Several aspects of conservative treatment of patients with cervical osteochondrosis

The aim of the research was to develop an algorithm of complex conservative treatment of patients with cervical osteochondrosis. We examined and provided conservative treatment to 40 patients with cervical osteochondrosis in periods 1-11 with severe pain syndrome. The treatment was mainly aimed at pain management. For this purpose, we assigned non-steroidal anti-inflammatory drugs (NSA1D) to the patients. NSA1D are the most effective medicinal agents, first of all due to their analgesic effect. Also, the treatment included physiotherapy and acupuncture. As a result of the treatment, neurological manifestations were reduced. Number of cervicalgia cases decreased from 12 (before the treatment) to 6 (after the treatment), number of cervical cranialgia cases - from 12 to 7, number of cervicobrachialgia cases - from 16 to 8 correspondingly. Developed complex of conservative treatment measures allows to obtain successful treatment results in most cases. 1t is important to note that proposed treatment regimen is available, simple and can be applied in all neurological and neurosurgical units and hospitals

History of development of neurosurgery in Scientific Center of Reconstructive and Restorative Surgery SB RAMS - combination of science and practice

The article is devoted to the description of all main milestones of development of neurosurgical ward from the foundation of Scientific Research nstitute of Traumatology and Orthopaedics in İ946 to nowadays. The problems of development of the ward, scientific and practical paradigm of scientific-clinical department of neurosurgery of Scientific Center of Reconstructive and Restorative Surgery SB RAMS are reviewed in the article. The periods of activity of Scientific Research Institute of Traumatology and Orthopaedics from the positions of clinical and scientific achievements are observed. The article presents the facts on the work of clinical and scientific officers that prove close connection of scientific researches and clinical developments in different spheres of neurosurgery. The stages of formation of professional growth of Scientific Research Institute of Traumatology and Orthopaedics in close relation with periods of the development of the country. Also the article presents main dissertation researches performed by the employees of Scientific Research Institute of Traumatology and Orthopaedics, shows their significance in science and clinical work and also illustrates main problems of development of neurosurgery nowadays and determines ways of their solving

Acupunctures in Complex Treatment of Cervical Pain Syndromes

To evaluate the effectiveness of the developed method of acupuncture in the complex of conservative treatment of pain in patients with osteochondrosis of the cervical spine in the neurosurgical Department of Irkutsk Scientific Centre of Surgery and Traumatology, 58 patients were under observation, 38 of whom were treated with acupuncture. The results of treatment were evaluated by the applying VAS testing and conducting stimulation electroneuromyography. The patients had 9–10 sessions of corporal and auricular acupuncture. Acupuncture was carried out according to 1st or 2nd variants of inhibitory action. When selecting points, the locally segmental principle was used, and the effect was carried out on symmetric points of general action (P7, GI4, GI 11 , E36 , RP6, VB34), on local pain ah shi points, in “near” and “far” points from the pain zone; on standard points of meridians of calming action: sympathetic, sedative and analgesic (points-cracks). Specific pain points were used: in pain in the area of the shoulder girdle – R5, E37, R4: in the rear surface of the chest and region of the scapula – T26, V43, V11; in neuralgia – V60, TR5, VB41. Corporal reflexology “enhance” auricular, we used impact on АТ55, АТ13, АТ22, АТ51, АТ34. In cases of severe pain and musculotonic syndromes, treatment was initiated with effects on auricular points: АР37 point of the cervical spine and АР55 point Shen Men. When comparing the results of VAS testing before and after the treatment, in all patients we noted a decrease in the intensity of pain, and 16 of patients went into the category of “mild cases”. The positive dynamics is confirmed by the data of electroneuromyographic studies: an increase in the amplitude of the M-response and a decrease in latency, a change in the characteristics of the F-wave. The obtained data indicate the high efficiency of acupuncture in the treatment of pain and muscle-tonic syndromes in patients with spinal osteochondrosis

Secretion of hormones of hypophysis, sexual gland and adrenals in patients with postoperative cicatricial-commissural epiduritis

The article is devoted, to the study of secretion of hormones of hypophysis, sexual gland and adrenals in patients with postoperative cicatricial-commissural epiduritis. Concentration of some hormones of hypophysis, sexual glands and adrenals in blood serum of 45 patients with postoperative cicatricial-commissural epiduritis before and. after standard conservative treatment was defined. Typical changes in secretion of studied hormones at postoperative cicatricial-commissural epiduritis were revealed. It was showed that standard scheme of treatment partly grades revealed endocrine disorders. Appropriateness of including research of hormonal profile for solving the problem of its possible correction in the complex of examination of patients with postoperative cicatricial-commissural epiduritis and. of calling endocrinologist for the examination of patients and further enhancement of the scheme of their treatment was proved

