Cervical Osteochondrosis Research Articles

Methods of physical rehabilitation of schoolchildren aged 15-17 with cervical osteochondrosis

Background. The problem of rehabilitation of children with cervical osteochondrosis can be solved by creating a special technique and performing additional exercises at home. The objective of the study is rehabilitation of high school students with osteochondrosis of the cervical spine. Methods: boys and girls aged 15-17 who were diagnosed with osteochondrosis of the cervical spine took part in the research. A total of 38 schoolchildren took part in the study. The study was conducted from February 28 to May 26, 2023 on the basis of several secondary schools in the city of Kirov. All students in both groups studied according to the standard program 3 times a week. Children from experimental group B additionally performed sets of physical exercises from the experimental methodology. The study used tests that evaluate the static strength of the abdominal and back muscles, the flexibility and endurance of the cervical spine and the speed and strength abilities of the arm muscles. When analyzing the results, their statistical processing was carried out using the arithmetic mean, square deviation, error and difference. Confidence at p<0.05. Results: According to the results of the research, it was found that children from the control group were able to slightly improve the studied indicators to 10.6%, the increase in indicators from the beginning to the end of the study on all tests turned out to be unreliable (p>0.05). In the experimental group, at the end of the study, the indicators for all tests improved from 23.5% to 66.7% (p<0.05). Thus, the experimental technique is more effective in the treatment of cervical osteochondrosis than the generally accepted technique.Conclusions: Systematic physical education with the use of special physical exercises aimed at eliminating problems in the cervical spine give a significant effect in the rehabilitation of cervical osteochondrosis. The indicators of the static strength of the abdominal and back muscles will improve, the flexibility and endurance of the cervical spine will also increase, and the speed and strength capabilities of the arm muscles will increase. Keywords: School children's health, Lifestyle, Rehabilitation, Joint mobility, Physical therapy.

Prediction of cervicalgia regression after surgery for cervical osteochondrosis

In the medical rehabilitation of patients with cervical osteochondrosis, a surgery is one of the stages in the treatment of this spinal pathology. However, the use of modern high-tech diagnostic and treatment methods does not always make it possible to achieve such a result of surgical intervention that would satisfy both the patient and the attending physicians. Due to this, we are obliged to constantly study and develop new diagnostic and therapeutic measures that could help improve the quality of treatment of clinical manifestations of cervical osteochondrosis. The multifactorial analysis of data about patients with cervical osteochondrosis allowed creating a database of various diagnostic and prognostic factors, on the basis of which the «Method for predicting the regression of cervicalgia intensity after surgery for cervical osteochondrosis» was developed depending on the severity of the identified diagnostic and prognostic factors and the volume of the upcoming surgical intervention. The proposed method of predicting the regression of cervicalgia intensity after surgery for cervical osteochondrosis can serve as an integral part of a comprehensive preoperative examination of patients with this spinal pathology. As a result of applying the proposed diagnostic method, additional opportunities arise to guide the surgeon to an individual set of surgical measures with the most promising outcome. Moreover, comfortable psychological conditions are created for the patient as fear and uncertainty in the result of the upcoming treatment are eliminated, which gives him / her confidence in the outcome of the upcoming operation and helps to improve treatment results and reduce the disability of patients. The work is based on the analysis of the results of a comprehensive clinical examination, treatment, and follow-up of 457 patients who underwent surgical treatment for cervical osteochondrosis. The reliability of predicting the regression of cervicalgia intensity after surgery for cervical osteochondrosis is 96.9 %.

