TSummary content. The thesis presents theoretical generalization and new solution of a scientific and practical problem in forensic medicine consisting in substantiation of forensic diagnostic criteria for determining degree of severity of bodily injuries in uncomplicated cervical spine injury considering the frequency of soft tissue injuries in the perivertebral area, clinical manifestations and the state of the neuromuscular supply of the stato-locomotive function, hemodynamic and central neurocirculatory reactions to the injury. The work revealed the criteria for forensic evaluation of the degree of severity of bodily injuries in cases of uncomplicated injuries of the cervical spine and perivertebral structures based on the analysis of the features of the clinical course, pathognomonic and specific pathogenetic manifestations of the bodily injuries. Diagnostic criteria of forensic determination of the injury severity at uncomplicated injuries of the cervical spine and perivertebral structures using quantitative assessment of the locomotive function, as an integral index of the spine neuromuscular function was developed and substantiated for proper forensic examination. For the first time, pathogenetically substantiated, systematic and technologically structured complex of diagnostic tests to assess the nature and outcomes of uncomplicated cervical spine injuries and paravertebral structures in forensic examination was presented. It was proven that the injury of the cervical spine caused formation of various changes in the functional support ability of the body, manifesting in displacement of its center of mass, stability reduction and asymmetric weight distribution in the locomotor segments of the spine. Uncomplicated cervical spine injuries result in varying severity of functional changes in the body support, manifested by displacement of its common center of mass (r<=0.05), reduction of static and dynamic stability (r<=0.05) asymmetry of body weight distribution over the locomotor segments of the spine (r<=0.01). The use of stabilographic samples, especially in the case of dynamic assessment of the results, diagnoses hidden locomotor disorders which is significant to improve the accuracy and reliability of forensic medical examination. These posttraumatic changes in the neuromuscular supply providing stato-locomotive functions have a definite criterion-classification character, are informative and meet the requirements of forensic examination to determine severity of the injuries. Uncomplicated trauma of the cervical spine and the related paravertebral structures, especially vertebral artery, result in forming pathognomonic vascular hemodynamic responses and changes of the neuroregulatory origin; their informativity and reversibility depend on the injury remoteness, the timing of the treatment, which is significant for reliable and accurate forensic conclusions of forensic examination in determining severity of bodily injuries (at the time of examination and at determining the final prognosis). It was found out that uncomplicated trauma of the cervical spine and the related perivertebral structures can result in forming the definite neuroregulatory reactions of the central genesis, leading to disorders of cerebrovascular reactivity and transitive or stable hemodynamic changes as a manifestation of prognostically unfavorable disintegration processes. As the severity of bodily injuries correlates with the level of disorganization in the regulatory mechanisms (rxy=+0.741), which requires consideration of the ultimate consequences of the uncomplicated trauma of the cervical spine and the related perivertebral structures in the system of forensic examination. The use of a complex of means of noninvasive diagnosis of the state of the spine neuromuscular system (locomotive function), vascular reactions (hemodynamic changes) as well as cerebrovascular reactivity and resistance (neuroregulatory changes) arising due to uncomplicated injury of the cervical spine and the related paravertebral structures allows significant determining of the injuries severity. In particular: 1) in mild severity of bodily injuries: stato-locomotive function of the spine is characterized by static asymmetry of the common center of mass distribution in the sagittal and frontal planes and dynamic spatial adaptation (1.0<ка<2.0); vertebral artery hemodynamic response (asymmetry indices ripple, pis=/pid) is missing or transient and disorders of cerebrovascular hemodynamics are absent (compensated by cerebrovascular reactivity or treatment); 2) at moderate injuries: spine function is characterized by asymmetry (r<=0.05) of stato-locomotive process (in the frontal plane - (12.6±3.1) mm, sagittal - (21.0±4.2) mm) and moderate spatial maladjustment (1.0<ка<2.0); vertebral artery hemodynamic response (pulsation indices asymmetry: pis?pid) is uncompensated; cerebrovascular hemodynamics is not disordered (indicators of circulatory resistance: ris=rid); 3) severe injuries: great static asymmetry (r<=0.001) of ССМ distribution (in the frontal plane by (14.0±2.1) mm, in the sagittal - (33.2±4.3) mm) and marked stato-locomotive spatial maladjustment (ка<=2.0): hemodynamic response of the vertebral artery (pulsation asymmetry: pis=/pid) is uncompensated and manifest by asymmetry of circulatory indices support (ris=/rid) - impaired cerebrovascular hemodynamics. The injuries of the cervical spine and the related perivertebral structures, especially vertebral artery, result in forming pathognomonic vascular hemodynamic responses and changes of the neuroregulatory origin, informativity and reversibility of which depend on the injury remoteness, the timing of the treatment, which is significant for accurate and reliable forensic medical expertise in determining the severity of injuries. In uncomplicated trauma of the cervical spine and the related perivertebral structures can lead to considerable neuroregulatory reaction of the central origin, leading to disorders of cerebrovascular reactivity and transitive or stable hemodynamic changes as a manifestation of prognostically unfavorable disintegration processes. As severity of injuries correlates with the level of regulatory mechanisms disorganization, it necessitates consideration in the system of forensic expertise of the consequences of uncomplicated trauma of the cervical spine and the related perivertebral structures. The diagnostic tactics, number of forensic examinations and practical suggestions for forensic examination at injuries of the cervical spine and perivertebral structures based on the neuromuscular supply of stato-locomotive function, cerebrovascular and vascular reflex reactions and neuroregulatory changes according to the criteria for the severity of injuries, were substantiated.
