COMPARATIVE CHARACTERISTICS OF SUBSTANCE P CONCENTRATION AND NEUROPATHIC PAIN COMPONENT IN PATIENTS WITH ACUTE AND CHRONIC COURSES OF VERTEBROGENIC LUMBAR-SACRAL PAIN SYNDROMES

Abstract

The aim. The primary aim of this study is to assess the variance in substance P concentration, taking into account pain intensity and the presence of a neuropathic component, among patients experiencing acute and chronic vertebral lumbosacral pain syndromes. Materials. Measurement of substance P concentration in serum blood, evaluation of pain syndrome using the VAS scale, and assessment of pain according to the DN4 questionnaire were performed in patients receiving comprehensive treatment. A total of 125 patients were included in the study, comprising 65 patients with acute pain and 60 patients with chronic pain syndrome. Results. Pain ratings according to the Visual Analog Scale (VAS) among patients from the acute pain group was 7.15±1.07 on the VAS scale, while patients in the chronic pain group rated it at 6.09±0.96. On the 7th day of treatment, patients in the acute pain group reported a pain rating of 4.46±0.73, whereas those in the chronic pain group reported a rating of 4.22±0.97. The level of substance p(SP) in serum blood on the first day of treatment was 13.96±1.93 ng/mL in the acute pain group and 10.34±2.92 ng/mL in the chronic pain group. By the 7th day of treatment, the level decreased to 7.72±1.90 ng/mL in the acute pain group and 8.03±2.14 ng/mL in the chronic pain group. According to the DN4 questionnaire, neuropathic component was ascertained in 38% of patients with acute pain syndrome and 56% of participants with chronic pain. The average DN4 score in the acute pain group was 2.26±1.01, while in the chronic pain group, it was 4.53±1.02. In the group of patients with chronic pain syndrome and the presence of a neuropathic component, the level of SP was 10.89±1.78 ng/mL. In contrast, without the presence of a neuropathic component, it was 6.51±1.94 ng/mL. Conclusions. The trajectory of acute and chronic pain syndromes in patients with lumbosacral vertebral pain syndromes exhibits dissimilarities. Patients experiencing acute pain displayed a more favorable trend characterized by a reduction in pain intensity and a decrease in pain-related neurotransmitter concentration in the bloodstream.