Диагностика острого синусита при шейном остеохондрозе

The article describes the pathogenesis of acute sinusitis; the authors identify the connection between cervical osteochondrosis and acute sinusitis. A surface electromyography method has been proposed for the diagnosis of acute sinusitis in adults. The study population consisted of 103 patients aged 18–26 years, including 61 females (59%) and 42 males (41%). The patients were divided into 3 groups. The first consisted of 20 relatively healthy individuals; the second, of 22 with other diseases of the ENT organs; the third, of 61 people suffering from acute sinusitis. Objective. To improve the diagnosis of acute sinusitis in adults. Methods. For the study of electromyography, we used the Viking Quest electroneuromyograph (Nicolet Biomedical), for processing statistical data we used the R 3.5.3 program and the Kruskal–Wallis comparative test. In addition, radiographic examination methods, otorhinolaryngological examination, and consultation with a neurologist were used. Results. Confidence intervals were established for the three study groups of patients. There is an increase in the amplitude of the M-response in the group of patients with the disease; in the group with other ENT pathologies and in healthy people, a lower level of amplitude of the M-response is observed. Conclusion. In patients with pathology of the cervical spine and inflammatory processes in the nasal cavity and maxillary sinuses, it is advisable to conduct an electromyographic study.

HEALTH CARE TECHNOLOGIES IN CREATING OPTIMAL WORKING CONDITIONS IN HIGHER EDUCATION INSTITUTIONS

Neck-shoulder syndrome is a real problem in general clinical practice, manifested by pain, reflex myotonic symptoms in the cervical spine and upper limbs. The goal of our research was a comprehensive study of the clinical and instrumental aspects of the neck-shoulder syndrome for the development of a preventive program and rehabilitation tactics. Materials and methods. We examined 103 people aged 18 to 50 years with clinical manifestations of reflex syndromes of cervical osteochondrosis in the form of cervicocranial pains, who underwent outpatient examination on the basis of National University «Yuri Kondratyuk Poltava Polytechnic» and the Skalyansky Clinic. Among them, 84 (78.64%) patients were women, 22 (21.36%) were men. The duration of having the neck-shoulder syndrome was from 1 to 10 years. The analysis of the obtained data revealed a mixed (musculovascular) mechanism of cervicocranial pain, which is a clinical manifestation of reflex syndromes of cervical osteochondrosis in young people. In this regard, it is advisable to include anti-inflammatory drugs (xefokam, denebol, olfen, nimesil, sigan, etc.), muscle relaxants (midokalm, sirdalud), vascular and venotonics (L-lysine escinat, troxevasin, actovegin) in the complex treatment of this category of patients , nicotinic acid preparations, etc.), vegetotropic drugs, as well as drugs that reduce irritative-paroxysmal phenomena and affect the pain syndrome (gabantine, lamotrine), antidepressants (amitriptyline, fluoxetine, etc.), physiotherapeutic methods and physical therapy. Conclusions. Modern diagnostics and a rational approach to treatment will further lead to early rehabilitation of patients and increase the working capacity of young patients with cervicocranial pain on the background of osteochondrosis of the cervical spine.

КЛИНИЧЕСКИЕ ОСОБЕННОСТИ ОСТРЫХ РЕФЛЕКТОРНЫХ И КОМПРЕССИОННЫХ СИНДРОМОВ ШЕЙНОГО ОСТЕОХОНДРОЗА

Pain syndromes of cervical osteochondrosis are among the most common in neurological practice. The complex anatomic and physiological features of the cervical spine result in a variety of clinical syndromes in case of cervical osteochondrosis. The clinical features of the formation of refl ex and compression syndromes of cervical steochondrosis were identifi ed as a result of the examination. In patients with refl ex pain syndromes, the distribution of pain over the sclerotome and myotome areas (myosclerotome pain)
 and the absence of motor and sensory disorders were characteristic. Patients with compression radicular syndrome featured the distribution of pain sensation over dermatome areas, motor disturbances in the form of muscle paresis or hypotonia, corresponding myotome, decrease or absence of corresponding tendon refl exes, and sensory disturbances in the dermatome area of the aff ected radicle.

