Neuropathic pain as a predictor of neurological disorders regression in patients with spinal cord traumatic injury

Background. Neuropathic pain is one of the principal secondary complications of spinal cord injury. The biological role of neuropathic pain has not been established yet. This type of pain is formed directly in the area of the spinal cord injury; therefore, it can be assumed that its intensity may ch...

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Autores principales:	O.S. Nekhlopochyn, V.V. Verbov, Ia.V. Tsymbaliuk, M.V. Vorodi, Ie.V. Cheshuk
Formato:	article
Lenguaje:	EN RU UK
Publicado:	Zaslavsky O.Yu. 2021
Materias:	spinal cord injury, subaxial level, neurological disorders, neuropathic pain, dynamics of recovery Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/5ba609c72ba84b62b6d9102d70fca737
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spelling	oai:doaj.org-article:5ba609c72ba84b62b6d9102d70fca7372021-11-12T07:53:09ZNeuropathic pain as a predictor of neurological disorders regression in patients with spinal cord traumatic injury2224-15072307-113310.22141/2224-1507.11.3.2021.243047https://doaj.org/article/5ba609c72ba84b62b6d9102d70fca7372021-10-01T00:00:00Zhttp://pjs.zaslavsky.com.ua/article/view/243047https://doaj.org/toc/2224-1507https://doaj.org/toc/2307-1133Background. Neuropathic pain is one of the principal secondary complications of spinal cord injury. The biological role of neuropathic pain has not been established yet. This type of pain is formed directly in the area of the spinal cord injury; therefore, it can be assumed that its intensity may characterize both degenerative and reparative processes. The aim of this work is to assess the possible relationship between the intensity of neuropathic pain in patients with spinal cord injury at cervical subaxial spine and the dynamics of neurological disorder regression. Materials and methods. We have performed a retrospective analysis of patients referred to outpatient department of the Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine in the period from 2010 to 2020 after a surgical treatment of subaxial cervical spine traumatic injury. The extent of neurological disorders and the intensity of neuropathic pain were assessed within 5–7 and 11–13 months after surgery. Results. All 102 patients selected for analysis were divided into three groups depending on the intensity of the registered pain sensations: 1) absence of constant pain sensations — 19.6 % of subjects, 2) moderate pain — 56.9 %, 3) severe neuropathic pain — 23.5 %. In the first group, the regression of neurological disorders was 3.5 (95% confidence interval (CI) 2.15–6.15), in the second — 25.0 (95% CI 24.14–29.58), in the third — 13.0 (95% CI 10.87–16.55). The differences are statistically significant (χ2 = 60.4, df = 2, p < 0.0001). In patients with severe neurological disorders, the dynamics of recovery did not correlate with the pain intensity. With ASIA B, the dynamics of group 1 was 8.5 (95% CI 10.56–27.56), of group 2 — 15.0 (95% CI 13.41–18.41), of group 3 — 10.5 (95% CI 7.45–14.89). With ASIA C functional class, the difference is even more pronounced: in group 1, the median was 8.0 (95% CI 0.83–20.83), in group 2 — 32.0 (95% CI 25.41–36.86), in group 3 — 15.5 (95% CI 10.27–27.4). With ASIA D, a similar trend was observed. Conclusions. The worst regression of neurological disorders is observed in patients without clinically significant pain, the best results of neurological dysfunction recovery are found in patients with mode rate neuropathic pain.O.S. NekhlopochynV.V. VerbovIa.V. TsymbaliukM.V. VorodiIe.V. CheshukZaslavsky O.Yu.articlespinal cord injury, subaxial level, neurological disorders, neuropathic pain, dynamics of recoveryMedicine (General)R5-920ENRUUKBolʹ, Sustavy, Pozvonočnik, Vol 11, Iss 3, Pp 110-117 (2021)
institution	DOAJ
collection	DOAJ
language	EN RU UK
topic	spinal cord injury, subaxial level, neurological disorders, neuropathic pain, dynamics of recovery Medicine (General) R5-920
spellingShingle	spinal cord injury, subaxial level, neurological disorders, neuropathic pain, dynamics of recovery Medicine (General) R5-920 O.S. Nekhlopochyn V.V. Verbov Ia.V. Tsymbaliuk M.V. Vorodi Ie.V. Cheshuk Neuropathic pain as a predictor of neurological disorders regression in patients with spinal cord traumatic injury
description	Background. Neuropathic pain is one of the principal secondary complications of spinal cord injury. The biological role of neuropathic pain has not been established yet. This type of pain is formed directly in the area of the spinal cord injury; therefore, it can be assumed that its intensity may characterize both degenerative and reparative processes. The aim of this work is to assess the possible relationship between the intensity of neuropathic pain in patients with spinal cord injury at cervical subaxial spine and the dynamics of neurological disorder regression. Materials and methods. We have performed a retrospective analysis of patients referred to outpatient department of the Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine in the period from 2010 to 2020 after a surgical treatment of subaxial cervical spine traumatic injury. The extent of neurological disorders and the intensity of neuropathic pain were assessed within 5–7 and 11–13 months after surgery. Results. All 102 patients selected for analysis were divided into three groups depending on the intensity of the registered pain sensations: 1) absence of constant pain sensations — 19.6 % of subjects, 2) moderate pain — 56.9 %, 3) severe neuropathic pain — 23.5 %. In the first group, the regression of neurological disorders was 3.5 (95% confidence interval (CI) 2.15–6.15), in the second — 25.0 (95% CI 24.14–29.58), in the third — 13.0 (95% CI 10.87–16.55). The differences are statistically significant (χ2 = 60.4, df = 2, p < 0.0001). In patients with severe neurological disorders, the dynamics of recovery did not correlate with the pain intensity. With ASIA B, the dynamics of group 1 was 8.5 (95% CI 10.56–27.56), of group 2 — 15.0 (95% CI 13.41–18.41), of group 3 — 10.5 (95% CI 7.45–14.89). With ASIA C functional class, the difference is even more pronounced: in group 1, the median was 8.0 (95% CI 0.83–20.83), in group 2 — 32.0 (95% CI 25.41–36.86), in group 3 — 15.5 (95% CI 10.27–27.4). With ASIA D, a similar trend was observed. Conclusions. The worst regression of neurological disorders is observed in patients without clinically significant pain, the best results of neurological dysfunction recovery are found in patients with mode rate neuropathic pain.
format	article
author	O.S. Nekhlopochyn V.V. Verbov Ia.V. Tsymbaliuk M.V. Vorodi Ie.V. Cheshuk
author_facet	O.S. Nekhlopochyn V.V. Verbov Ia.V. Tsymbaliuk M.V. Vorodi Ie.V. Cheshuk
author_sort	O.S. Nekhlopochyn
title	Neuropathic pain as a predictor of neurological disorders regression in patients with spinal cord traumatic injury
title_short	Neuropathic pain as a predictor of neurological disorders regression in patients with spinal cord traumatic injury
title_full	Neuropathic pain as a predictor of neurological disorders regression in patients with spinal cord traumatic injury
title_fullStr	Neuropathic pain as a predictor of neurological disorders regression in patients with spinal cord traumatic injury
title_full_unstemmed	Neuropathic pain as a predictor of neurological disorders regression in patients with spinal cord traumatic injury
title_sort	neuropathic pain as a predictor of neurological disorders regression in patients with spinal cord traumatic injury
publisher	Zaslavsky O.Yu.
publishDate	2021
url	https://doaj.org/article/5ba609c72ba84b62b6d9102d70fca737
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Neuropathic pain as a predictor of neurological disorders regression in patients with spinal cord traumatic injury

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