The staged use of neurophysiological methods in diagnostics of spondilotic cervical myelo- and radiculopathy
DOI:
https://doi.org/10.25305/unj.45302Keywords:
spondilotic cervical myelopathy, radiculopathy, electrophysiological diagnosticsAbstract
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.
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