The Place of Physical Factors in Prophylaxis and Treatment of Cervical Osteochondrosis

The Place of Physical Factors in Prophylaxis and Treatment of Cervical Osteochondrosis

Voice rehabilitation after laryngectomy: problems, complications and ways of their elimination

Voice rehabilitation after laryngectomy: problems, complications and ways of their elimination

Forensic evaluation of cervical spine distortion injuries in non-fatal road traffic accidents: An observational study

Background. The study relevance is substantiated by the growing numbers of road vehicles and cervical spine traumas occurring among all spinal injuries. Currently, there is no common vision of the cervical trauma pathogenesis, diagnostic algorithm or treatment, which stipulates difficulties in the forensic evaluation of soft tissue injuries of the neck, especially combined with the head or spine traumas around neck, as well as certain diseases.Objectives. A study of the incidence of cervical spine distortion injuries and their clinical and forensic assessment for severity to human health.Methods. A retrospective selective single-stage trial and analysis of 32 forensic medical reports on road accident and physical injury administrative cases in 2017 (single year) have been conducted. Normally distributed data are presented as mean (M), standard deviation (SD) and percent shares. The significance of inter-share variation was estimated with Student’s t-test.Results. Cervical spine distortion injuries more frequently associated with traumas to drivers than passengers inside the salon (81.2%), especially in passenger vehicles, with front-seat travellers inflicted most often (60.0%). Cases of independent pathology were very rare. The most common were combinations with soft tissue injuries, combined blunt trauma to the head, torso and limbs, with craniocerebral or maxillofacial trauma. Cervical osteochondrosis was revealed in 18% cases. Primary diagnosis predominantly grounded on complaints and history (67%), with only 12% cases using a comprehensive neurological examination or instrumental methods. The severity was assessed in the context of concomitant injuries. Acute and moderate severity had equal rates of 6.2%, light severity — 37.5%, no damage — 9.3%. Non-qualified remained 39.8% cases due to a lack of full clinical and instrumental examination (66.7%) or the victim’s failure to appear (13.3%); 20% cases were expert-reported as uncertain for trauma circumstances and mechanism.Conclusion. Further research and systematisation of the data accumulated are necessary. The following clinical and forensic evaluation, as well as statistical analyses will facilitate common diagnostic and severity assessment algorithms to develop for mechanical soft tissue and ligament injuries of the cervical spine.

Роль нарушений липидного обмена и эндотелиальной дисфункции в формировании вертебробазилярной недостаточности у лиц молодого возраста

Актуальность. В патогенезе формирования сосудистой патологии мозга значимую роль играет не только внешний негативный (спондилогенный) фактор, но и дисбаланс различных эндогенных систем (эндотелиальной, липидной), влияющих на церебральную гемодинамику. Следовательно, актуальность изучения этих взаимосвязей имеет не только теоретическое, но и важное практическое значение.Целью исследования было изучение состояния липидного обмена и функции эндотелия у пациентов молодого возраста со спондилогенной вертебрально-базилярной недостаточностью. Материалы и методы. Нами было обследовано 98 пациентов (женщин — 56, мужчин — 42) с проявлениями вертебрально-базилярной недостаточности на фоне мышечно-рефлекторных, нейрососудистых и корешковых синдромов остеохондроза шейного отдела позвоночника. В исследование были включены больные от 18 до 40 лет (средний возраст 28,5 ± 3,8 года). Всем пациентам проводилась функциональная рентгенография шейного отдела позвоночника со сгибанием и разгибанием, МРТ шейного отдела позвоночника, а также ультразвуковое допплерографическое исследование сосудов шеи и магистральных артерий головы с применением функциональных нагрузок с ротацией головы, а также дуплексное сканирование сосудов шеи. Показатели липидного обмена в сыворотке крови определяли спектрофотометрическим методом, концентрацию эндотелина-1 в сыворотке крови — методом иммуноферментного анализа, cодержание S-NO — спектрофлюориметрическим методом.В результате проведенного исследования было выявлено, что спондилогенная вертебрально-базилярная недостаточность сопровождается нарушением обмена липидов, характеризующимся разнонаправленными сдвигами уровня холестерина, липопротеидов низкой плотности, липопротеидов очень низкой плотности и липопротеидов высокой плотности, свидетельствующим о сдвиге плазменных показателей липидтранспортной системы в сторону атерогенеза. Эндотелиальная дисфункция у данного контингента больных характеризуется увеличением концентрации эндотелина-1, являющегося вазоконстрикторным фактором на фоне уменьшения активного метаболита оксида азота — S-NO, обладающего вазодилатирующими свойствами.

