CHRONIC CEREBRAL VENOUS DYSFUNCTION SYNDROME AND DEGENERATIVE-DYSTROPHIC CHANGES OF THE CERVICAL SPINE: ANATOMO-PHYSIOLOGICAL UNDERSTANDING OF COMORBIDITY

Aim: to investigate the features of CS DDC in patients with CCVDS in comparison with patients without clinical signs of chronic venous cerebral dysgemia, to substantiate comorbidity. Material and methods. In compliance with ethical norms, 2 groups of patients were examined: 125 patients have CCVDS and different levels of blood pressure (98 women, 27 men, average age 53.60±10.27ys), 28 similar patients, but without CCVDS (17 women and 11 men, 52.54±10.03 years old). General clinical and clinicalneurological examination, clinical assessment of the hypoglossal veins condition, MRI of the cervical spine, X-ray functional tests, MedStat programs. Results. The main group patients had a mixed headache, stiffness, limitation of movements and pain in the CS, irradiation in the upper limb aggravated by movements and forced positions; paresthesias and arm pain, which were significantly different from the control group except for tension headache. A significant difference in cerebral complaints – dizziness, transient visual and hearing impairments (<0.001). Limitation of mobility in the CS up to 30-45 degrees, tension, compaction and tenderness of the paravertebral muscles during palpation, usually asymmetric, expansion and fullness of the sublingual veins of patients in the main group were significantly different from the indicators of the control group (<0.001). According to the MRI and X-ray spondylography, the patients of the main group had structural changes in the spinal cord significantly worse than the control group (<0.001). Conclusions. Patients with CCVDS had significantly worse clinical, structural and dynamic changes in the cervical spine, which were significantly different from the indicators of patients without chronic brain venous dyshemia (<0.001). DDC of the cervical spine should be considered a significant comorbid factor of chronic cerebral venous blood flow disorders, which can be explained by anatomical and physiological dependences.