r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2024-29-1-67-76r-n-j-520Research ArticleЛЕКЦИЯLECTUREАнатомический акцент на значимость крестцово-копчиковой области в неврологииAnatomical focus on the sacrococcygeal region importance in neurologyhttps://orcid.org/0000-0003-3164-9737СаньковаМ. В.SankovaM. V.

Москва

Moscow

cankov@yandex.ruhttps://orcid.org/0000-0001-9532-9957НиколенкоВ. Н.NikolenkoV. N.

Москва

Moscow

vn.nikolenko@yandex.ruhttps://orcid.org/0000-0001-6432-5179ОганесянМ. Н.OganesyanM. V.

Москва

Moscow

marine-oganesyan@mail.ruhttps://orcid.org/0000-0003-0658-0520СаньковА. В.SankovA. V.

Москва

Moscow

A.V.Sankov@yandex.ruПервый МГМУ имени И.М. Сеченова (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationПервый МГМУ имени И.М. Сеченова (Сеченовский Университет); Московский государственный университет имени М.В. ЛомоносоваРоссияI.M. Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State UniversityRussian Federation2024110320242916776Copyright © Санькова М.В., Николенко В.Н., Оганесян М.Н., Саньков А.В., 20242024Санькова М.В., Николенко В.Н., Оганесян М.Н., Саньков А.В.Sankova M.V., Nikolenko V.N., Oganesyan M.V., Sankov A.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/520

Цель: проанализировать морфофункциональные особенности структур крестцово-копчиковой области, их синтопии к соседним анатомическим образованиям и внутренним органам, а также связанные с ними патологические процессы и аномалии их развития для совершенствования поиска причин сакралгии и кокцигодинии.Материал и методы: использовались данные электронных ресурсов e-Library.ru, КиберЛенинка, Cochrane Library, Академия Google, Global Health, Medline, Elsevier, Scopus, Web of Science и PubMed.Результаты. Крестцово-копчиковая область является местом концентрации многочисленных нервных ветвей и сплетений, иннервирующих органы малого таза и нижние конечности. Даже небольшое изменение формы и функции любого из составляющих крестцово-копчиковой области нарушает их правильную синтопию и приводит к запуску патогенетических механизмов, ведущим проявлением которых является боль. Основу большей части случаев болевого синдрома составляет скелетно-мышечная неспецифическая боль, при которой в качестве анатомических источников болевой импульсации определяются фасеточные суставы, крестцово-подвздошные сочленения, мышцы позвоночника, грушевидная мышца и связки. Серьезным фактором риска несостоятельности связок опорно-двигательного аппарата, возникновения нестабильности соединений и хронизации болевого синдрома в трудоспособном возрасте является синдром дисплазии соединительной ткани. Существенно реже выявляется боль, вызванная сдавлением спинномозговых корешков грыжей межпозвоночного диска или спондилолистезом. Реже всего встречается боль в крестцово-копчиковой области, обусловленная специфическими причинами, к которым относятся аномалии развития, травмы, заболевания внутренних органов, новообразования, инфекционные и аутоиммунные процессы.

Objective

Objective: to study morphofunctional features of the sacrococcygeal region structures, their syntopy to neighboring anatomical formations and internal organs, as well as associated pathological processes and anomalies of their development to improve the search for the sacralgia and coccygodynia causes.Material and мethods: data from electronic resources e-Library.ru, CyberLeninck, Cochrane Library, Google Academy, Global Health, Medline, Elsevier, Scopus, Web of Science and PubMed were used.Results. The sacrococcygeal region is a place of concentration of numerous nerve branches and plexuses innervating not only the pelvic organs but also the lower extremities. Even a small change in the form and function of any sacrococcygeal region components violates their correct syntopy and leads to the pathogenetic mechanisms, the leading manifestation of which is pain. The basis of the most pain syndrome cases is skeletal-muscular or nonspecifi c pain, in which the facet joints, sacroiliac joints, spinal muscles, piriformis muscle and ligaments are identifi ed as anatomical pain impulsation sources. Connective tissue dysplasia syndrome is a serious risk factor for musculoskeletal ligament failure, joint instability, and pain syndrome chronifi zation at working age. Neuropatic pain caused by compression of the spinal root or “cauda equina” by disc herniation or spondylolisthesis is much less common. The least common pain in the sacroiliac region is caused by specifi c causes, including developmental abnormalities, injuries, internal organ diseases, tumors, infectious and autoimmune processes.

 

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The authors declare that there are no conflicts of interest present.