[Role of computed tomography in the estimation of the density of the bony block of an injured vertebral column segment at different stages of treatment with an external transpedicular fixation apparatus].

A Somatom AR.HP computed tomograph (Siemens) was used to make studies in 54 patients with injury to the vertebral column and spinal cord in order to determine the formation of a bony block and its density in different portions of an injured segment at the stages of treatment. During therapy, the highest values of bony block density were observed in the dorsal portions of an injured segment (mean 377.32 +/- 184.57 HU). This may be accounted for by a slight effect of artefacts of an external transpedicular fixation apparatus, the main components of which are present at the posterior supporting complex. After treatment, the highest values of bony block density were noted in the central portions of an injured segment (mean 353.11 +/- 208.01 HU). This may be associated with rather serious intervertebral disk damage in this portion. The bony block density index was 339.75 +/- 139.41 HU in the left lateral portions and as high as 312.56 +/- 135.07 HU in the right ones. In the late period, the highest bony block density index (mean 397 +/- 193.07 HU) was seen in the right portions of an injured segment, which may be due to slight scoliotic deformity with the angle being open to the right.

[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.