Exercise is a major factor in the development of occupational pathology of the connective tissue and musculoskeletal system, including chronic lumbosacral radiculopathy (LSRP), which accounts for 20% of occupational diseases in Ukraine. Some problems remain insufficiently studied despite a significant number of scientific works devoted to the study of issues of etiology, pathogenesis, features of clinical manifestations, the use of diagnostic and prophylactic measures in LSRP. The criteria for diagnosing changes in the peripheral nervous system need to be clarified and systematized by in-depth study of the functional state of the nervous apparatus in patients with LSRP of professional genesis. The research was carried out in a group of 60 miners of the main professions (coal-cutter, mining worker of a clearing pit (MWCP), drifter) suffering from LSRP. The activity of the neuromuscular apparatus was assessed according to the indices of electroneuromyography (ENMG), namely: the amplitude of the M-response during stimulation at the distal point of the right and left m. Abductor Hallucis, n. Plantar Medial, S1, S2 (mV), as well as indicators of terminal and residual latencies (ms), the speed of the impulse along the indicated nerves (m/s). It was found that the average amplitude of the M-response during stimulation at the distal point m. Abductor Hallucis, n. Plantar Medial in the MWCF group was at 6.37 mV (with a reference value of 4-5.8 mV), the average pulse conduction velocity was 38.46 m/s (with a reference value of 40.00 -50.00 m/s), it was found that most often in the group of coal-cutters (64.2%), a pathological indicator of terminal latency was recorded, while in a group of drifter, it did not go beyond the normal range in one of the surveyed miners suffering from LSRP of occupational genesis. Thus, ENMG of the long nerves of the lower extremities is a useful tool of objectifying the diagnosis of LSRP of ocupational genesis, it allows to determine the degree of impairment of the functional activity of peripheral nerves, neuromuscular synapses and the contractility of the striated muscles.
Read full abstract