Postradiative stenosis of the spinal canal: features of the clinic, diagnosis and treatment (clinical case)

Postradiation epidural fibrosis is one of the rare complications of cancer treatment in patients receiving radiation therapy, leads to a mosaic clinical picture, including manifestations of polyneuropathy, caudogenic intermittent lameness syndrome and can significantly affect the quality of life of...

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Main Authors: O. V. Sklyarenko, S. N. Larionov, A. P. Zhivotenko, V. A. Sorokovikov, A. V. Gorbunov, V. E. Potapov
Format: Article
Language:Russian
Published: Private institution educational organization of higher education "Medical University "ReaViz" 2025-04-01
Series:Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье
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Online Access:https://vestnik.reaviz.ru/jour/article/view/1183
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author O. V. Sklyarenko
S. N. Larionov
A. P. Zhivotenko
V. A. Sorokovikov
A. V. Gorbunov
V. E. Potapov
author_facet O. V. Sklyarenko
S. N. Larionov
A. P. Zhivotenko
V. A. Sorokovikov
A. V. Gorbunov
V. E. Potapov
author_sort O. V. Sklyarenko
collection DOAJ
description Postradiation epidural fibrosis is one of the rare complications of cancer treatment in patients receiving radiation therapy, leads to a mosaic clinical picture, including manifestations of polyneuropathy, caudogenic intermittent lameness syndrome and can significantly affect the quality of life of patients. Depending on the type of cancer, the volume of the affected tissues and the level of damage to the spine, radiation fibrosis syndrome is characterized by a diverse clinical picture. The main clinical manifestations of post-radiation fibrosis of the spinal canal at the level of the lumbar spine are pain, numbness, paresthesia in the lower extremities. A thorough history and physical examination, combined with the use of neuroimaging data, help establish an accurate diagnosis and select an effective treatment. When studying the problem of post-radiation fibrosis, it is extremely difficult to predict the time, risk group and specificity of characteristic symptoms, given the development of pathology in elderly and senile patients, against the background of existing degenerative changes in the spine. However, there is a close relationship with dosage, anatomical impact, nature of damage and clinical symptoms. Conservative methods of treating post-radiation fibrosis with spinal canal stenosis include the use of analgesic, antiinflammatory therapy. With a prolonged course of pain syndrome, insufficient effectiveness of conservative treatment, local blockades or epidural injections are carried out. In the absence of the effect of conservative treatment, indications for surgical intervention arise.
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publishDate 2025-04-01
publisher Private institution educational organization of higher education "Medical University "ReaViz"
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series Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье
spelling doaj-art-a2c29c166d8a4c37bcf8aef840e64e192025-08-20T02:54:27ZrusPrivate institution educational organization of higher education "Medical University "ReaViz"Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье2226-762X2782-15792025-04-0115113013710.20340/vmi-rvz.2025.1.CASE.5711Postradiative stenosis of the spinal canal: features of the clinic, diagnosis and treatment (clinical case)O. V. Sklyarenko0S. N. Larionov1A. P. Zhivotenko2V. A. Sorokovikov3A. V. Gorbunov4V. E. Potapov5Irkutsk Scientific Center of Surgery and TraumatologyIrkutsk Scientific Center of Surgery and TraumatologyIrkutsk Scientific Center of Surgery and TraumatologyIrkutsk Scientific Center of Surgery and Traumatology; Irkutsk State Medical Academy of Postgraduate EducationIrkutsk Scientific Center of Surgery and TraumatologyIrkutsk Scientific Center of Surgery and TraumatologyPostradiation epidural fibrosis is one of the rare complications of cancer treatment in patients receiving radiation therapy, leads to a mosaic clinical picture, including manifestations of polyneuropathy, caudogenic intermittent lameness syndrome and can significantly affect the quality of life of patients. Depending on the type of cancer, the volume of the affected tissues and the level of