International Medical Journal, Vol. 24., Iss. 3, 2018, P. 64−68.
ULTRASOUND DIAGNOSIS OF INTERVERTEBRAL DISCS PROTRUSIONS IN ADOLESCENT AND YOUNG PATIENTS WITH CERVICOGENIC HEADACHE
Kharkiv Medical Academy of Postgraduate Education, Ukraine
Intervertebral discs protrusions, often beginning in the childhood and adolescence, are one of the most common causes of cervicogenic headaches. The diagnostic features of cervicogenic headaches are the signs of involvement of the cervical spine: possibility of mechanical provocation of the headache attack by iatrogenic and/or subjective action; reduction in the volume of movements; diffuse ipsilateral pain syndrome in the region of the neck, shoulder girdle, arm of nonradicular nature, or (rarely) pain in these areas of radicular origin. In the existing publications the data on comparison of the results of ultrasound examination of intervertebral disks protrusions in the cervical spine in adolescents and young patients with cervicogenic headaches are absent. With this purpose, ultrasound examination of intervertebral cervical disks protrusions in the cervical spine was performed in 86 teenagers and young patients with cervicogenic headaches. The study was conducted at the level of the cervical spinal disks in sagittal and axial projections. Relationships between the sizes of intervertebral discs and the vertebral canal, the anterior and posterior dural space, as well as the state of the pulp nucleus and the fibrous ring were determined. The results of the study showed that in adolescents and young patients with cervicogenic headaches, median protrusions with the most frequent localization in the spinal cord segments C2−3, C3−4 predominated. The leading quantitative signs of protrusion of intervertebral discs are increase in the index of intervertebral discs/vertebral channels, decrease in the indices of the anterior and posterior dural space, and the anterior dural space/vertebral canal. In patients with cervicogenic headaches in the context of protrusions, changes in the pulp nucleus with a marked increase in prevalence in young people are detected in comparison with the adolescent group.
Key words: intervertebral discs protrusions, cervical spine, ultrasound diagnosis, cervicogenic headache.