Ménière’s disease and chronic cerebrovascular diseases

Ménière’s disease (MD) is an idiopathic inner ear disease, which is characterized by noise in the ears, periodic attacks of vertigo and the development of sensorineural hearing loss. MD is characterized by endolymphatic hydrops – an increase in the volume of endolymph that fills the membered labyrinth of the inner ear. Currently highlighted subtypes MD. The first subtype meets most often and is characterized by classical manifestations of MD. The second subtype is characterized by the development of sensorineural hearing loss, to which only after a long time are joined by the episodes of dizziness. The third subtype of MD includes family cases of the disease. The fourth and fifth subtypes of MD is observed in patients with migraine and autoimmune diseases. The diagnosis of definite MD is based on the 2 or more spontaneous episodes of vertigo with each lasting 20 minutes to 12 hours, low-to medium-frequency sensorineural hearing loss in one ear, fluctuating aural symptoms (fullness, hearing, tinnitus) located in the affected ear, and lack of data for other reasons for dizziness. There are no effective treatment for auditory disorders MD, therapy is aimed at preventing dizziness attacks. The first line of MD’s therapy includes a dietary salt restriction, the use of betahistine and diuretics. Betahistine (Betaserc) is usually used in a daily dose of 48 mg for 3–6 months to reduce the frequency of vertigo. For long-term treatment, it is convenient to use a betahistine modified-released (Betaserc Long) 48 mg, taken once a day. With the ineffectiveness of conservative therapy, other methods of therapy are possible: intratympanic administration of corticosteroids or gentamicin, labyrinthectomy or vestibular neurectomy. Unfortunately, many patients suffering from BM mistakenly makes a diagnosis of cerebrovascular disease, vertebrobasilar insufficiency, cervical osteochondrosis. Diagnostic errors are usually caused by the fact that the patients with MD are not conducted audiometry, vestibular tests, and the signs of cerebral microangiopathy identified when MRI brain are mistakenly regarded as confirmation of vascular dizziness genesis.

Analysis of the frequency of pathologies of the cervical spine in adolescents according to computed tomography

Spinal pathologies today occupy a leading position in the rankings of diseases with a high degree of disability of patients, translating the problem into the category of medical and social. Cervical lesions are one of the most common manifestations of spinal pathology, and cervical osteochondrosis ranks second after lumbar. Literature sources indicate that today spinal pathologies have a pronounced tendency to rejuvenate. The aim of our study was to determine the frequency of pathological lesions of the cervical spine among adolescents in a randomized sample according to computed tomography. 100 series of anonymized computed tomograms of young people (18-21 years old) were processed. The examination was performed on the TSX-101A Aquilion 16. According to the analysis, only 22% of the examined young people do not have pathological changes in the study area. Changes in intervertebral discs in the form of protrusions of different localization were found in 51% of the examined persons, in 23% - intervertebral hernias. The high frequency of pathological lesions of the cervical spine indicates the need to identify the causes of their occurrence, as well as the development and application of effective preventive measures.

Роль внутричерепной гипертензии в патогенезе центральной серозной хориоретинопатии

