ГоловнаArchive of numbers2024Volume 32, issue 2 (119)Markers of inflammation in degenerative-dystrophic changes of the cervical spine
Title of the article Markers of inflammation in degenerative-dystrophic changes of the cervical spine
Authors Khramtsov Denys
Vorokhta Yurii
Kalashnikov Valerii
In the section MECHANISMS OF FORMATION AND MODERN PRINCIPLES OF TREATMENT OF NEUROLOGICAL DISORDERS
Year 2024 Issue Volume 32, issue 2 (119) Pages 28-31
Type of article Scientific article Index UDK 616.248-053.2-036-074 Index BBK -
Abstract DOI: https://doi.org/10.36927/2079-0325-V32-is2-2024-4

 The purpose of the study was to evaluate the dynamics of inflammatory markers in patients with degenerative-dystrophic diseases of the cervical spine accompanied by chronic pain syndrome. 94 patients with chronic cervicalgia aged from 20 to 70 years were examined. Women predominated among those examined (59 or 62.8 %). The average age of the patients was 57.6 ± 2.1 years. An analysis of the intensity of the pain syndrome in dynamics according to VAS, functional indicators according to the NPAD and NDI scales was carried out. In addition, the content of interleukin-6 and tumor necrosis factor in the blood, as well as the content of cortisol in saliva, were evaluated by the method of solid-phase enzyme immunoassay. All patients complained of long-term pain in the neck, which had the character of cervicocranialgia in 23 (24.5 %) patients, cervicobrachialgia in 31 (33.0 %) patients, cervicothoracic pain in 14 (14.9 %), isolated cervicalgia in 26 (14.9 %) patients. Pain intensity at the time of application was 6.8 ± 0.3 points. The score for NPAD was 65.5 ± 3.7 points, for NDI — 34.5 ± 1.1 points. All patients had pain in the neck, including 62 (66.0 %) — unilateral, and limitation of neck movements. In 37 (39.4 %) patients, the pain was mainly in the left half of the neck, in 25 (26.6 %) — in the right half. In 31 (33.0 %) neck pain was accompanied by pain in the shoulder girdle or upper limbs. Goniometric evaluation of the volume of neck movements revealed its decrease in all planes, more pronounced in the transverse plane. The cortisol content in the patients’ saliva was 6.5 ± 0.1 ng/ml, the IL-6 and TNF levels were 15.5 ± 0.8 and 8.6 pg/ ml, respectively. Correlation analysis showed a significant relationship between the degree of movement limitation, pain intensity and levels of pro-inflammatory cytokines and cortisol With chronic cervical pain, the cytokine cascade is activated, which leads to an increase in the levels of IL-6 and TNF to 15.5 ± 0.8 and 8.6 pg/ml, respectively, as well as cortisol to 6.5 ± 0,1 ng/ml. The degree of severity of clinical manifestations correlates with the content of cytokines and cortisol. The severity of the inflammatory reaction in chronic cervical pain should be taken into account when choosing therapy and rehabilitation measures.
Key words degenerativedystrophic changes of the spine, cervical spine, chronic pain, inflammation, cytokines
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Bibliography 1. Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc. 2015 Feb;90(2):284-99. doi: 10.1016/j. mayocp.2014.09.008. PMID: 25659245.
2. Kazeminasab, S., Nejadghaderi, S.A., Amiri, P. et al. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 23, 26 (2022). https://doi.org/10.1186/s12891- 021-04957-4.
3. Fandim JV, Nitzsche R, Michaleff ZA, Pena Costa LO, Saragiotto B. The contemporary management of neck pain in adults. Pain Manag. 2021 Jan;11(1):75-87. doi: 10.2217/pmt-2020-0046. Epub 2020 Nov 25. PMID: 33234017.
4. Alagingi NK. Chronic neck pain and postural rehabilitation: A literature review. J Bodyw Mov Ther. 2022 Oct;32:201-206. doi: 10.1016/j.jbmt.2022.04.017. Epub 2022 Apr 20. PMID: 36180150.
5. Tan LA, Riew KD, Traynelis VC. Cervical Spine Deformity- Part 1: Biomechanics, Radiographic Parameters, and Classification. Neurosurgery. 2017 Aug 1;81(2):197-203. doi: 10.1093/ neuros/nyx249. PMID: 28838143.
