MODERN CLINICAL AND SCIENTIFIC APPROACHES TO METHODS FOR ASSESSING PAIN SYNDROME IN VBDR

Vertebrogenic lumbar radiculopathy (VBDR) is a multifactorial condition involving intervertebral disc degeneration, facet joint osteoarthritis, paravertebral muscle changes, and nerve root compression. Its pathogenesis is influenced by physical, hormonal, and psychoemotional factors, with gender-specific differences affecting pain perception, muscle response, and compensatory mechanisms. Laboratory biomarkers such as NGF, S100B, cortisol, and serotonin reflect peripheral sensitization, glial activation, HPA-axis function, and pain modulation, providing insight into disease severity and treatment response. Neurovisualization methods—including MRI, DWI/DTI, CT/myelography, and high-frequency ultrasound—allow detailed assessment of structural and microstructural changes, highlighting gender-dependent variations in perineural fibrosis and inflammatory response. Neurophysiological assessments, including ENMG, SSEPs, and TMS, offer functional evaluation of nerve root and corticospinal integrity, with observed differences between men and women linked to hormonal status. Integration of laboratory, neurophysiological, and imaging data enables personalized, gender-sensitive rehabilitation strategies, optimizing pain management, functional recovery, and prognosis in VBDR.