ROLE OF DOPPLEROGRAPHY IN DIAGNOSIS OF HEMODYNAMIC DISORDERS IN VERTEBRAL ARTERIES WITH INSTABILITY AND ARTHROSIS OF ATLANTO-AXIAL JOINTS

Abstract

Biomechanical dysfunction of the cervical vertebral motor segment is one of the most common causes of cervicogenic headache. Cervical pain syndrome of vertebrogenic genesis is often observed against the background of congenital anomalies of bone and soft tissue structures. It has been established that anatomical variation of the place of junction, the level of entry into the bone canal, as well as doubling of the vertebral arteries create prerequisites for pathological changes of hemodynamics in them at different functional loads, therefore, timely diagnosis is important to prevent these disorders. Due to the fact that the vertebral arteries are contained in the vertebral canal, which is formed by the transverse processes of the cervical vertebrae, they are normally protected against rotational movements. The development of osteoarthritis with the appearance of osteophytes leads to compression of the vertebral artery or irritation of the cervical nerve plexuses located on the walls of blood vessels. This, in turn, leads to a spasm of the vertebral arteries during rotational movements. To develop informative hemodynamic parameters in the vertebral and basal arteries in case of pathologies of the cervical spine, an analysis of the Doppler sonography results was performed in patients with instability and arthrosis of the atlanto−axial junction. The maximum systolic velocity (Vs), end diastolic velocity (Vd), resistance index (RI) in the second and third segments of the vertebral arteries in neutral position of the head and during rotational movements were determined. Thus, hemodynamic disturbances in the vertebral arteries in patients with instability and arthrosis of the atlanto−axial articulation are manifested by a decrease in Vs, an increase in RI. These changes are most pronounced with functional loads in the form of rotational movements of the head. Key words: dopplerography, atlanto−axial joints, third segment of the vertebral artery.