Osteogenic theory of Neuroorthopedic diseases - Pain Clinic

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Osteogenic theory of Neuroorthopedic diseases

Osteogenic theory of Neuroorthopedic diseases


  Under the combined actions of the etiological factors in different parts of the skeleton occurs dystrophic - degenerative bone changes and disturbance in intraosseous blood flow, which leads to increased intraosseous pressure and over stimulation of the receptors.

  Increased afferentation of intraosseous receptors promotes to the facilitation of other afferent flow, increased motor reactions, corticofugal reduction reactions and effects on the respective segmental level,  which at this level leads to the formation of typical clinical symptoms: pain, musculo-tonic, vasospastic and hypertrophic syndromes. The set of clinical symptoms depends on the degree of representated "target tissues" in the appropriate area of the affected segmental division of the musculoskeletal system.

  The set of clinical symptoms depends on the degree of representated "target tissues" in the appropriate area of the affected segmental division of the musculoskeletal system. So, hyperafferentation of intraosseous receptor in spinal osteochondrosis manifested by various clinical picture: in the lumbar - represented by affecting various local tissues, in the cervical – additionally affecting  the vertebral artery, in the thoracic - affecting the internal organs, vertebro- visceral syndromes.

  Increased  afferent impulses from various intraosseous receptors of the skull bones can cause mainly pain and vasospastic syndrome in the face or head, and to a lesser degree musculo-tonic syndrome. The mechanisms in effectiveness of the therapeutic intraosseous blockades is based on  cortical bone trepanation and immediate impact on the bone marrow, leading to the normalization of intraosseous pressure, through the mechanisms described above reducing the Neuroorthopedic clinical manifestations.


The therapeutic effect of intraosseous blockade is due to several factors:

   1. Inserting a needle into the bone is cortical decompressive trepanation, which reduces the intraosseous pressure and hence reduce intraosseous receptor overstimulation.

   2. Within 3-6 weeks after insertion of the needle is the restoration of damaged bone trabeculae, which stimulates reparative regeneration and improves local microcirculation.

   3. Inserting a needle into the bone exerts a powerful reflex positive impact on the pathogenetic mechanisms of spinal osteochondrosis.

   4. The introduction of drugs directly into the bone marrow vertebral allows them to reach high concentrations in bone and maximum impact on osteoreceptors.

   5. Due to the peculiarities of the blood outflow from the bone is reintroduced with the drugs letting the drug flow into all the surrounding bone tissue.     

  6. Introduction of liquid into the bone under pressure and opens reserved  bone vessels, thereby creating conditions for normalization of intraosseous flow.

   The therapeutic blockade has marked characteristics, three phase changes in the pain. The first phase - the aggravation of "recognizable pain," which is caused by mechanical stimulation of the receptors in the painful area with the introduction of the first portions of the solution, the duration of the phase corresponds to the latent period of the anaesthetic. The second phase - anaesthesia when under the influence of anaesthetic pain reduced to minimum - to an average of 25% from the baseline. The duration of this phase corresponds to the duration of the anaesthetic in the painful area. Phase 3 - therapeutic effect when, after closure of the anaesthetic and its elimination from the body pain is resumed, but on average to 50% from the baseline. The duration of this phase can be from several hours to several days.

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