A method of treating patients with lesions of the spinal cord

 

(57) Abstract:

The invention relates to medicine, namely to vertebrology, neurology, and neurosurgery. Establish an epidural wire electrode at the level of Thl2-L1 vertebrae, cutaneous plate electrode is disposed on the front surface of the abdomen. Stimulate in the position of the patient with hanging on the Balkan frames bent legs with current pulses of rectangular shape with a duration of 0.5 - 1.0 MS frequency 3 - 5 Hz with potentiation frequencies of 30 - 60, and 100 Hz with amplitude of 4 to 20 mA, causing coordinated locomotor movements with the legs. In subsequent stimulation is carried out through cutaneous electrodes located at the same level, the amplitude of the 30 - 85 mA with the same motor effect. The method allows to increase the efficiency of recovery of voluntary movements due to activation of spinal locomotor generator.

The invention relates to medicine, namely to vertebrology, neurology, and neurosurgery.

There is a method of treatment of patients with consequences of spinal cord injury, the proposed centuries Botoucharova, L. C. Kauravas, C. N. Musekinin, (inventor's certificate SU 1512625 A1), which consists in the stimulation of poverhnosti lumbar enlargement of the spinal cord. Disadvantages of the method are the necessity of performing laminectomy to access the epidural space and the absence of locomotor effect during electrostimulation.

The aim of the proposed method is the recovery of motor function of the lower extremities in patients with lesions of the spinal cord in diseases and injuries of the spine.

The objective is achieved by calling a coordinated shagadelic movements of the feet by the electrical stimulation of locomotor zone lumbar enlargement of the spinal cord at the level of vertebrae Th12 - L1 via a pair of electrodes, the active wire electrode is implanted in the posterior epidural space of the spinal cord, and the indifferent plate located cutaneous centrally on the front surface of the abdomen. After a course of epidural stimulation procedures continue with the same motor effect in a couple of cutaneous electrodes having active on the surface of the back over the spinous processes of Th12 - L1 at the same position indifferent electrode. Electrical stimulation is carried out by current pulses of rectangular shape with a duration of 0.5 - 1 MS, a frequency of 3-5 Hz with potentiation frequencies 30 - 60 Holosonic hanging on the Balkan frames legs lying on the back or side of the patient.

The method allows you to call in paralyzed patients coordinated siteline foot traffic and to restore the lost arbitrary motion, activating and training the spinal locomotor generator.

The method is as follows.

In patients with paresis and paralysis when confirmed by testing H-reflex preservation of motor nuclei of the lumbar enlargement of the spinal cord epidural stimulation of the lumbar enlargement of the spinal cord is called coordinated siteline foot traffic. Stimulation is carried out through a pair of electrodes arranged so that the lumbar enlargement of the spinal cord between them. Active is an epidural wire cable-electrode which is implanted transcutaneous puncture and aspiration in the posterior epidural space of the spinal cord through a standard epidural needle Thouhy at the level of Th12 - L1 vertebrae, the outer part of the electrode is fixed to the surface of the skin patch, at the time of the procedure connected to the stimulator. Indifferent metal plate electrode area of 1.5 square cm, placed in a humid cloth strip, have cutaneous centrally on the front surface of the abdomen and obodno suspended on two Balkan frames legs lying on the back or side of the patient. Duration of procedures ranging from 40 to 120 minutes 5-6 times per week, the rate of epidural stimulation is 1-4 (average 2) months, after which an epidural electrode is removed and the electrical stimulation of the spinal cord continues cutaneous. Cutaneous electrostimulation is carried out through a pair of metal plate electrodes, the active electrode is located on the surface of the back over the spinous processes of Th12 - L1 vertebrae, indifferent - centrally on the front surface of the abdomen. Electrical stimulation is carried out by current pulses of rectangular shape with a duration of 0.5-1 MS, a frequency of 3-5 Hz with potentiation frequencies 30-60 Hz and 100 Hz amplitude 4-20 mA with epidural stimulation and 30-85 mA when used. Use the pacemaker complex stimulation migratin ANGST-01.

The effect of shahania feet is achieved targeted elektrosistem on the spinal locomotor generator, located in the lumbar enlargement of spinal cord. Fixture spinal locomotor generator to the perception of artificial excitatory electroconductive allows further wiseley method can be used in the treatment of myelopathy, caused by inflammatory diseases of the spine malformations, deformations or instability of the spine, combined with the trauma of the spine and spinal cord, as well as in appearances with the necessity of correction of the gait.

