[The dynamic changes in the somatosensory evoked potentials in spinal and spinal cord trauma after meningomyeloradiculolysis]. / Dinamika izmenenii somatosensornykh vyzvannykh potentsialov pri travme pozvonochnika i spinnogo mozga posle meningomieloradikuloliza.

Sport-latent somatosensory evoked potentials (SLSEP) were used to objectivize the time course of clinical changes after surgery for meningomyeloradiculosis in the late period of spinal traumatic injury. New evidence was obtained for the correlation between the changes in SLSEP with displacement from the lower thoracic and lumbar regions of the spine and these in the clinical picture of the disease (both neurological and urological) following spinal injury.

The algesic syndrome in spinal cord trauma.

This article represents the author's experience in the diagnosis and management of pain in patients with spinal cord injuries, and describes methods applied to objectively evaluate pain syndromes and different surgical procedures to alleviate such pain. Instrumental methods for pain relief are also briefly discussed.

[Changes in the somatosensory evoked potentials of patients with trauma to the cervical spinal cord]. / Izmeneniia somatosensornykh vyzvannykh potentsialov u bol'nykh s travmoi sheinogo otdela spinnogo mozga.

Study of somatosensory induced potentials (SSIP) occurring in response to stimulation of the median nerve in a group of patients with damage (traumatic) to the cervical segment of the spine and spinal cord (34) showed a dependence of the degree of changes of the SSIP on the type of injury to the spinal cord. It was found that the changes of SSIP were more marked in transverse damage to the spinal cord than in ventral damage, and in a higher (C5-6) than in a lower (C7-8) level of the trauma. Under conditions of traumatic damage to the nervous system the produced IP will be more clear in changes of the stimulation parameters: reduction of the frequency of the stimulus and the number of summations in averaging.

[Microsurgical reinnervation of the bladder in spinal cord lesions]. / Mikrokhirurgicheskaia reinnervatsiia mochevogo puzyria pri porazhenii spinnogo mozga.

The article generalizes the results of 23 reconstructive operations on the roots of the spinal cord for reinnervation of the urinary bladder in patients with injury to the spinal cord. It was found that the operation was indicated in injury to the inferior motoneuron attended by the development of areflexia or hyporeflexia of a hypotonic bladder, which was manifested by the absence of voluntary micturition with a large amount of residual urine and absence of the urge to urinate.

[Electrostimulation of the phrenic nerve in dogs]. / Elektrostimuliatsiia diafragmal'nogo nerva u sobak.

Respiratory parameters have been studied by electrical stimulation of phrenic nerves (EPN) in 12 dogs. The optimal parameters of an electrical stimulus were found for long-term EPN. EPN increased minute respiratory volume, when respiratory rate raised to 18 per min, and decreased, when respiratory rate diminished to 6 per min. Another parameter--oxygen utilization index--diminished at high respiratory rate and increased at low one, which reflected hyper- or hypoventilation status, respectively. The data obtained indicate that controlled lung ventilation may maintain living status of dogs for a long time without alteration of general respiratory parameters.

[Characteristics of the late components in somatosensory evoked potentials of patients with a pain syndrome in spinal cord involvement]. / Osobennosti pozdnikh komponentov somatosensornykh vyzvannykh potentsialov u bol'nykh s bolevym sindromom pri porazhenii spinnogo mozga.

In spinal trauma patients SSEPs were studied under median carpal nerve stimulation. In cases with pain syndrome, late SSEP waves (180-280 ms) were more pronounced as related to control group of patients without pain and to normal subjects. Psychoemotional personality scaling (MMPI) revealed the increased levels in the first three scales (s.c. "neurotic triad") in the pain group. A correlation was found between the late (P227) SSEP waves and the "neurotic triad" in MMPI.

[Jendrassik's maneuver for determination of efferent conduction in spinal cord injuries]. / Priem Endrassika dlia opredeleniia éfferentnoi provodimosti pri travme spinnogo mozga.

