ФУНКЦИОНАЛЬНАЯ ДИАГНОСТИКА И ИГЛОРЕФЛЕКСОТЕРАПИЯ У ПАЦИЕНТОВ С ОСТЕОХОНДРОЗОМ ШЕЙНОГО ОТДЕЛА ПОЗВОНОЧНИКА

Abstract

We developed an algorithm for spinal diagnostics to optimize the diagnosis and treatment of patients with cervical osteochondrosis. This algorithm includes physical and neurological examination of a patient, radiological methods, multi-layer spiral CT (MRI) of cervical spine, densitometry and electroneuromyography (ENMG) and is used in practical work of neurosurgical unit of Irkutsk Scientific Center of Surgery and Traumatology. We managed 40patients with cervical osteochondrosis in period I–III localized in CIII–CIV, CIV–CV, CV–CVI, CVI–CVII segments and with severe muscular tonic syndrome (cervicalgia, cervical cranialgia, cervicobrachialgia). Patients with osteochondrosis in period I–II had medium decreased conduction of peripheral nerve motor fibers on both sides of spine, which indicates the lesion of some motor fibers. In patients with osteochondrosis in period III in case of protrusion and herniation of intervertebral discs the ENMG values corresponded to the increase in neurility and conduction velocity of motor nerve and muscle fibers in diseased segment.Conservative treatment was conducted up to the Standard approved by the Ministry of Health of the Russian Federation and was supplemented with acupuncture (9–10 sessions) based on the changes in ENMG values. Performed treatment caused significant decrease in pain syndrome, reduction of neurological manifestations and, as a consequence, positive dynamics of ENMG values. Proposed algorithm for management of patients with osteochondrosis allowed to diagnose the localization of diseased functional spinal unit, to reveal problem peripheral nerves and, as a result, to choose adequate treatment tactics and to estimate its effectiveness.