Clinical case of treatment of chronic vertebrogenic pain syndrome caused by vertebral fracture | Ukrainian Medical Journal

The article presents a clinical case of treatment of a patient with a pathological vertebral fracture of Th5–Th10 with pronounced vertebrogenic polyradiculomyelopathy. Since surgical treatment is not recommended due to concomitant diseases in the form of osteoporosis, attention is focused on pathogenetic and symptomatic treatment with an emphasis on correcting the chronic pain syndrome. Due to insufficient effectiveness, the therapy was modified to include inhalation of a xenon-oxygen mixture. After 8 sessions, the severity of pain decreased to 20 points by the Visual Analogue Scale and continued to remain at this level. In the neurological status, a decrease in the severity of paresthesias and the frequency of imperative urges to urinate was observed. In connection with the decrease in the severity of the pain syndrome, a significant decrease in the level of disability according to the Barthel index was observed. The use of new approaches to the correction of chronic pain syndrome in the form of a combination of pathogenetic therapy and xenon-oxygen inhalations allows to obtain pronounced positive dynamics, reduce the degree of disability and significantly improve the quality of life of patients with even severe organic pathology, for example, chronic pain syndrome caused by vertebral fracture.

References

1. Raja S.N., Carr D.B., Cohen M. et al. (2020) The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain, 161(9): 1976–1982. doi: 10.1097/j.pain.0000000000001939.
2. Treede R.D., Rief W., Barke A. et al. (2019) Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the international classification of diseases (ICD-11). Pain, 160(1): 19–27. doi: 10.1097/j.pain.0000000000001384.
3. Національне дослідження здоров’я населення України 2019 року (http://www.phc.org.ua/naukova-diyalnist/doslidzhennya/doslidzhennya-z-neinfekciynikh-zakhvoryuvan/nacionalne-doslidzhennya-steps-v-ukraini).
4. Зозуля І.С., Максименко М.В., Зозуля А.І. (2016) Біль: підходи до діагностики та лікування в неврології та хірургії. Укр. мед. часопис, 2(112): 37–40.
5. Віничук С.М. (ред.) (2008) Неврологія. Підручник. Здоров’я, Київ, 659 с.
6. Franks N.P., Honore E. (2004) The TREK K-2P channels and their role in general anaesthesia and neuroprotection. Trends Pharmacol. Sci., 25(11): 601–608.
7. Yamakage M., Namiki A. (2010) Xenon anesthesia: a review of its merits and demerits. Acta Anaesthesiol. Taiwan., 48(1): 28–35. doi: 10.1016/S1875-4597(10)60006-9.
8. Haase H., Moller J., Hamm B. et al. (2016) Xenon inhalation improves GABAergic inhibition and attenuates neuronal injury caused by oxygen-glucose deprivation in vitro. Neuroscience, 339: 284–295. doi: 10.1016/j.neuroscience.2016.10.042.