Central serous chorioretinopathy (CSCR) is a pachychoroid condition, but the causes of pachychoroid development remain unknown. Taking into account the anatomical features of the blood supply to the eyeball, it was suggested that the phenomena of pachychoroid can be caused by intracranial hypertension. Purpose. Evaluate blood supply disorders at the level of eyeball vessels, intracranial vessels and vertebrobasilar basin in patients with CSCR. Material and methods. 10 patients with CSCR were examined, 4 of them additionally underwent magnetic resonance imaging (МРТ) of the brain and cervical spine, intra-and extracranial arterio-and venography, and ultrasound of extra-and intracranial vessels. Results. By OCT data, all patients had significant increase in the choroidal thickness both in eyes with CSCR, and in fellow eyes. OCT of the optic disc revealed subarachnoid space expansion - a marker of intracranial hypertension. By ultrasound B-scan data, 8 patients with CSCR showed moderate expansion of the perineural space of the optic nerve and significant expansion of orbital vessels, which also indicates intracranial hypertension. By MRI data, all patients showed signs of internal hydrocephalus, which may indicate intracranial hypertension. In addition, the presence of signs of cervical osteochondrosis and asymmetry in the vertebral arteries was established. In 50% of cases, there was a decrease in intravascular blood flow along the orbital vein on the side of the affected eye, and an asymmetry of venous blood flow along the transverse and cavernous sinuses. By ultrasound dopplerography signs of intracranial venous hypertension of extra-and intracranial vessels were revealed. Conclusion. The role of pathological changes of central genesis in the development of CSСR has been established, requiring interdisciplinary research and expansion of therapeutic measures aimed at limiting the identified disorders. Key words: central serous chorioretinopathy, pachychoroid condition, intracranial hypertension.

P-PN025. Peculiarities of differential diagnosis and treatment of upper limb tunnel neuropathies

Introduction . It is well-known that numbness in hands is associated with peripheral nerves compression or “tunnel neuropathies” (TN). According to numerous authors, TN account for up to 40% of all neurological diseases. However, TN diagnosing in outpatients is practically uncommon. Methods . 597 cases of hand numbness were selected on analysis of 2495 outpatient records in two remote ambulatories during 2016-2017, with the share of TN being 0.7% of all initial diagnoses. 92 patients with mild to moderate TN symptoms were included in the study, and divided into main (n=50) and control (n=42) groups. Both groups received B vitamins and thioctic acid as baseline medications. Ipidacrine (Ipigrix by Grindex, Latvia) was added in the main group: 15 mg I.M. q.d. for a week and 20 mg p.o. q.d. for 3 more weeks. Thorough clinical and ENMG examinations were carried out before and after treatment. Results . All initial diagnoses were associated with cervical osteochondrosis, including radiculopathy, lacking any signs of its objectification. The Kruskal-Wallis test revealed sample homogeneity regardless of the diagnoses, and no statistically significant inter-group differences by clinical or ENMG markers of TN were originally detected. A 4-week follow-up analysis compared with the baseline results demonstrated that the control group had a positive trend, but no significant differences before and after treatment. Meanwhile, in the main group, additionally receiving ipidacrine, there was a statistically confirmed improvement of hypoesthesia, paresthesia, provocative test results, SNAP amplitudes and conduction time within carpal and pronator TN, as well as CMAPs in the cubital TN (p<0.05). Conclusion . The study describes typical “diagnostic masks” of TN, traditionally associated with osteochondrosis, the role of which in the occurrence of hand numbness is greatly exaggerated. Furthermore, the results suggest the efficacy of a short course of ipidacrine in the complex treatment of patients with mild and moderate TN.