SOME FEATURES OF ELECTRONEUROMYOGRAPHY AND DENSITOMETRY IN PATIENTS WITH CERVICAL OSTEOCHONDROSIS

Manifestations of cervical osteochondrosis are largely predetermined by degenerative changes in the most mobile lower cervical spine (CV-CVI, CVI-CVII). Clinical picture of cervical osteochondrosis depends not so much on the presence of hernial protrusions as on the changes in bone structures with the formation of arthrosis with pain syndrome. In this regard, we found interesting to study relation of electroneuromyographic parameters and bone mineral density in patients with cervical osteochondrosis. A survey of 38 patients with cervical osteochondrosis localized predominantly in the segments CIII-CIV, CIV-CV, CV-CVI CVI-CVII there were 20 men and 18 women. Subjective and objective examinations showed pronounced muscular-tonic syndrome (with cervicalgia, cervicocranygia, cervicobrachialgia) in all patients. We studied threshold values, M-response amplitude, nerve conduction in motor fibers of the axillary, radial, medial and ulnar nerves, as well as amplitude and frequency indices characterizing the functional state of the deltoid and trapezius muscles. When studying the state of bone tissue, we measured the speed of sound velocity (SV, m/sec) in the radial bones, determined the T-index - the number of standard deviations from mean for healthy young people, and the Z-index - the number of standard deviationsfrom mean for the age group. Comparative analysis of the results of studies by electroneuromyography and osteodensitometry in patients with cervical osteochondrosis of I-II periods, in the presence of neurotrophic disorders have not revealed changes in bone density. At the same time, in patients with cervical osteochondrosis of the III period in the presence of both protrusions and hernias of CVI-CVII CVII-CVIII discs, a reduction in threshold values of direct muscle response, an increase in the amplitude of evoked potentials, and a shortening of the latent period were recorded in the ENMG. Mineral density in patients with this pathology differed from the norm, indicating the presence of osteopenia

Залежність процесу виробництва сичужних напівтвердих сирів від якісних показників молока-сировини

The analysis of literature sources on the question of the relevance of the influence of raw milk and its casein fraction on the production of rennet cheeses is presented in the paper. The studies were conducted to determine the suitability of using milk for the production of rennet milk from raw materials of cows of Ukrainian brown dairy and Ukrainian black-rumped dairy breeds of the state enterprise “Research Institute of Agriculture of the North East of NAAS”. As a result of the studies on the cheesiness of milk samples from the two study groups, we can conclude that, compared to the literature data, the average milk values obtained from cows of Ukrainian brown dairy and Ukrainian black-and-white breeds are confirmed. While analyzing the technological parameters of milk, it should be noted that there is no significant difference between the samples. We should note only that the first sample is inferior to fat by 0.41. This ratio of fat to protein, in turn, affects the yield of the product and its consumption characteristics. The first sample the creation of casein was in 3.2 min. faster , phase of gelforming – for 0.3 min. faster and the clot processing was done requiring 3 min less time. The consumption of milk per 1 kg of cheese in the first sample was lower than 0.4 in the second. It should be noted that the curd grain obtained from the milk of cows of the Ukrainian black-ruby dairy breed had a softer structure, ie it contained more moisture than the grain from the milk of cows of the Ukrainian brown dairy breed. This subsequently affected the mass fraction of moisture in the finished product in the direction of increase and was reflected in the organoleptic evaluation. As a result of the evaluation, members of the tasting committee noted that the consistency, taste and smell of cheese made from milk of Ukrainian brown dairy breed were slightly better. The difference was not significant and was respectively 1 point. It should be noted that the mass fraction of fat in the first sample was 1.3% higher than in the second sample. In this case, we observe a decrease in the mass fraction of moisture in the first sample compared to the second by 1.8%. The difference in terms of mass fraction of salt was not significant and is 0.1%. Considering the results of the presented studies, it should be noted that both samples of cheese of semi-solid cows made of milk of Ukrainian brown dairy and Ukrainian black-and-white breeds meet the requirements of state standart 4669:2006 in terms of organoleptic, physicochemical and microbiological parameters. However, the production of cheese from the milk of cows of Ukrainian brown dairy breed will reduce the loss of raw materials and produce cheese with better organoleptic characteristics.У роботі представлено аналіз літературних джерел щодо питання актуальності впливу молока-сировини та його казеїнової фракції на процес виробництва сичужних сирів. Дослідження проводили з метою встановлення придатності використання молока для виробництва сирів сичужних з молока-сировини корів української бурої молочної та української чорно-рябої молочної порід державного підприємства “Дослідне господарство Інституту сільського господарства Північного Сходу НААН”. Аналізуючи технологічні показники молока слід зазначити, що між зразками суттєва різниця відсутня. Однак перший зразок поступається другому за вмістом жиру на 0,41. У першому зразку утворення казеїнового згустку пройшло на 3,2 хв швидше, фаза гелеутворення – на 0,3 хв швидше, а обробку згустку проводили на 3 хв менше. Витрати молока на 1 кг сиру у першого зразка були нижчими, порівняно з другим, на 0,4. Варто відмітити, що сирне зерно отримане з молока корів української чорно-рябої молочної породи мало м’якшу структуру, тобто містило більше вологи в порівнянні з зерном із молока корів української бурої молочної породи. Це в подальшому вплинуло на масову частку вологи в готовому продукті в бік збільшення та відобразилося при органолептичній оцінці. В результаті проведеної оцінки члени дегустаційної комісії відзначили, що консистенція, смак і запах сиру, виробленого з молока української бурої молочної породи були дещо кращими. Різниця була не достовірною і становила відповідно по 1-му балу. Слід відмітити, що показник масової частки жиру у першому зразку на 1,3% був вищим, ніж у другому зразку. При цьому спостерігаємо зниження масової частки вологи у першому зразку порівняно з другим на 1,8%. Різниця за показником масової частки кухонної солі була не суттєва і становить 0,1%. Враховуючи результати представлених досліджень зауважимо, що обидва зразки сиру напівтвердого виробленого із молока корів української бурої молочної та української чорно-рябої порід відповідають вимогам ДСТУ 4669:2006 за органолептичними, фізико-хімічними та мікробіологічними показниками. Однак, виробництво сиру з молока корів української бурої молочної породи дозволить зменшити втрати сировини та виробити сир з кращими органолептичними показниками