Example No. 1. Patient P. A., age 14. I. B. N 867/ 1994, was Admitted with a diagnosis: Implications fibrous dysplasia Th2 - Th4 vertebrae. The state after the second surgery (resection of vertebrae and removal of extradural component of the tumor) with fixation of the spine by two contractors. Lower spastic paraplegia (type And Frankel). Dysfunction of the pelvic organs by type of incontinence. Prescription paraplegia at the moment of delivery - 2 years. When examining a neurologist clinic transverse lesions of the spinal cord from the level of D3. When the magnetic-pulse transcranial magnetic stimulation - the lack of response of the muscles of the lower extremities, SOMATO-sensory potentials are not called. H-reflex on both sides saved, the amplitude is increased, the lack of reaction to audiodatarate and receive Ingrassia.

Initiated a comprehensive rehabilitation therapy that includes stimulation of the spinal cord with the needle electrode is placed at the level of L1. When conducting stimulation% is viginia feet. Duration of epidural electrostimulation - 3 months, and then skin - 2 months. Re rehabilitation therapy after 1 year. Achieved positive neurological and rehabilitative effect is to reduce the level sensitive disorders into 4 segments, reducing spasticity, recovery support ability of foot, the emergence of an arbitrary voltage of the muscles of the anterior abdominal wall, thighs, shins. Prolonged retention of urine, regular self defecation. Sitting without additional external support. Moves on all fours, kneeling with additional support. Stands with additional support, able to walk with additional support (Walker) for a limited time. Regarded as the type With Frankel.

Example No. 2. Patient M. A., 3.5 years old I. B. 463 N/g. He admitted with a diagnosis of active tuberculosis spondylitis h6 - L1, complicated by epidural abscess, kyphotic deformity of the spine at an angle of 75 degrees, the lower spastic paraplegia (type In Frankel), dysfunction of pelvic organs hyperreflection type.

Operation 7.06.94 - extended reconstruction h5 - L2 with sneakerboy fixation by the contractor and additional posterior spinal fusion. Within 1 month after the evoked response in the muscles of the legs. H-reflex on both sides saved. In order to restore the functions of the spinal cord 7.07.94 held puncture statement of the cable electrode in the posterior epidural space at the level of Th12 - L1. Rhythmic epidural stimulation of the lumbar enlargement of the spinal cord by the current pulse frequency of 3-5 Hz, 30 Hz and 100 - 120Hz caused coordinated movement of both legs. 2 weeks after the beginning of epidural stimulation of the lumbar thickening appeared to decrease spasticity, arbitrary movement of the lower extremities. Duration of epidural stimulation is 4 months, then cutaneous stimulation is 3 months. During the stimulation - regression of neurological disorders to the type D scale Frankel - random motion in all joints of the lower extremities, the normalization of the functions of pelvic organs.

The method of treatment of patients with spinal injuries, including epidural electrical stimulation of the spinal cord in a continuous mode, wherein the set of epidural wire electrode applied transcutaneously, puncture and aspiration at the level of Th12 - LI vertebrae, cutaneous plate is disposed on the front surface of the abdomen, the stimulation is carried out in the position of the patient with hanging on the Balkan frame is the situation of frequencies 30 - 60 Hz with amplitude of 4 to 20 mA, causing coordinated locomotor movements of the legs, in the subsequent stimulation is carried out through akanye electrodes located at the same level, the amplitude of the 30 - 85 mA with the same motor effect.

 

Same patents:

The invention relates to medical equipment and can be used in psychiatry and therapy for the treatment of recurrent superficial disorders of the peripheral nervous system, relieve pain syndromes of different origin and correction of psycho-physical condition of the person, as well as for treatment of mental disorders by the method of lateral subthreshold stimulation

The invention relates to medicine and can be used for electrical stimulation of muscles, including in cosmetology

The invention relates to medicine, namely to dentistry
The invention relates to ophthalmology
The invention relates to medicine, speech therapy

The invention relates to medical engineering, in particular to devices physiotherapeutic treatment of diseases of the genitourinary system

The invention relates to ophthalmology

The invention relates to electrotherapy and can be applied to the reproduction of cattle for the prevention of postpartum diseases in cows

The invention relates to medical technology, and is intended for the treatment of several diseases of the nervous, cardiovascular, muscular, dental systems and skin
The invention relates to medicine, pulmonology
The invention relates to ophthalmology

The invention relates to the field of medical equipment and can be used for the treatment of cancer, various kinds of neoplasms in various pathological changes of organs and tissues, as well as when conducting research in the field of medicine and biology
The invention relates to medicine, and is intended for the treatment of gallstone disease
The invention relates to medicine, and is intended for the treatment of urolithiasis

The invention relates to medicine, namely to dentistry
The invention relates to medicine, psychiatry

The invention relates to medicine, neurology, physiotherapy
The invention relates to medicine, namely, neurology, and can be used for the treatment of speech disorders

The invention relates to medicine and can be used in traumatology, orthopedics and neuropathology in the rehabilitation of patients after injuries and lesions of the musculoskeletal different Genesis
Up!