathy , reduced motor and sensory innervation Until the loss of pelvic functions or development of peripheral paresis and paralysis ). Dorsopathy is the most common syndrome among diseases of the musculoskeletal system worldwide [6] [7] [8] . The many faces of morphological forms of dorsopathies and their wide distribution among the population determine the great importance of this pathology, both for the healthcare system and for patients faced with this problem. Dorsopathies are one of the main reasons for issuing a disability certificate, significantly reducing the quality of life and working capacity , thereby providing a significant economic effect , while remaining the leading reason for seeking medical attention [9] [10] after ARI . According to the results of epidemiological and sociological studies, up to 80% of the adult population experiences back pain associated with spinal pathology (at least once in a lifetime) [11] [12] , and in different age groups [13] [14] . Dorsopathies constitute the main part of the XIII class of diseases of the musculoskeletal system and connective tissue (letter M, ICD-10 ). According to the Federal State Statistics Service [15], among the causes of disability and permanent disability, this class takes third place after diseases of the circulatory system (XIII class, letter I) and malignant neoplasms (II class, letter C) [16] .
| Dorsopathy | |
|---|---|
| ICD-10 | M40 - M54 |
| ICD-9 | , , and |
Content
Causes of Dorsopathy
The most important factors associated with the motor activity of modern man and contributing to the development of dorsopathies are: The use of modern implements of production and high automation of labor in various sectors of the economy that minimize physical labor and reduce the natural load on the musculoskeletal system ; Widespread use for the movement of mechatronic vehicles , excluding active muscle contractions ( car , public transport , gyro scooter , etc.); The presence of remote communications to minimize the need for human movement in space ( telephone , cellular , computer , Internet , remote control panels , etc.); Overweight and obesity , which have a direct gravitational effect on the spinal column; The need to perform frequently repeated (routine) movements and stay in long fixed working poses (static loads), as well as the effects of various production and harmful household factors ( vibration , sound vibrations, electromagnetic radiation , smoking, etc.); A long period of training in various types of activity, accompanied by a prolonged sitting position (especially during bone growth, in childhood and adolescence), can lead to changes in muscle tone , impaired posture and changes in the physiological bends of the spine ( scoliosis , lordosis , kyphosis , kyphoscoliosis , flat back, etc.); High psycho-emotional stress, combined with individual psychophysiological characteristics, leading to an increase in the level of personal responsibility (especially among representatives of such professions as teachers, managers, financial workers, dispatchers, operators, law enforcement officers, medical workers, etc.), as well as acute or chronic stressful effects on the human body contribute to the development of muscular-tonic disorders and changes in motor stereotype ; Unnormal physical activity in combination with the specific impact of environmental factors (elevated and low temperatures, forced situation, high probability of injury , etc.) among athletes [17] and representatives of certain professions (workers, movers, builders, miners, machine operators, steelworkers, military personnel etc.) can also lead to muscle strain, changes in proprioception , impaired motor stereotype , the development of osteochondrosis and other dorsopathies.
Diagnosis of Dorsopathy
For the diagnosis of dorsopathies, methods are used such as: polling complaints; history taking ; general clinical examination; manual muscle testing; functional research methods in the form of determining the range of motion ( goniometry ) of various parts of the spine, assessing muscle strength and stability during its movements (bending, flexing, tilting and turning to the sides), as well as performing stabilography , which allows us to globally evaluate the dynamics of changes in the projection of the center of mass of the body on the surface of the support; neurological examination; radiography of the spine; magnetic resonance imaging (MRI); computed tomography ; electroneuromyography; laboratory clinical, biochemical, immunological and other studies [18] .
Dorsopathy Treatment
It includes: medical treatment [19] , including painkillers and anti-inflammatory drugs, drugs that improve tissue trophism and microcirculation, normalize muscle tone and help restore neuromuscular activity, as well as vitamins and general strengthening agents; physiotherapy , including electro-impulse treatment (electrophoresis, diodynamic currents, electromyostimulation), magnetotherapy, laser therapy, ultrasound therapy; balneotherapy (therapeutic baths, body wraps, underwater traction of the spine [20] , hydrotherapy) and mud therapy [21] ; reflexology ; manual therapy [22] and massage ; osteopathic treatments; Exercise therapy and physical rehabilitation [23] ; kinesiotape ; rational psychotherapy ; therapeutic nutrition and the use of natural drinking mineral waters [24] . In some cases, strictly for medical reasons [25] , surgical methods of treatment of dorsopathies can be used (laser evaporation of a hernia of the intervertebral disc, open or video endoscopic discectomy [26] , installation of intervertebral cages, spinal fusion [27] , metal osteosynthesis, vertebroplasty, etc. .). After performing such operations, specialized medical rehabilitation is carried out [28] [29] [30] .
Dorsopathy Prevention
It largely depends on the prevention of factors contributing to the development of dorsopathies. Important components of preventive measures are: maintaining optimal physical activity, regular exercise , swimming , hardening , normalizing body weight, giving up bad habits (including smoking ) and following the rules of a healthy lifestyle .
Literature.
- ↑ Order of the Ministry of Health of the Russian Federation dated May 27, 1997 No. 170 (as amended on January 12, 1998) “On the Transition of Russian Federation Health Care Bodies and Institutions to the International Statistical Classification of Diseases and Problems Related to Health of the Xth Revision”. zakonbase.ru (1997).
