Barchina Y. Diagnostics and Treatment of the Spastic Syndrome in Patients with Old Injuries of the Spine

The dissertation presents a study devoted to a complex therapy of patients with the spastic syndrome in old injuries of the spine and spinal cord. The dissertation is based on the results of the examination and treatment of 100 patients with the spastic syndrome in old injuries of the spine and spinal cord. The spastic syndrome is differentiated by the clinic appearances depending on the extent and degree of injury of the spinal cord. Thus, in the disturbances of cervical and upper-thoracic spine, predominantly in the patients of A-B classes according to Fankel, as distinct from diseases of middle-thoracic and thoracic-lumbar spines in C-D class patients, the spastic syndrome appears shortly following the trauma, bearing a pronounced character and progressing rapidly, and yielding badly to treatment. Moreover, in the disease of cervical and upper-thoracic spine, significant pain syndrome is observed affecting the spastic disturbances of the muscular tonus. As follows from the comparative studies of theapplication of clinical and electrophysiological examination methods of patients with the spastic syndrome, the Ashworth Scale of Spasticity and interferential electromyography (TEMG) provides most reliable information for the determination of the pathologic process and effectiveness of the prescribed treatment. The treatment of patients with the spastic syndrome in old injuries of the spine and spinal cord should be substantiated pathogenetically, i.e. taking into account the extent and degree of the insult to the spinal cord. For all patients the reasonability for using the conservative treatment, for the spinal cord function recovery, massage, exercise therapy, special patient positioning as well as the spine unblocking can be shown, and in the presence of pain syndrome the corresponding pain therapy. Providing insufficient effect of these therapies, the drug antispastic treatment can be prescribed and other physical therapies (drugs administration through the bioactive points and in endolumbal region, reflexotherapy, DANSE). As a result of the application of the proposed rehabilitation therapies, the good and satisfactory results of the spastic syndrome treatment have been obtained in 14.6 ± 0.7 % and 16.1 ± 1.2 % of classes A-B and 28.3 ± 1.8 % and 46.9 ± 1.9 % of classes C-D of the diseases of cervical spine, and correspondingly in 26.0 ± 1.4 % and 34.4 ± 0.8 % of classes A-B and in 37.7 ± 1.4 % and 59.6 ± 1.9 % of classes C-D of the diseases of thoracic spine, and in 21.6 ± 1.7 % of classes A-B and 45.4 ± 1.3 % and 69.0 ± 0.9 % of classes C-D diseases of thoracic-lumbar spine.