6. Elbinoune I, Amine B, Shyen S, Gueddari S, Abouqal R, Hajjaj-Hassouni N. Chronic neck pain and anxiety-depression: prevalence and associated risk factors. Pan Afr Med J. 2016 May 27;24:89. doi: 10.11604/pamj.2016.24.89.8831. PMID: 27642428; PMCID: PMC5012832.
7. Harvie DS, Vasco D, Sterling M, Low-Choy S, Niederstrasser NG. Psycho-sensory relationships in chronic pain. Br J Pain. 2021 May;15(2):134-146. doi: 10.1177/2049463720933925. Epub 2020 Jun 27. PMID: 34055335; PMCID: PMC8138622.
8. Farrell SF, de Zoete RMJ, Cabot PJ, Sterling M. Systemic inflammatory markers in neck pain: A systematic review with meta-analysis. Eur J Pain. 2020 Oct;24(9):1666-1686. doi: 10.1002/ ejp.1630. Epub 2020 Jul 20. PMID: 32621397.
9. Instruction 00398. Pain in the area of the neck and shoulder joint. https://guidelines.moz.gov.ua/documents/3261.
10. Abdel-Aziem AA, Mohamed RR, Draz AH, Azab AR, Hegazy FA, Diab RH. The effect of McKenzie protocol vs. deep neck flexor and scapulothoracic exercises in subjects with chronic neck pain — a randomized controlled study. Eur Rev Med Pharmacol Sci. 2022 May;26(9):3138-3150. doi: 10.26355/eurrev_202205_28731. PMID: 35587064.
11. Blozik E, Himmel W, Kochen MM, Herrmann-Lingen C, Scherer M. Sensitivity to change of the Neck Pain and Disability Scale. Eur Spine J. 2011 Jun;20(6):882-9. doi: 10.1007/ s00586-010-1545-0. Epub 2010 Aug 8. PMID: 20694734; PMCID: PMC3099161.
12. Vernon H. The Neck Disability Index: state-of-the-art, 1991-2008. J Manipulative Physiol Ther. 2008 Sep;31(7):491-502. doi: 10.1016/j.jmpt.2008.08.006. PMID: 18803999.
13. Гоженко А. І. Предиктори атеросклерозу: нові досяг- нення / А. І. Гоженко, С. Г. Котюжинська, Л. А. Ковалевська // Лікарська справа. [Gozhenko AI, Kotyuzhinskaya SG, Kovalevskaya LA.] [Predictors of atherosclerosis: new developments]. Likarska sprava [Medical case]. 2014 Dec;(12):18-25. doi: https:// doi.org/10.31640/LS-2014-12-03. (In Ukrainian).
14. Agay D, Andriollo-Sanchez M, Claeyssen R, Touvard L, Denis J, Roussel AM, Chancerelle Y. Interleukin-6, TNF-alpha and interleukin-1 beta levels in blood and tissue in severely burned rats. Eur Cytokine Netw. 2008 Mar;19(1):1-7. doi: 10.1684/ ecn.2008.0113. Epub 2008 Feb 26. PMID: 18299267.
15. Blair J, Adaway J, Keevil B, Ross R. Salivary cortisol and cortisone in the clinical setting. Curr Opin Endocrinol Diabetes Obes. 2017 Jun;24(3):161-168. doi: 10.1097/MED.0000000000000328. PMID: 28375882.
16. Miller FG. Bioethics as a Vocation. Perspect Biol Med. 2020;63(3):429-443. doi: 10.1353/pbm.2020.0031. PMID: 33416617.
17. TIBCO Statistica® User’s Guide. https://docs.tibco.com/ pub/stat/14.0.0/doc/html/UsersGuide/GUID-058F49FC-F4EF- 4341-96FB-A785C2FA76E9-homepage.html.
18. Ellrich J, Fischer A, Gilsbach JM, Makowska A, Spangenberg P. Inhibition of nitric oxide synthases prevents and reverses alpha,beta-meATP-induced neck muscle nociception in mice. Cephalalgia. 2010 Oct;30(10):1225-32. doi: 10.1177/0333102410361538. Epub 2010 Mar 26. PMID: 20855368.
19. Risbud MV, Shapiro IM. Role of cytokines in intervertebral disc degeneration: pain and disc content. Nat Rev Rheumatol. 2014 Jan;10(1):44-56. doi: 10.1038/nrrheum.2013.160. Epub 2013 Oct 29. PMID: 24166242; PMCID: PMC4151534.