Low back pain (lumbar pain) due to injury of or damage to intervertebral discs is common in all societies. The loss of work time as a result of this problem is massive. Recent research suggests that melatonin may prevent or counteract intervertebral disc damage. This may be especially relevant in aging populations given that endogenous melatonin, in most individuals, dwindles with increasing age. The publications related to melatonin and its protection of the intervertebral disc are reviewed herein, including definition of some molecular mechanisms that account for melatonin’s protective actions.
Сomputed tomography (CT) is widely used in the diagnosis of degenerative pathology of the lumbar spine, but the relationship between clinical manifestations of lumbar stenosis and its anatomical prerequisites has not been sufficiently studied to date.The objective: to determine the significance of the morphometric parameters of lumbar stenosis according to CT scans and to establish their relationship with the prevailing symptoms of the disease.Material and methods. Seventy-five consecutive patients with clinically significant lumbar stenosis who underwent CT scan before surgery were enrolled in this study. The average values of thirteen different morphometric parameters were calculated at LIII–SI levels of the intervertebral discs and of the pedicels in the axial and sagittal views. The possibility of classification of clinical observations and the correlation of morphometric parameters with the clinical forms of lumbar stenosis were investigated using discriminant and logistic regression analysis. Results. CT scan with high probability allocates patients with predominant symptoms of neurogenic claudication or bilateral radiculopathy. The most significant morphometric predictors of this clinical group are the depth of the lateral recesses and the cross-sectional area of the spinal canal.Conclusion. CT scan significantly expands the informative value of magnetic resonance imaging and can be used in planning the decompressive stage of the surgery intervention in patients with lumbar spinal canal stenosis.
A complex therapy of patients with degenerative-dystrophic diseases of the spine with herniated intervertebral discs with neurological manifestations was carried out with the addition of phonophoresis Kariflex gel followed by segmental massage with Kariflex cream. The comparative evaluation of the method was carried out in 89 patients. Comparative analysis revealed the reliable efficiency of the method used. Against the background of the proposed therapy, there was a significant decrease in pain and muscle-tonic syndromes, an increase in the range of motion in the spine