- ↑ International Classification of Diseases 10th Revision. World Health Organization (2010).
- ↑ Shostak N.A. Dorsopathies in the practice of a therapist are new treatment options. / Therapeutic Archive, 2003 No. 12.
- ↑ Ivanov M.F., Evtushenko S.K. Dorsalgia due to degenerative-dystrophic pathology of the spine / International Neurological Journal, 2009 № 3
- ↑ Big Medical Encyclopedia T. 7. https: //bme.org/index.php/ DISCOZ
- ↑ Kharitonov N.A. [(Russian medical journal): https://www.rmj.ru/articles/revmatologiya/Vozrastnye_aspekty_dorsopatiy/#ixzz5mHuY33yt Follow us: rusmedjournal on Facebook Age aspects of dorsopathies] // breast cancer medical review. - 2015. - September ( No. 17 ). - S. 994 .
- ↑ European Commission Special Eurobarometer // Eur. Commission. 2007.272 p
- ↑ Health of Russia. Atlas / ed. L.A. Boqueria. M .: NTSSSH im. A.N. Bakuleva RAMS, 2016.376 s.
- ↑ Maniadakis N., Gray A. The economic burden of back pain in the UK // Pain. 2000. Vol. 84. P. 95–103.
- ↑ Brooks PM The burden of musculoskeletal disease - a global perspective // Clin. Rheumatol. 2006. Vol. 25. P. 778–781.
- ↑ McBeth J., Jones K. Epidemiology of chronic musculoskeletal pain // Best Pract. Res. Clin. Rheumatol. 2007. Vol. 21. P. 403-425.
- ↑ Louw QA, Morris LD, Grimmer-Somers K. The prevalence of low back pain in Africa: a systematic review // BMC Musculoskelet. Disord 2007. Vol. 8. P. 105.
- ↑ Schepper EI, Damen J., van Meurs JB et al. The association between lumbar disc degeneration and low back pain: the influence of age, gender, and individual radiographic features // Spine. 2010. Vol. 35. P. 531-536.
- ↑ Moiseeva I.E., Polyakova E.V. Analysis of the structure of causes of temporary disability in general medical practice // Russian Family Doctor. 2006. No. 1: 76-79.
- ↑ Distribution of the number of persons first recognized as disabled by reason of disability . www.gks.ru. Date of appeal April 27, 2019.
- ↑ Oksenoit G.K. Healthcare in Russia 2017. Statistical digest. - FSGS. - Moscow: Rosstat, 2017 .-- 170 p. - ISBN 9785-89476-448-1 .
- ↑ Gridin L.A., Akhmerova K.Sh., Matyunina Yu.V., Medvedeva EA, Fadeev A.V. Comprehensive treatment of vertebrogenic dorsopathy with the methods of osteopathy and kinesiotherapy with physiotherapies "intrarich" as a factor in the prevention of sports injuries // Sports Medicine. 2015. No. 4. P. 7-8.
- ↑ Rachin A.P., Anisimova S.Yu. Dorsopathies: an Actual Problem of a Practitioner / Russian Medical Journal, 2012 No. 19
- ↑ Putilina M.V. Features of the diagnosis and treatment of dorsopathies in neurological practice / Consilium medicum, 2006 No. 8
- ↑ Kochuneva O.Ya. Underwater vertical traction of the spine in the comprehensive rehabilitation treatment of patients with dorsopathy of the lumbosacral level / Abstract of thesis. Candidate of Medical Sciences, Moscow, 2004 117 s
- ↑ Badalov N.G., Krikorova S.A. Mud therapy: theory, practice, problems and development prospects // Issues of balneology, physiotherapy and physiotherapy. 2012.No 3: 50-54.
- ↑ Veselovsky V.P., Popelyansky A.Ya., Sakhovsky P.I., Khabriev R.U. Rehabilitation of patients with vertebrogenic diseases of the nervous system: studies. allowance for cadets. L .: Kazan. IWL, 1982. 48 p.
- ↑ Starikov S.M., Polyaev B.A., Bolotov D.D. Physical rehabilitation in the complex treatment of patients with dorsopathies. Monograph RMAPO M .: Red Star, 2012.154 s.
- ↑ Healing waters and plants of Russia. Atlas of the Russian Geographical Society. M.: 2019. 304 p.
- ↑ Order of the Ministry of Health of the Russian Federation of 12.24.2012 N 1547н "On the approval of the standard of specialized medical care for lesions of the intervertebral disc and other parts of the spine with radiculopathy. [1]
- ↑ Big Medical Encyclopedia T.7 https: //bme.org/index.php/ DISCECTOMY
- ↑ Big Medical Encyclopedia T.24 https: //bme.org/index.php/SPONDYLODESIS
- ↑ Kozlova L.V., Kozlov S.A., Semenenko L.A. The basics of rehabilitation. Rostov-on-Don: Phoenix, 2013.447 s.
- ↑ Karepov G.V. Exercise therapy and physiotherapy in the system of rehabilitation of patients with traumatic spinal cord disease. To: Health, 1991.184.
- ↑ Medical Rehabilitation / Ed. V.M. Bogolyubov. M .: BINOM, 2007.582 s.