Functional State of the Bioelectrical Activity of the Brain in Cervical Osteochondrosis

Spinal osteochondrosis takes one of the first places among all chronic diseases, and every second osteochondrosis patient has dystrophic and degenerative changes in the spine in the cervical region. Manifestations of osteochondrosis of the cervical spine are diverse, which often interferes with the diagnosis and subsequent treatment. In osteochondrosis of the cervical spine, clinical symptoms may occur associated with insufficient blood supply to areas of the brain and that would require diagnostic methods that are not included in the standards for diagnosing the disease. In order to study the bioelectrical activity of the brain in 25 patients of the Department of Neurosurgery of Irkutsk Scientific Centre of Surgery and Traumatology with osteochondrosis of the cervical spine with cerebrovascular syndrome; a comparison was made of EEG indicators with a group of healthy volunteers that is representative by sex and age. Encephalogram indices were recorded using an EEG-21/26 Encephalan-131-03 encephalograph (Taganrog) with a standard installation of scalp EEG electrodes using the "10-20"system. An analysis of the rhythms of the bioelectrical activity of the brain in the clinical comparison group revealed a normal zonal distribution with an alpha rhythm dominating the EEG, which generally reflects a high degree of organization of neuroactivity and indicates the stability of cerebral homeostasis. At the same time, in the main group, EEG indicators significantly differed from the values of the norm and indicators of the control group. Analysis of the bioelectrical activity of the brain of patients with osteochondrosis of the cervical spine was characterized by disorganization of cortical rhythmics with a combination of moderate and diffuse disorders of varying severity. There was a shift in the frequency of bioelectric activity towards slow waves, which is a characteristic of dyscirculatory encephalopathy. Thus, the study of brain biopotentials (EEG) in patients with osteochondrosis of the cervical spine has diagnostic and prognostic significance, as well as a measure of the current clinical condition of the patient

