TREATMENT ALGORITHM FOR PATIENTS WITH CONSEQUENCES OF PRIMARILY NUNCOMPLICATED TRAUMA OF THE CERVICAL SPINE

Objective. To develop an optimal algorithm of diagnostics and treatment of patients with consequences of primarily uncomplicated trauma of the cervical spine.

Material and Methods. Ninety seven patients with clinical symptoms of radiculopathy associated with posttraumatic changes in the spine were examined. To clear pathogenetic diagnosis the plain, functional, and 3/4 radiographs were taken added by positive myelograms, CT, MRI, and electroneuromyographic studies. Cervical positive myelography was performed in 61 patients, CT of the cervical spinal cord – in 74. Additional MRI study of the cervical spinal cord was performed in 85 patients.

Results. Grade I deformation of the spinal column was detected in 42 patients, grade II and III – in 55 patients. Comparison of clinical and radiological findings showed that of patients with uncorrected grade II and III deformity of the spinal canal 35 patients (63.6 %) had marked signs of myelopathy, and 20 (36.4 %) had pain and radicular syndromes. At the same time among 42 patients with grade I deformity the signs of myelopathy and the pain and radicular syndromes were observed in 19.2 % and 80.8 % of cases, respectively. Comparison of clinical signs and instrumental examination findings allowed to develop an algorithm of diagnostic and treatment of patients with consequences of primarily nuncomplicated trauma of the cervical spine. The degree of angular deformity of the spinal canal was one of the key factors which form the basis of the suggested diagnostic scheme.

Conclusion. The developed procedure for diagnosis of reflectory and compression syndromes of cervical myelopathy allows to select the proper treatment of patients with consequences of primarily nuncomplicated spinal trauma.

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