Vertebral Algic Syndrome Treatment in Long COVID—Cases Reports

Abstract

Though pain is a frequent symptom of long COVID-19, little attention has been paid to vertebral algic syndrome. Therefore, we present the cases reports of two precisely selected physically active patients where vertebral algic syndrome and radiculopathy dramatically worsened in acute SARS-CoV-2 infections. The vertebral pain with radicular irritation was resistant to conservative treatment in chronic post-COVID syndrome. The neurological difficulties corresponded to the radiologic imaging presented on MRI scans. Due to the absence of standard therapeutic guidelines in literature sources, it was decided to provide routine therapeutic procedures. Spinal surgery with radicular decompression was performed within 6 months after acute SARS-CoV-2 infection. This led to the improvement of their neurological status and was in corroboration with decreases of VAS (from 9 to 0 in Patient 1 and from 7 to 1 in Patient 2). Our experience indicates that these patients benefited from the standard neurosurgical radicular decompression, and sufficient pain relief was achieved; nevertheless, the initial trigger of neurological worsening was acute SARS-CoV-2 infection.

Global Trends and Research Hotspots in Long COVID: A Bibliometric Analysis

“…The symptoms of long COVID were varied. First, there were some physical symptoms: fatigue [ 9 , 12 , 35 ], dyspnea [ 35 , 36 ], cough [ 35 , 36 ], loss of taste or smell [ 12 ], loss hair [ 9 ], fever [ 35 , 37 ], sleep disorder [ 38 ], joint pain [ 39 , 40 ], headache [ 41 ], spinal pain [ 42 ], muscle pain [ 39 , 43 ], diarrhea [ 44 ], and organ (heart, lungs, kidneys, liver, pancreas, and spleen) damage [ 45 ]. Second, there were some mental symptoms: insomnia, delirium, fear, and depression [ 46 , 47 ].…”

“…Instead, personalized treatment was recommended for each patient [ 30 , 49 , 50 ]. For specific symptoms, there were the following studies: (1) Robbins Tim et al used hyperbaric oxygen therapy to treat chronic fatigue syndrome, which significantly improved fatigue [ 51 ]; Vollbracht C and Kraft K believed that injections of Vitamin C can help relieve symptoms of fatigue [ 52 ]; and (2) Dzubera A et al used spinal surgery with radicular decompression to treat spinal pain in patients [ 42 ]. (3) Maria Ines Mitrani et al found that amniotic fluid-derived extracellular vesicle biologic could be used to treat respiratory disorders [ 53 ].…”

COVID-19 Worsens Chronic Lumbosacral Radicular Pain—Case Series Report

“…The brain [ 7 ], spinal cord [ 8 , 9 , 10 , 11 ], and peripheral nerves [ 7 , 12 ] can be affected in acute and chronic COVID-19 [ 4 , 5 ]. The SARS-CoV-2 associated back difficulties and radicular pain are of sparse occurrence in literature [ 13 , 14 ].…”

“…There is sparse information of neural root impairment in COVID-19. Only anecdotal clinical case reports of back pain in acute [ 13 ] and long COVID-19 [ 14 ] were presented. Back pain with radicular or pseudoradicular syndrome was the first complaint in acute SARS-CoV-2 infection.…”

“…Back pain with radicular or pseudoradicular syndrome vanished after SARS-CoV-2 recovery in the majority of cases [ 13 ] spontaneously. On the other hand, the radicular pain can become chronic and neurosurgical intervention can be necessary [ 14 ].…”