Markers of inflammation in degenerative-dystrophic changes of the cervical spine

Abstract

The purpose of the study was to evaluate the dynamics of inflammatory markers in patients with degenerative-dystrophic diseases of the cervical spine accompanied by chronic pain syndrome. 94 patients with chronic cervicalgia aged from 20 to 70 years were examined. Women predominated among those examined (59 or 62.8 %). The average age of the patients was 57.6 ± 2.1 years. An analysis of the intensity of the pain syndrome in dynamics according to VAS, functional indicators according to the NPAD and NDI scales was carried out. In addition, the content of interleukin-6 and tumor necrosis factor in the blood, as well as the content of cortisol in saliva, were evaluated by the method of solid-phase enzyme immunoassay. All patients complained of long-term pain in the neck, which had the character of cervicocranialgia in 23 (24.5 %) patients, cervicobrachialgia in 31 (33.0 %) patients, cervicothoracic pain in 14 (14.9 %), isolated cervicalgia in 26 (14.9 %) patients. Pain intensity at the time of application was 6.8 ± 0.3 points. The score for NPAD was 65.5 ± 3.7 points, for NDI — 34.5 ± 1.1 points. All patients had pain in the neck, including 62 (66.0 %) — unilateral, and limitation of neck movements. In 37 (39.4 %) patients, the pain was mainly in the left half of the neck, in 25 (26.6 %) — in the right half. In 31 (33.0 %) neck pain was accompanied by pain in the shoulder girdle or upper limbs. Goniometric evaluation of the volume of neck movements revealed its decrease in all planes, more pronounced in the transverse plane. The cortisol content in the patients’ saliva was 6.5 ± 0.1 ng/ml, the IL-6 and TNF levels were 15.5 ± 0.8 and 8.6 pg/ ml, respectively. Correlation analysis showed a significant relationship between the degree of movement limitation, pain intensity and levels of pro-inflammatory cytokines and cortisol With chronic cervical pain, the cytokine cascade is activated, which leads to an increase in the levels of IL-6 and TNF to 15.5 ± 0.8 and 8.6 pg/ml, respectively, as well as cortisol to 6.5 ± 0,1 ng/ml. The degree of severity of clinical manifestations correlates with the content of cytokines and cortisol. The severity of the inflammatory reaction in chronic cervical pain should be taken into account when choosing therapy and rehabilitation measures. Key words: degenerativedystrophic changes of the spine, cervical spine, chronic pain, inflammation, cytokines