ODONTALGIA IN MAXILLOFACIAL REGION

Odontogenic lesions of the trigeminal nerve branch system (neuritis, neuralgia, odontalgia) that tend to have a long chronic course are more common in middle and old age. They can be caused by defects in the treatment and restoration of teeth, inflammatory and traumatic processes in the maxillofacial region, and others. The dentist should distinguish between the terms: "odontalgia" and "odontogenic trigeminal neuralgia". Odontogenic neuralgias do not disappear after the elimination of the main odontogenic pathological focus. If after the sanitation of the oral cavity pain disappears, then we are talking about odontalgia.&#x0D; Sometimes it is very difficult to find the cause of the disease. Pain in the facial area and occipital region of the head can also occur with osteochondrosis of the cervical ridge and provoke pain in the system of the trigeminal nerve branches. Pain and paresthesias can occur in the occipital region of the head and neck, and then spread to the parietal, zygomatic region or the entire face. More often the pain radiates to the frontal region, orbit, or ear. The reverse development of the syndrome may also occur: pain sensations begin in the face and spread to the cervico-occipital region.&#x0D; The article presents a case of odontalgia of the maxillofacial region that arose after the treatment of complicated caries of the 26th tooth. The pain periodically appeared in the left occipital region, and then passed to the orbit; a feeling of distension in the eyeball appeared, then the pain passed to the left upper jaw and gradually subsided. The patient described pain as acute, appeared in the form of seizures, and was not associated with the action of thermal stimuli. After clinical and laboratory examination, the oral cavity was sanitized, including the course of treatment of generalized periodontitis, restoration of the destroyed crown of tooth 23, and root canal therapy of previously treated tooth 26 for chronic pulpitis complicated by periodontitis. An old filling was removed from the tooth (no R-contrast lining material was found at the bottom of the tooth cavity). After the preparation of the tooth cavity, an attempt was made to carry out high-quality endodontic treatment, but the root canals were completely obliterated. Endodontic retreatment of the tooth 26 was unsuccessful. An antiseptic solution was left at the bottom of the tooth cavity, then a paste and a phosphate cement pad were placed; after that a photocomposite restoration was done. In parallel, a course of the treatment for osteochondrosis of the cervical spine was carried out by a neurologist. The performed oral sanitation and the treatment of cervical osteochondrosis failed to be effective. Pain in the back of the head and maxillofacial area practically did not change, continued with the same frequency and intensity. Additional clinical, laboratory and X-ray examination did not allow us to establish an obvious cause of the disease. Therefore, after the medical consultation with doctors of related specialties (oral surgeons, neurologists), we decided to perform therapija ex juvantibus, i.e. to remove the "causal" tooth. After the 26 tooth was removed, the pain completely disappeared.&#x0D; The above case testifies that sometimes it can be very difficult to establish the cause of neurological pain, and thus, to make correct diagnosis and to prescribe proper treatment. It is possible to presume that recurrent pain attacks in the left occipital region that move to the orbit of the eye, a feeling of distension of the eyeball, pain in the left upper jaw, slowly subsiding and not associated with the action of thermal stimuli were provoked by the painful condition of the pulp-periodontal complex of tooth 26, which did not respond to endodontic treatment. The extraction of the tooth led to the complete disappearance of neurological pain, which is characteristic of odontalgia of the maxillofacial region.

Discriminant Analysis of the Coordinated Work Indicators of the Heart and Blood Vessels in Health and Disease

A discriminant method was proposed for modeling and quantifying the consistency of regulatory mechanisms in the cardiovascular system (CVS) of apparently healthy volunteers and those suffering from circulatory disorders associated with cervical spine osteochondrosis (OCS) and somatoform autonomic dysfunction (SAD). The congruence of the parameters of ECG intervalometry (DCI) and pulse wave duration (PWD) according to the volunteers’ photoplethysmograms (PPG) was established by calculating the disparity measure and deviations from the mean values using the coeffi cients of displacement, slope of the approximating straight line, as well as by comparing the reliability and correlation of the trend model with the initial data. We discovered gross violations of congruence in the work of efferent and afferent regulatory CVS mechanisms, mismatch and decrease in comparison with the norm of DCI and PWD, a signifi cant decrease in their approximation in the SAD volunteers. In volunteers with OCS, deviations in DCI and PWD from their mean values are much lower than in those with SAD, being inferior compared to healthy volunteers. Similar to SAD, these patients are inferior to healthy volunteers in terms of the disparity measure.

Prediction of Occupational Diseases Due to Exposure to High Radiation Electromagnetic Environment Using a Fuzzy Logic Model.

Several researchers studied the health impacts of electromagnetic fields in work environment. However, the previous research focuses on the statistical analysis of past exposure. There are no studies that addressed prediction of health symptoms. Prediction and early diagnosis of occupational diseases of electric power workers with acceptable accuracy is needed. The objective of this study is to develop a data driven mathematical model for predicting and diagnosis of occupational diseases in workers in electric power industry. The complex nature of disease occurrence due to electromagnetic radiation is appropriate for the fuzzy rules set by medical experts which are analyzed and validated to produce hybrid fuzzy decision rules. The selected group of medical experts suggested using hormonal disorders, endocrine diseases, coffee abuse, chronic diseases of the internal organs, allergic diseases, cervical osteochondrosis, severe course of infectious diseases, intoxication, injury. The developed hybrid fuzzy logic model predicts high risk of developing nervous system diseases. The prediction accuracy exceeded 0.88, which is acceptable for supporting tool.

