Некоторые особенности показателей электронейромиографии и денситометрии у пациентов с остеохондрозом шейного отдела позвоночника

Abstract

Manifestations of cervical osteochondrosis are largely predetermined by degenerative changes in the most mobile lower cervical spine (C V -C VI , C VI -C VII ). 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 C III -C IV , C IV -C V , C V -C VI C VI -C VII 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 C VI -C VII C VII -C VIII 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.