The effect of Jendrassik's manoeuvre on test H-responses of the gastrocnemius muscle was studied in 40 patients with trauma of the spinal cord and in 6 healthy individuals. In healthy individuals Jendrassik's manoeuvre led to a decrease of the amplitude of H-responses by 1.6-2.5 times (2.1 times on the average). The H-responses were also inhibited (by 1.3-2.0 times, 1.7 times on the average) in 7 patients in whom movements of the lower limbs were partly maintained. In 15 of 33 patients with lower limb paraplegia the H-responses were inhibited (by 1.2-2.4 times, 1.5 times on the average); Jendrassik's manoeuvre produced no effect in the other 18 patients of this group. It is concluded that the quantitative index of the effect of Jendrassik's manoeuvre on test monosynaptic reflexes of the lower limb muscles can be used for evaluating the maintenance of conductivity along the efferent conduction pathways of the spinal cord.

[Short-latency somatosensory evoked potentials in injuries of the cervical division of the spinal cord]. / Issledovanie korotkolatentnykh somatosensornykh vyzvannykh potentsialov pri travme sheinogo otdela spinnogo mozga.

Short-latent cortical potentials and induced potentials (IP) recorded from the cervical spine in response to electrical stimulation of the median nerve on the wrist were studied in patients with injury to the cervical parts of the spine and spinal cord. The changes in the pronounced character of the somatosensory induced potentials (SSIP) proved to be more marked than those in the controls. A group of patients with considerable increase of peak N1 and corresponding increase of the time of conduction along the central nervous system (up to 20 msec) was distinguished. The latent period (LP) of IP recorded in the region of the cervical parts of the spinal cord was also prolonged in these patients. The pronounced character of the SSIP changes corresponded to that of the neurological disorders in these patients and the course of the subsequent restorative period.

[Diagnostic significance of the H-reflex in traumatic lesions of the spinal cord]. / Diagnosticheskoe znachenie H-refleksa pri travmaticheskom porazhenii spinnogo mozga.

The study of H-reflexes, their latent periods and M-responses involved 69 patients with trauma to the spinal cord. The results showed that these parameters were normal in 39 patients. The remaining patients lacked H- or M-responses, which was indicative of inhibition of neural and muscular activity due to disorders of hemodynamic and metabolic processes in the spinal cord or in muscles of the lower extremities. The study of latent periods and the speed of impulse conduction along the peripheral nerve revealed that after an injury to the spinal cord some patients presented impairment of impulse conduction at the level of the spinal cord or spinal radicles as a result of their compression.

[Attempt at objective evaluation of pain and analgesia during stimulation of the posterior columns in patients with spinal cord lesions]. / Popytka ob'ektivizatsii boli i protivobolevogo éffekta pri stimuliatsii zadnikh stolbov u bol"nykh s porazheniem spinnogo mozga.

In a group a patients with a pain syndrome in spinal cord injury electric stimulation of n. medianus causes the appearance of a component of a somatosensory induced potential (IP) which is a high-amplitude superficial-positive oscillation with a latent peak period of 200-280 mc. A similar oscillation is revealed in a group of healthy individuals in response to nociceptive stimulation of the skin on the forearm. The amplitude of this potential reduced markedly in effective antipain stimulation through electrodes implanted into the posterior columns of the spinal cord. In the absence of an antipain effect the oscillation described persisted at the time of the patient's discharge from the clinic. The existence of a connection between the described potential (P240) with the pain syndrome and the perception of pain stimulation is suggested. On the basis of the data obtained the possibility of objectifying the intensity of the pain sensations by somatosensory IP recording is contemplated.

[Studies of efferent conductivity along the spinal cord after traumatic injury]. / Issledovanie éfferentnoi provodimosti po spinnomu mozgu pri ego travmaticheskom porazhenii.

