Diagnostic value of neurophysiological complex “transcranial magnetic stimulation – electroneuromyography” at spondilogenic cervical myelopathy
Keywords:spondylogenic cervical myelopathy, diagnostics, transcranial magnetic stimulation, central motor conduction time
Movement disorders diagnostics in patients with spondilogenic cervical myelopathy (SCV) was improved using complex of transcranial magnetic stimulation (TMS) and electroneuromyography (ENMG).
Neurophysiological (NPh) research of segmental and conductive spinal function have been conducted in 160 patients using ENMG, F-wave registration and TMS. 40 patients with secondary cervical spine stenosis have been operated, 120 patients underwent pharmacological treatment and physiotherapy.
At cervical spine compression, confirmed by clinical and MRI-data the considerable rejections of NPh-research indexes were exposed: motor potentials (EMS) latentness lengthening (absence); duration of central motor conduction (DCMC) increasing, EMS polyphase. At radiculomyelopathy syndrome, except of marked indexes of TMS, the most diagnostic value of parameters changes of motive units potentials was marked by needle ENMG and F-waves. Indexes of DCMP and EMP amplitude from upper extremities were the reliable criteria for positive prognosis of clinical renewing of spinal cord functions.
The use of TMS–ENMG complex in SCV diagnostics significantly increases the objective estimation of neurological deficit and changes of segmental and conductive structures after surgical treatment. According to results of clinical and NPh investigations indexes of TMS were certain, which can be considered as predictors of motor function renewing in patients, have been operated because of SCM.
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