A Clinical Picture, Diagnosis and Surgical Treatment of Pain Syndromes in Spondylarthrosis of the Cervical Spine and Upper Thoracic Aperture Syndrome

S.L.Sarychev

(Chair of Neurosurgery, Russian Medical Academy of Postgraduate Education, Central Clinical Hospital of Civil Aviation, Moscow)

According to medical reports, pain syndromes of radicular genesis account for 30-40% of cases with degenerative diseases. At the same time pain syndromes of non-radicular origin are much more frequent. High mortality and relatively quick loss of working capacity, ineffective treatment due to misdiagnosis make treatment of pain syndromes of upper extremities and a shoulder girdle to be a problem of high importance.

We examined 66 patients with this pathology; 18 and 48 of them had a facet syndrome and syndrome of compression of a neurovascular bundle in the area of the upper thoracic aperture respectively.

The conclusion is as follows: elaborated clinical criteria allow to use a differentiated approach to treatment of pain syndromes, caused by neurovascular compression in the area of the upper thoracic aperture and arthrosis of arch-and-process joints of the cervical spine. Transcutaneous radio-frequency destruction of articular nerves of the cervical spine is a highly effective and almost atraumatic operation in pain facet syndrome, caused by spondyarthrosis. Transaxillary resection of the first rib is an adequate decompressive operation in pain syndromes, resulting from compression of a neurovascular bundle in the area of the upper thoracic aperture.