Study of the audiospinal effect on the monosynaptic reflex in healthy individuals showed that sound stimulations increased the amplitude of the H-reflex response. Intensification of the H-response was evidence of functioning efferent conduction along the spinal cord pathways. This provided the basis for using the audiospinal effect for testing the functional condition of the efferent spinal pathways in patients with traumatic lesion of the spinal cord. Twenty two patients with spinal cord injury were examined. Sound stimulation increased the H-response amplitude in 9 patients with paraparesis and in 6 patients with paraplegia. In the other 7 patients with lower limb paraplegia the H-response was not intensified by sound stimulation. This was evidence of disturbed efferent conduction along the spinal cord, which corresponded clinically to total impairment of all conduction functions of the spinal cord for a long time after the trauma.

[Use of a method of recording somatosensory evoked potentials to evaluate the intensity of painful stimulation and the effectiveness of analgesic stimulation]. / Primenenie metoda registratsii somatosensornykh vyzvannykh potentsialov dlia otsenki intensivnosti bolevoi stimuliatsii i éffektivnosti protivobolevykh stimuliatorov.

The authors propose a modified variant of experimental pain stimulation with the attendant registration of somatosensory evoked potentials (EPs) induced by electrocutaneous stimulation via electrodes placed on the ulnar surface of the lower arm. The amplitude of EPs taken from the cranial surface directly correlates with the subjective sensation of pain. These EPs represent superficial positive vibrations with the peak latent period of 240 +/- 23 msec, which are most expressed in leads with saggital electrodes. Transcutaneous antinociceptive stimulation diminishes the amplitude of the recorded EPs in accordance with the subjective analgesic effect. The suggested model may be used for objective evaluation of the pain effect and for selecting the optimum parameters of antinociceptive stimulation.

[Electrostimulation of the anal sphincter in incontinence among patients with spinal cord lesions]. / Elektrostimuliatsiia anal'nogo sfinktera pri neupravliaemom akte mocheispuskaniia u bol'nykh s travmaticheskim porazheniem spinnogo mozga.

The effect of electrostimulation of the rectum on the sphincter of the urinary bladder in patients with traumatic damage to the spinal cord and involuntary micturition was studied. It was established that the therapeutic effect of electrostimulation was determined by the parameters of the stimulating current. The optimum parameters were as follows: pulse duration, 0.8-1 msec; pulse shape, rectangular, diphase; frequency of electric pulse flow, 50 per sec. Output voltage--4 to 15 v. These electric current parameters were fed into a constructed electric stimulator of the urinary bladder sphincter ESMP 15-1. The effect of electric stimulation of the bladder sphincter in patients with damage to the spinal cord was highest in mild resistance of the sphincter; after a course of therapeutic electrostimulation the resistance grew. This facilitated the possibility of holding the urine in patients with injury to the spinal cord.

[Surgical treatment of bedsores with blind suture and active drainage in spinal cord lesions]. / Khirurgicheskoe lechenie prolezhnei glukhim shvom i aktivnym drenirovaniem rany pri porazheniiakh spinnogo mozga.

Operations were performed on 32 patients for persistent bedsores of different localization. The operative technique included plastic surgery of the bedsore with prolonged irrigation of the postoperative wound with solutions of antibacterial agents. In 75% of cases the wound healed by first intention, in 85% the bedsores healed within one month. The operative technique described may be recommended for use on a wide scale in patients with injury to the spinal cord.

[Disorders of higher cortical function and EEG features in patients with spinal cord lesions]. / Narusheniia vysshikh korkovykh funktsii i osobennosti EEG u bol'nykh s porazheniem spinnogo mozga.

Combined electroencephalographic and neuropsychic studies of 60 patients showed the variable nature of the functional brain disorders associated with spinal cord impairments at the cervical, thoracic and lumbar-sacral levels. Changes in the EEG criteria of brain function were reflected in an altered character of the principal psychic processes. The results obtained are statistically significant.