The staged use of neurophysiological methods in diagnostics of spondilotic cervical myelo- and radiculopathy
Keywords:spondilotic cervical myelopathy, radiculopathy, electrophysiological diagnostics
Purpose. To elaborate principles and schemes for optimal staged use of neurophysiological (NPh) methods in diagnostics of cervical neurocompressive syndromes.
Materials and methods. Clinical NPh examinations were conducted ib 163 patients with spondilotic cervical myelopathy (SCM) and in 39 — with cervical radiculopathy using following methods: clinical neurological examination, neurovisualizing methods, stimulatig electroneuromyography (ENMG), needle electromyography (EMG), skin-muscle reflex recording (SMR), motor evoked potentials (MEPs), somatosensory evoked potentials (SSEPs) recording.
Results. SCM was diagnosed in 90 (55.2%) patients, cervical myeloradiculopathy — in 73 (44.8%). MEPs deviated in 73.01% patients with SCM, SSEPs — in 52.5%, initial latency and silent period (SP) reduction or absence while ES recording (p<0,01) — in 85.7%. In 21.5% patients with SCM according needle EMG data amyotrophic lateral sclerosis (ALS) was diagnosed. At mieloradikulopathy combined with defeat of spinal and peripheral structures most informative indicators for verification of cervical roots combined two-level lesion of cervical root, tunnel syndrome of the upper limb were determined.
Conclusion. A complex of NPh methods which allow to determine and evaluate disfunction of segmental and conduction apparatus of cervial spine. We developed and implemented a phased scheme of NPh diagnostic criteria optimal use.
Popelyanskiy YA. Ortopedicheskaya Nevrologiya (Vertebronevrologiya): Rukovodstvo Dlya Vrachey. 4th ed. Moskva: MEDpress-inform; 2008. Russian.
Khabirov F. Rukovodstvo Po Klinicheskoy Nevrologii Pozvonochnika. Kazan': Meditsina; 2006:520. Russian.
Yakhno N, Isaykin A. Nevrologicheskiye oslozhneniya osteokhondroza. Kachestvo zhizni Meditsina Bolezni nervnoy sistemy. 2004;4(7):63-69. Russian.
Patel A, Spiker W, Daubs M, Brodke D, Cannon-Albright L. Evidence of an Inherited Predisposition for Cervical Spondylotic Myelopathy. Spine. 2012;37(1):26-29. CrossRef
Jurek S, Rao RD. Cervical Spondylosis: Pathophysiology, Natural History, and Clinical Syndromes of Neck Pain, Radiculopathy, and Myelopathy. 6th ed. Philadelphia: Rothman-Simeone. 2011;36.
Sheyn AP, Krivoruchko GA. Standartizatsiya protokola neyrodiagnosticheskogo testirovaniya bol'nykh s povrezhdeniyami i zabolevaniyami pozvonochnika i spinnogo mozga. Materialy Scientific-practical conference with international participation «Clinical Neurophysiology»; 2013 November 19;. Saint-Petersburg, Russia. Saint-Petersburg, 2013;25–28.
Skoromets A, Skoromets A, Skoromets T. Spinalnaya Angionevrologiya: Rukovodstvo Dlya Vrachey. Moskva: T.P. Tissen. SPb MEDpress-inform; 2003. Russian.
Tretyakova AI, Chebotaryova LL. [Diagnostic value of neurophysiological complex “transcranial magnetic stimulation – electroneuromyography” at spondilogenic cervical myelopathy]. Ukrainian Neurosurgical Journal. 2011;(4):48-53. Russian. [eLIBRARY]
Stetkarova I, Kofler M. Cutaneous Silent Periods in the Assessment of Mild Cervical Spondylotic Myelopathy. Spine. 2009;34(1):34-42. CrossRef
Gushcha AO, Shevelev IN. Patogeneticheskoye obosnovaniye printsipov lecheniya i reabilitatsii bolnykh s degenerativno-distroficheskimi porazheniyami sheynogo otdela pozvonochnika. Aktualnyye voprosy meditsinskoy neyroreabilitatsii: tezisy dokl. III nauch.-prakt. konf., posvyashch. 30-letiyu GB №10. Moscow. 1996:95–96. Russian
Grinberg M. Neyrokhirurgiya. Moscow: per. s angl. M.S. Gelfenbeyn. MEDpress-inform; 2010. Russian
Papadopoulos CA, Katonis P, Papagelopoulos PJ, Karampekios S, Hadjipavlou AG. Surgical decompression for cervical spondylotic myelopathy: correlation between operative outcomes and MRI of the spinal cord. Orthopedics. 2004; 27(10):1087–1091. PubMed
Slynko EI, Verbov VV. [Ligament-sparing lumbar microdiscectomy. Results of clinical application of a technique]. Ukrainian Neurosurgical Journal. 2003;(1):54–61. Russian. [eLIBRARY]
Babayev Ye, Slynko E, Troyan A, Zolotoverkh A. Klinika, diagnostika i pokazaniya k operativnomu lecheniyu pri miyeloradikulopatii, vyzvannoy degenerativnymi kompressionnymi protsessami sheynogo otdela pozvonochnika. Ukr nauk-med molodizh zhurn. 2008;1–2:77–82. Russian.
How to Cite
Copyright (c) 2015 Albina Tretiakova, Lidiya Chebotariova
This work is licensed under a Creative Commons Attribution 4.0 International License.
Ukrainian Neurosurgical Journal abides by the CREATIVE COMMONS copyright rights and permissions for open access journals.
Authors, who are published in this Journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the Journal under the terms of Creative Commons Attribution License, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this Journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form of which it has been published by the Journal (for example, to upload the work to the online storage of the Journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this Journal is included.