Vertebrogenic Pain Syndrome in Adolescents with Orthopedic Pathology, Aspects of Therapy

Abstract

Relevance. Pain in the cervical, thoracic and lumbar spine is relevant not only for adults, but also for children and adolescents. Scoliosis is a predisposing factor for the development of pain syndrome in the back. Osteopathic techniques allow to expand the arsenal of methods in order to increase the effectiveness of treatment of patients with back pain.The aim of the study was to evaluate vertebrogenic pain syndrome in adolescents undergoing outpatient treatment with the diagnosis of dorsalgia. Materials and Methods: An observational study was conducted to analyze 157 case histories of adolescents (95 (60.5%) girls and 62 (39.5%) boys) undergoing outpatient treatment for dorsalgia diagnosed between the ages of 8 and 17 years. The reliability of differences between the studied groups was assessed by frequency analysis, using Pearson's Chi-squared criterion. All obtained differences were considered at a significance level not lower than p?0.05. Results. Among the 157 patients studied, orthopedic pathology (scoliosis of the spine, cervical instability, rotational subluxation of C1-C3, wedge deformity of the thoracic spine, L5 antelisthesis, Spina bifida S1) was diagnosed in 76 (48.4%) patients. Thoracic scoliosis of the 2nd degree was significantly more common in girls (p=0.043). L5 antelisthesis was significantly more common in boys (p=0.019). Lumbar scoliosis of the 2nd degree was significantly more frequent in the group of patients with moderate pain syndrome (VAS 4-6 points) (p=0,001). The cause of low back pain syndrome in 61 (38.9%) adolescents was benign musculoskeletal pain without orthopedic pathology. Conclusion: Vertebrogenic pain syndrome is one of the most frequent reasons for seeking outpatient medical care in adolescents. Detection of orthopedic pathology (scoliosis, instability, wedge deformity of vertebrae) against the background of pain syndrome requires examination by a neurologist, orthopedist and osteopath. The basis of therapy and prevention of back pain in adolescents is non-medication therapy, including osteopathic correction. Osteopathic correction is indicated in the detection of somatic dysfunctions.