MODERN CLINICAL AND SCIENTIFIC APPROACHES TO METHODS FOR ASSESSING PAIN SYNDROME IN VBDR
Keywords:
Vertebrogenic lumbar radiculopathy, VBDR, gender differences, pain biomarkers, NGF, S100B, cortisol, serotonin, MRI, DTI, ENMG, SSEPs, TMS, neurophysiological diagnostics, personalized rehabilitation, hormonal influence, perineural fibrosis, neuroinflammation.Abstract
Vertebrogenic lumbar radiculopathy (VBDR) is a multifactorial condition involving intervertebral disc degeneration, facet joint osteoarthritis, paravertebral muscle changes, and nerve root compression. Its pathogenesis is influenced by physical, hormonal, and psychoemotional factors, with gender-specific differences affecting pain perception, muscle response, and compensatory mechanisms. Laboratory biomarkers such as NGF, S100B, cortisol, and serotonin reflect peripheral sensitization, glial activation, HPA-axis function, and pain modulation, providing insight into disease severity and treatment response. Neurovisualization methods—including MRI, DWI/DTI, CT/myelography, and high-frequency ultrasound—allow detailed assessment of structural and microstructural changes, highlighting gender-dependent variations in perineural fibrosis and inflammatory response. Neurophysiological assessments, including ENMG, SSEPs, and TMS, offer functional evaluation of nerve root and corticospinal integrity, with observed differences between men and women linked to hormonal status. Integration of laboratory, neurophysiological, and imaging data enables personalized, gender-sensitive rehabilitation strategies, optimizing pain management, functional recovery, and prognosis in VBDR.
References
Misterska, E., Jankowski, R., & Głowacki, M. (2013). Chronic pain coping styles in patients with herniated lumbar discs and coexisting spondylotic changes treated surgically: Considering clinical pain characteristics, degenerative changes, disability, mood disturbances, and beliefs about pain control. Medical Science Monitor, 19, 1241–1251. Gatchel, R. J., Polatin, P. B., & Mayer, T. G. (1988). The dominant role of psychosocial risk factors in the development of chronic low back pain disability. Pain, 34(2), 171–184.
Kovacs, F. M., Muriel, A., Bago, J., & Gestoso, M. (2015). Strategies for coping with chronic lower back pain in patients with long physiotherapy wait time. Medical Science Monitor, 21, 1832–1840.
Hancock, M. J., Maher, C. G., Latimer, J., & McAuley, J. H. (2007). Multidisciplinary interventions for chronic low back pain. Cochrane Database of Systematic Reviews, 2007(2), CD000963.
Keefe, F. J., Rumble, M. E., Scipio, C. D., Giordano, L. A., & Perri, L. M. (2004). Psychological aspects of persistent pain: Current state of the science. The Journal of Pain, 5(4), 195–211. Nicholas, M. K., Molloy, A. R., Tonkin, L., & Beeston, L. (2007). Manage your pain: Practical and positive ways of adapting to chronic pain. Sydney, Australia: ABC Books.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer Publishing Company.
Trevlakis, E., Papadoloulou, A.-X., Papadopoulou, O., & Trevlaki, E. (2022). Patient’s coping strategies on chronic low back pain. Biomedical Research Journal, 33(2), 1–9.
Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T., Shekelle, P., & Owens, D. K. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147(7), 478–491.
Breivik, H., Collett, B., Ventafridda, V., Cohen, R., & Gallacher, D. (2006). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain, 10(4), 287–333. Mitykovskiy, S. V., Kiparisova, E. S., & Mitykovskiy, V. G. (2021). Chronic back pain: Diagnostic criteria and analysis of coping strategies (review). Saratov Scientific Medical Journal, 17(3), 45–52.
Sabirova, M. Z., Sibgatullin, M. M., & Altunbaev, R. A. (2010). Analysis of modern therapeutic approaches to acute and chronic back pain. Neurology Bulletin, 5(2), 10–18.
Levin, O. S., Vasenina, E. E., Nebozhin, A. I., & Nikitina, A. Y. (2023). Treatment algorithm for chronic vertebrogenic back pain: The role of chondroprotectors. Clinician, 8(1), 45–53. Vasilyuk, F. E. (1984). Psychology of experience: Analysis of overcoming critical situations. Moscow: Moscow University Press.
Misterska, E., Jankowski, R., & Głowacki, M. (2012). Pain coping strategies and disability in lumbar disc herniation patients. Ortopedia Traumatologia Rehabilitacja, 14(2), 123–131.
