The ClinicianThe ClinicianКлиницист1818-83382412-8775Publishing House ABV Press32110.17650/1818-8338-2017-11-3-4-17-22REVIEWОБЗОРDEGENERATIVE SPINE INJURY ASSOCIATED WITH BACK PAIN: MORPHOGENETIC ASPECTSДЕГЕНЕРАТИВНОЕ ПОРАЖЕНИЕ ПОЗВОНОЧНИКА, АССОЦИИРОВАННОЕ С БОЛЬЮ В СПИНЕ: МОРФОГЕНЕТИЧЕСКИЕ АСПЕКТЫhttps://orcid.org/0000-0003-4669-1006PravdyukN. G.ПравдюкН. Г.
Russian Federation

Department of Faculty Therapy named after Acad. A.I. Nesterov.

1 Ostrovityanova St., Moscow 117997

Наталья Григорьевна Правдюк - кафедра факультетской терапии им. акад. А.И. Нестерова.

117997 Москва, ул. Островитянова, 1

pravda547@yandex.ruhttps://orcid.org/0000-0002-9710-699XShostakN. A.ШостакН. А.
Russian Federation

Department of Faculty Therapy named after Acad. A.I. Nesterov.

1 Ostrovityanova St., Moscow 117997

Кафедра факультетской терапии им. акад. А.И. Нестерова.

117997 Москва, ул. Островитянова, 1

N.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России15102017113-417220706201807062018Copyright ©; 2017, Pravdyuk N.G., Shostak N.A.Copyright ©; 2017, Правдюк Н.Г., Шостак Н.А.2017Pravdyuk N.G., Shostak N.A.Правдюк Н.Г., Шостак Н.А.https://creativecommons.org/licenses/by/4.0https://klinitsist.abvpress.ru/Klin/article/view/321

Degeneration of the intervertebral disk (IVD) is a pathological process resulting from an interplay between genetic and environmental factors causing structural and functional damage of the IVD and neighboring structures. It is the first stage of degenerative cascade in the vertebral motion segment. Initiation and progression of IVD degenerative processes traditionally involves several factors: inadequate mechanical load, decreased diffusion of nutrients through the arch laminae, and genetic factors playing a significant role in the development  of degenerative changes. Three categories of candidate genes whose coding variants are associated with different forms of degenerative changes in the IVD are identified, a conceptual model of genetic interactions in degenerative disease of the disk is developed. The study  of the role of structural changes in back pain genesis, evaluation of risk factors allow to optimize the tactics of patient care and find new therapeutic solutions preventing disease progression.

Дегенерация межпозвонкового диска (МПД) – патологический процесс, возникающий вследствие взаимодействия генетических и средовых факторов, обусловливающих структурное и функциональное повреждение МПД и смежных структур, и являющийся начальным этапом дегенеративного каскада в позвоночно-двигательном сегменте. В инициации и прогрессировании дегенеративных процессов МПД традиционно обсуждается участие нескольких факторов: неадекватной механической нагрузки, снижения диффузии питательных веществ через замыкательные пластины и генетических факторов, которые вносят существенный вклад в развитие дегенеративных изменений. Выделяют 3 категории кандидатных генов, варианты кодирования которых ассоциированы с различными формами дегенеративных изменений МПД; разработана концептуальная модель генетических взаимодействий при дегенеративной болезни диска. Изучение вклада структурных нарушений в генез боли в спине, оценка влияния факторов риска позволяют оптимизировать тактику ведения больных и находить новые терапевтические решения, препятствующие прогрессированию болезни.

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