Changes in Bone Density in Patients with Osteochondrosis of the Cervical Spine

Osteoporosis and osteochondrosis have common clinical manifestations: poor posture, reduced flexibility and mobility of the spine, joint pain, fatigue, weakness; both diseases appear most often in old age. Having a lot in common in symptoms, osteoporosis and osteochondrosis differ in etiology, treatment and prognosis.The development of osteoporosis is based on impaired bone remodeling, but it has been established that this process is also important in the pathogenesis of osteochondrosis. The results of previous studies indicate that there is a relationship between the functional state of the neuromotor apparatus and the violation of the structure of bone tissue in the spinal canal stenosis of the lumbar spine. There is data on the study of the nerve conduction and bone mineral density in patients with osteochondrosis of the cervical spine in a small sample.To study the functional state of peripheral nerves and the presence of disorders of bone tissue structure in 2018, 25 patients of the neurosurgical department of Irkutsk Scientific Centre of Surgery and Traumatology were observed with the diagnosis "Dorsopathy, Osteochondrosis of the cervical spine" (М50.1) and 25 volunteers of the control group, representative of the main sex and age. As a result of the examination, all patients of the main group showed sufficiently deep afferent-efferent dysfunctions of the segment apparatus of the cervical spine, while in the control group changes in ENMG indicators showing initial changes in the function of the neuromotor apparatus were observed in 20 % of the examined. The change in bone density was observed in most of the main group examined (72 %), in the control group the decrease in bone density was less frequent (54 %, of which 29 % registered osteopenia). The results of the examination indicate the existence of a relationship between osteochondrosis and osteoporosis - the more symptoms of sensory-motor dysfunction of the root increase in osteochondrosis of the cervical spine, the more often the change in bone density - osteoporosis or osteopenia - is diagnosed

Experience of unilateral and bilateral transpedicular fixation in degenerative diseases of the lumbar spine

The aim. To study the effectiveness of using monosegmental fixation systems in surgeries involving resection of part of the facet joint in patients with posterolateral and foraminal hernias in the lumbar spine. Materials and methods. The study included 40  patients with degenerative diseases of the lumbar spine who underwent medial facet resection and the removal of posterolateral or foraminal disc hernia. Among them, 10  patients underwent unilateral single-level transpedicular fixation with interbody fusion using titanium cage (UTPF cage group), and the other 10 patients underwent unilateral monosegmental transpedicular fixation (UTPF group). The remaining 20 patients underwent bilateral transpedicular fixation (BTPF group). The amount of intraoperative blood loss, duration of surgery and length of hospital stay, as well as the frequency of perioperative complications in the groups were assessed. Visual analogue scale (VAS) pain score, Oswestry index and McNab score were assessed before and 6 and 12 months after surgery. Results. Intraoperative blood loss in the UTPF  cage and UTPF groups was less than in the BTPF group, as was the duration of surgery; the differences were statistically significant (p < 0.05). Indicators of VAS score and Oswestry Quality of Life Index in the studied groups indicated the effectiveness of the technology. Discussion. Unilateral decompressive and stabilizing surgeries in patients with posterolateral and foraminal hernias of the lumbar spine can reduce the duration of the surgery, the volume of blood loss and the severity of pain in the postoperative period due to adequate decompression of the neurovascular formations of the spinal canal and stabilization of the spinal motion segment, which prevents the relapse of the disease and provides early rehabilitation of patients. Conclusion. Unilateral transpedicular fixation is acceptable and safe for lumbar degenerative diseases and improves the quality of life of the patients

Radiological and Functional Research Methods in the Diagnosis of Segmental Instability in Cervical Osteochondrosis and of Cervicobrachial Syndrome

This paper presents the analysis of diagnostic policy of 72 patients with cervical osteochondrosis and cervicobrachial syndrome. All patients were examined according to a single program, which included a specially designed questionnaire containing address data, diagnosis, history of life and illness, patient complaints, with a mandatory examination by a neurologist for the presence of compression of neural structures of the cervical spine with a detailed description of the local status and clinical and neurological syndromes. Patients underwent general spondylography of the cervical spine in the anteroposterior and lateral projections. For the diagnosis of segmental instability, functional spondylography was performed in the position of maximum flexion and extension and functional spondylography with burdening, which is based on mathematical modeling of the distribution of the vector force load system in the cervical spine under conditions of inclination of the head at an angle of 45° (flexion) and 15° (extension) with the weight on the head weighing up to 500 grams (putting a special device on the head). A mathematical formula for calculating the index of instability of the vertebral motor segment in the cervical spine is proposed. Sagittal balance of the cervical spine was studied with the correlative dependence of its indicators with the intensity of the pain syndrome according to standard spondylography and magnetic resonance imaging. Identified marker indicator of electroneuromyographic studies of the upper extremities - F-wave. Based on the obtained fundamental knowledge, an algorithm for diagnosing osteochondrosis of the cervical spine and cervicobrachial syndrome has been developed and scientifically substantiated