Поясничная радикулопатия у взрослых: клиника, диагностика, терапевтические подходы

Боль в нижней части спины считается важной проблемой общественного здравоохранения. Радикулопатия описывается как раздражение нервных корешков в результате различных патологий, включая грыжу межпозвоночного диска, костные шпоры, нестабильность позвоночника и травму. Что касается поясничной радикулопатии, которая развивается на фоне грыж межпозвоночных дисков, следует отметить, что это патология, при которой происходит изменение межпозвоночного диска вследствие разрыва фиброзного кольца и выпячивания пульпозного ядра. Клинически выявляется нарушение болевой, температурной, вибрационной и другой чувствительности (в т. ч. в виде парестезий, гиперили гипоалгезии, аллодинии, гиперпатии) в соответствующем дерматоме, снижение или выпадение сухожильных рефлексов, замыкающихся через соответствующий сегмент спинного мозга, гипотония и слабость мышц, иннервируемых данным корешком. Исследования показывают, что распространенность поясничной радикулопатии составляет до 5%, чаще встречаясь у мужчин в возрасте от 30 до 50 лет. К числу наиболее важных факторов риска развития радикулопатии на фоне межпозвоночной грыжи относятся возраст, острые травмы, поднятие тяжестей, скручивания, сгибания, вождение автомобиля, курение, беременность, сахарный диабет, повышенный индекс массы тела, артериальная гипертензия, гиперхолестеринемия и семейный анамнез. Учитывая патофизиологию и этиологию заболевания, весьма актуальным является проведение клинического опроса и серии диагностических тестов для подтверждения наличия данного клинического состояния. Лечение данной патологии может быть немедикаментозным, фармакологическим или хирургическим. Для купирования болевого синдрома препаратом первой линии являются нестероидные противовоспалительные средства.

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