damage to the spine, radiation fibrosis syndrome is characterized by a diverse clinical picture. The main clinical manifestations of post-radiation fibrosis of the spinal canal at the level of the lumbar spine are pain, numbness, paresthesia in the lower extremities. A thorough history and physical examination, combined with the use of neuroimaging data, help establish an accurate diagnosis and select an effective treatment. When studying the problem of post-radiation fibrosis, it is extremely difficult to predict the time, risk group and specificity of characteristic symptoms, given the development of pathology in elderly and senile patients, against the background of existing degenerative changes in the spine. However, there is a close relationship with dosage, anatomical impact, nature of damage and clinical symptoms. Conservative methods of treating post-radiation fibrosis with spinal canal stenosis include the use of analgesic, antiinflammatory therapy. With a prolonged course of pain syndrome, insufficient effectiveness of conservative treatment, local blockades or epidural injections are carried out. In the absence of the effect of conservative treatment, indications for surgical intervention arise.https://vestnik.reaviz.ru/jour/article/view/1183post-radiation fibrosis / radiation fibrosis [d005355, d014157]epidural fibrosis / epidural fibrosis [d005355, d013116]spinal canal stenosis / spinal stenosis [d013130]radiation therapy / radiotherapy [d011878]decompressive-stabilizing surgery / decompression, surgical [d003627]spinal fusion [d013123]radiation therapy complications / radiation injuries [d011832]pathological fracture / fractures, spontaneous [d050723]radiculopathy / radiculopathy [d011843]neuroimaging / neuroimaging [d059906]transpedicular fixation / pedicle screws [d062326]
spellingShingle O. V. Sklyarenko
S. N. Larionov
A. P. Zhivotenko
V. A. Sorokovikov
A. V. Gorbunov
V. E. Potapov
Postradiative stenosis of the spinal canal: features of the clinic, diagnosis and treatment (clinical case)
Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье
post-radiation fibrosis / radiation fibrosis [d005355, d014157]
epidural fibrosis / epidural fibrosis [d005355, d013116]
spinal canal stenosis / spinal stenosis [d013130]
radiation therapy / radiotherapy [d011878]
decompressive-stabilizing surgery / decompression, surgical [d003627]
spinal fusion [d013123]
radiation therapy complications / radiation injuries [d011832]
pathological fracture / fractures, spontaneous [d050723]
radiculopathy / radiculopathy [d011843]
neuroimaging / neuroimaging [d059906]
transpedicular fixation / pedicle screws [d062326]
title Postradiative stenosis of the spinal canal: features of the clinic, diagnosis and treatment (clinical case)
title_full Postradiative stenosis of the spinal canal: features of the clinic, diagnosis and treatment (clinical case)
title_fullStr Postradiative stenosis of the spinal canal: features of the clinic, diagnosis and treatment (clinical case)
title_full_unstemmed Postradiative stenosis of the spinal canal: features of the clinic, diagnosis and treatment (clinical case)
title_short Postradiative stenosis of the spinal canal: features of the clinic, diagnosis and treatment (clinical case)
title_sort postradiative stenosis of the spinal canal features of the clinic diagnosis and treatment clinical case
topic post-radiation fibrosis / radiation fibrosis [d005355, d014157]
epidural fibrosis / epidural fibrosis [d005355, d013116]
spinal canal stenosis / spinal stenosis [d013130]
radiation therapy / radiotherapy [d011878]
decompressive-stabilizing surgery / decompression, surgical [d003627]
spinal fusion [d013123]
radiation therapy complications / radiation injuries [d011832]
pathological fracture / fractures, spontaneous [d050723]
radiculopathy / radiculopathy [d011843]
neuroimaging / neuroimaging [d059906]
transpedicular fixation / pedicle screws [d062326]
url https://vestnik.reaviz.ru/jour/article/view/1183
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AT apzhivotenko postradiativestenosisofthespinalcanalfeaturesoftheclinicdiagnosisandtreatmentclinicalcase
AT vasorokovikov postradiativestenosisofthespinalcanalfeaturesoftheclinicdiagnosisandtreatmentclinicalcase
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AT vepotapov postradiativestenosisofthespinalcanalfeaturesoftheclinicdiagnosisandtreatmentclinicalcase