[Failed back syndrome in patients after the surgery for compressive lumbosacral radiculopathy].
A study of 80 patients after the surgery for compressive lumbosacral radiculopathy revealed that myogenic trigger zones and skin zones of hyperalgesia in lumbar and low extremities on the side of radicular compression and the contralateral side were formed before the surgery. Trigger zones remained in the latent state after the surgery in 33 patients who had no anxiety and depressive symptoms before the operation. These zones were treated with exercises (a fitness program). Symptoms of anxiety and depression that predict the relapse of pain in the post-surgery period were noted in 47 patients. The relapse of pain followed the <<blazed way>> in these patients but it was caused by the pain conditioned by trigger zones formed before the surgery in the insufficiency of the antinociceptive system. Moreover, an iatrogenic zone emerged in the post-surgery scar. Treatment of this group of patients should include antidepressants (velaxin), local anesthetics (novocaine, plasters with 5% lidocaine gel) and later - a fitness program.
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Kazanskaia gosudarstvennaia meditsinskaia akademiia; Kazanskiĭ gosudarstvennyĭ meditsinskiĭ universitet; Respublikanskaia klinicheskaia bol'nitsa #2, Kazan'
Danilov
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Minkina
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D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy / Q000209:etiology; D003863:Depression / Q000188:drug therapy / Q000209:etiology; D004359:Drug Therapy, Combination; D005081:Exercise Therapy; D055111:Failed Back Surgery Syndrome / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011379:Prognosis; D011843:Radiculopathy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013117:Spinal Cord Compression / Q000150:complications* / Q000503:physiopathology / Q000601:surgery
D000779:Anesthetics, Local; D000928:Antidepressive Agents