Abstract:
The COVID-19 pandemic has highlighted the problem of long-term consequences of the disease, in particular on the nervous system. More and more clinical observations indicate that patients who have had COVID-19 have persistent or progressive neurological disorders, especially in the presence of degenerative changes in the spine. Myalgias and arthralgias are characteristic manifestations of COVID-19 and are observed in 50–90% of patients in the acute period. During the convalescence period, prerequisites are formed for the chronicity of symptoms with the involvement of the autonomic nervous system, which is associated with degenerative-inflammatory changes in the musculoskeletal system, immune disorders and organic damage to all parts of the nervous system. Decompensation of existing vertebrogenic pathology is of particular importance.
The aim of this study is to assess the impact of cervical spine degeneration on the neurological status of people who have had COVID-19.
The study included 65 patients with upper body pain syndrome that arose, persisted, or worsened after the acute period of COVID-19; the control group consisted of 14 practically healthy individuals. Pain intensity was assessed using the visual analog scale (VAS). All patients underwent computed tomography of the cervical spine with determination of the Pavlov–Torg index and morphometric-densometric assessment of vertebral body density. scan.
Pain syndrome was the leading complaint mainly in the form of cervicalgia, often combined with upper back pain and irradiation to the upper extremities. Headache, vestibular and autonomic disorders had reflex-vascular mechanisms of implementation. Signs of acquired cervical stenosing pathology with a maximum in the C6 segment were found in 75.4% of patients, accompanied by pronounced neurological symptoms.
Conclusions. The transferred COVID-19 acts as a trigger for decompensation of degenerative changes in the cervical spine with the formation of persistent pain and neurological syndromes. This necessitates a multi-level assessment of the patient's condition, individualized treatment and rehabilitation tactics, and dynamic neurological monitoring.