СОВРЕМЕННЫЕ АСПЕКТЫ КИНЕЗИТЕРАПИИ ПРИ ОСТЕОХОНДРОЗЕ ШЕЙНОГО ОТДЕЛА ПОЗВОНОЧНИКА

The aim of our work is to develop and justify the methods of health-improving classes for women aged 30-40 years with the osteochondrosis of the cervical spine. It was assumed that the developed method would help to reduce this pathology. The results of the study of the influence of the proposed methodology on the morphofunctional state of the subjects are presented. The whole complex of health-improving classes consisted of three cycles and was of a complex nature. The main emphasis of the methodology is made on the use of simulators for various purposes when conducting classes with patients. Classes were held three times a week in the health and rehabilitation center “Parallel” in Tambov. The choice of exercise equipment was determined by the diagnosis, the degree of cervical osteochondrosis and the condition of the subjects. Such simulators include: narrow-area simulators, local impact simulators, multi-functional simulators, simulators with artificial weights, simulators with natural weights, imperative simulators, simulators with free “geometry”. To assess the physical development of women aged 30-40 years with osteochondrosis of the cervical spine, heart rate and blood pressure were measured, pain was assessed, functional testing of muscles on local action simulators, multifunctional rehabilitation simulators, and lateroflexia was measured. We note the positive dynamics in women aged 30-40 years with osteochondrosis of the cervical spine.

Relationship of Cerebral Hemodynamics and Cerebral Bioelectrical Activity in Patients with Cervical Osteochondrosis

Introduction . Osteochondrosis of the cervical spine is a very common disease that causes a significant decrease in the quality of life of patients. In the case of pronounced changes in the cervical spine with osteochondrosis, there is a violation of blood circulation in the cerebral cortex, which leads to pronounced clinical symptoms. The aim of this study was to identify a correlation between bioelectrical activity and cerebral hemodynamics in patients with osteochondrosis of the cervical spine. Materials and methods . The examination involved 25 patients of the neurosurgical department who received conservative treatment for exacerbation of osteochondrosis of the cervical spine, and 25 volunteers without a history of diseases of the spine and joints. The cerebral bioelectrical activity and blood flow indicators were recorded in the pool of the common carotid and vertebral arteries. Results . In the main group and the clinical comparison group, the rheographic index and the peripheral vascular resistance index were studied, which characterize both the volume pulse blood filling of the vascular bed and the tone of small and medium caliber arteries. At the same time, the EEG rhythm indices were analyzed: а -, в -, S-, and в -waves. An analysis of the intersystem interaction of bloodflow indices and the biopotentials of the cortical rhythm of the brain in the main group showed a mismatch in the intra-system connections, which corresponds to the period of the general stress of the body. An analysis of the correlation between the indicators of electroencephalography and rheoencepha-lography in the control group revealed a stable system of correlation between the indicators, showing intersystem and intrasystem consistency and reflecting a high level of reserve capacity of the body and the state of steady adaptation to adverse factors. Conclusion . The use of simultaneous recording of cerebral hemodynamics and brain biopotentials in patients with osteochondrosis of the cervical spine will allow clinicians to correctly assess the functional state of the central nervous system and to prescribe adequate treatment in a timely manner.

Occupational pathology of soft tissues of the shoulder joint and difficulties of examination

A predominant development tendinosis the long head of m. biceps. The difficulties of examination of the connection of the disease with the profession are due to hyperdiagnosis of cervical osteochondrosis and osteoarthritis of the shoulder joints, ignoring the pathology of soft tissues of the shoulder area.

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.