[REACTIVITY AND RESISTANCE OF THE SPINAL STRUCTURES WHEN PERFORMING INSTRUMENTAL CORRECTION OF SPINAL DEFORMITIES].

The aim of the study was the electroneuromyographic evaluation of the spinal cord pyramidal structures reactivity and resistance in response to the impact of intraoperative factors associated with the application of technologies instrumental correction of spinal deformities of various etiologies and degrees of severity, realized with the help of submersible transpedicular fixation systems. Before treatment and 4-31 (9.6 ± 0.3) days after surgery using methods of global and stimulation (M-responses) electroneuromyography were examined 135 patients 8-50 (16.4 ± 0.6) years (42 male, 93 female) with spinal deformities of various etiologies and severity. The intrao perative maximum angle correction of the spinal column ranged from 3° to 95° (37.2 ± 1.5°). To assess the reactivity of the spinal cord structures located at the top of the primary arc deformation used integral index - the index of sensorimotor deficit (ISD). The lowest values of ISD and most distinct postoperative negative trends of this indicator were observed in persons with spinal deformities of neuromuscular etiology.

[ENMG-assessment of efficiency of temporal epidural electroneurostimulation in combined with robotic kinesotherapy in the treatment of patients with spinal cord injury consequences].

The goal of this study was to ENMG-assess effectiveness of the short combined neurorehabilitation course (temporal epidural stimulation of the spinal cord combined with a robotic kinesotherapy) in the restorative treatment of patients with traumatic spinal cord disease. Before and after completion of the combined instrumental neurorehabilitation (course duration--2-3 weeks) were tested 75 patients with spinal cord injury consequences. The authors used global and stimulation (H-reflex, M-response) electromyography methods. On the ENMG-data basis were calculated indices of sensorimotor deficit (ISD) and their postrehabilitation trends. ENMG-signs of sensorimotor deficit regression in the lower extremities were observed in 46.6% of events, in the upper extremities (if damaged cervical spine)--in 78.6% of events. The stabilizing effect of the used neurorehabilitation technology was identified an average of 24.0% of events. In 18.8% of events, the using of the combined neurorehabilitation technology has been ineffective. As indications for the use of combined neurorehabilitation courses series may be employed ENMG-signs of the partial corticospinal tracts conduction safety and a positive ISD trend after the each course completion.

[Neurophysiological correlates of pyramidal insufficiency of ischemic and traumatic genesis in conditions of distraction osteosynthesis application].

Analyzed main trends in variations of quantitative electroneuromyographic characteristics at patients with stroke and severe craniocerebral trauma consequences in the treatment process using transosseous distraction osteosynthesis. Studied specific features of central nervous system reaction on present surgical treatment at patients depending on age, etiology and severity of initial brain structures damage. Formulated notions about staging and mechanisms of reactive change in the brain-cortex under the influence of rehabilitation by transosseous distraction osteosynthesis at patients of noted nosological groups.

[Efficacy of motor control at patients with cerebral hemiparesis in rehabilitation conditions with application of transosseous distraction cranio-osteosynthesis].

To study influence of transosseous distraction cranio-osteosynthesis on functional state of neuromotor system at patients with hemispheric stroke consequences, severe craniocerebral trauma analyzed dynamics of electroneuromyography index--cerebrospinal index, obtained by testing of extremities muscles at 28 persons in residual disease period. Data analysis obtained in control period testify to positive cerebrospinal index dynamics is maximum evident in long-term post-operative period and on leads from upper paretic limb. Thus, electrophysiologically identified increase of motor control efficacy of paretic limbs muscles at patients with cerebral alteration consequences in treatment by transosseous distraction cranio-osteosynthesis.

[Voluntary control of lengthened and intact limbs muscles tension under different force load ranges].

The data are presented which supporting the hypothesis of the presence of isometric force load zone, within which the subjects tested organize the voluntary muscle tension controlling with maximal accuracy and minimal specific power expenses, estimated indirectly, by the ratio of the surface electromyogram (EMG) area (integral of EMG) to force moment impulse. The asymmetries of the integral values of visual-and-motor tracking have been analyzed as well using isometric control organs in 23 patients at the age of 15-35 years (6 - males and 17 - females) in different periods after surgical elimination of lower limb length discrepancies. Poorly marked zone of minimization of integral discrete visual-and-motor tracking estimates, manifesting itself within 25-35% of the maximal force of the muscle group tested (foot dorsal flexors) has been noted in tested healthy subjects (26 normal males at the age of 19-39 years) and orthopedic patients (intact limb). The zone of "optimal' loads is marked more clearly on patients' lengthening side with the tendency towards its shift to the area of weaker forces.

[Responsiveness and resistance of spinal cord structures in patients with closed thoracic and lumbar spinal injuries: neurophysiological and clinical aspects]. / Neirofiziologicheskie i klinicheskie aspekty reaktivnosti i rezistentnosti spinnomozgovykh struktur u bol'nykh s zakrytymi povrezhdeniiami grudnogo i poiasnichnogo otdelov pozvonochnika.

The study was undertaken to explore the time course of parameters of neuromotor dysfunction in patients with thoracic and lumbar spinal fractures characterized by the varying degrees of neurological symptoms. The study was based on the results of complex neurophysiological testing (global and stimulation electroneuromyography (EMG) in 45 patients with thoracic and lumbar spinal fractures who had been admitted to the "VTO" Russian Research Center without complications. The patients were divided into 2 groups: 1) 17 patients without neurological disorders and 2) 28 with mild neurological ones. There was evidence that there were no complicated vertebral injuries. Group 1 patients were found to have steady-state changes in the EMG structure, lower voluntary and involuntary activities (M responses) of the muscles of the hip, leg, and foot, enhanced reflex excitability of leg muscles, EMG signs of spasticity and irritation of segmental radicular structures, long-term asymmetry virtually in all EMG parameters. It was also ascertained that the group of patients with uncomplicated vertebral fractures was represented by individuals having more fitness or those belonging to the so-called "muscular" somato-type. The findings lead to the conclusion that the VTO treatment of vertebrospinal injuries, that is based on the use of a refinement of an external spinal fixation apparatus, creates necessary prerequisites for prevention of further development of neurological deficit and for the optimal course of compensatory-reparative processes in the damaged spinal cord structures.