The method of evaluation of the spinal cord

 

(57) Abstract:

The invention relates to medicine, can be used in clinical laboratory diagnostics, in particular for assessment of functional state of the spinal cord in patients with spinal injury. The patient under local anesthesia by a lumbar puncture spinal cord, get the liquor. On a special object glass put two drops of the liquor. In one drop add drop of 0.9-aqueous NaCl solution. Every drop cover cover glass. After drying at room temperature the drugs studied in polarized light using a light meter, determine the transmittance in the optical units. Calculate the index of the functional condition (ANDf) as the difference between the transmittance of native CSF and CSF in saline environment and the importance of ANDf0,035 determine quickly progressing processes of disorders of the spinal cord. In this case the patient carry out urgent surgical treatment. When the value off0,035 evaluate processes of disorders of the spinal cord as a stable and decide about the choice of tactics of treatment. Technical result: simply, quickly and accurately activley patients and prevent disability.

The method relates to medicine, can be used in clinical laboratory diagnostics, in particular for assessment of functional state of the spinal cord in patients with spinal injury.

Known methods of assessment of the functioning of the spinal cord to study the cellular and chemical composition of the liquor, which allow to evaluate the properties with diagnostic value lymphocytosis, protein, glucose, chloride, etc. (Laboratory research methods in the clinic. Handbook edited by Prof. centuries Menshikov. M.: Medicine, 1987, S. 101-105).

These methods have some diagnostic information content only if the integrated use. Studies of the cellular and chemical composition require a large amount of liquor, and a large number of clinical and biochemical techniques that use expensive reagents or test systems.

Closest to the present invention is a method crystallographic studies of lacovara (C. I. Neretin, C. A. Kiryakov Crystallographic method studies of the cerebrospinal fluid in diseases of the Central nervous system, J. Soviet medicine, No. 7, 1977, S. 96-102).

The method According to crystallographic picture of the liquor define diseases of the Central nervous system of the patient - the presence of tumor or inflammatory processes.

However, the functional state of the spinal cord is not evaluated. In addition, the disadvantages of this method are: the use for research of a large number of CSF (2.0 ml); the duration of microscopic analysis (20 min); microscopic (subjective) view of the results of the study (on crystallographic pattern); low specificity of the method.

The task is to assess the function of the spinal cord of patients with spinal injury, a simplified method of evaluating and improving its accuracy, is solved as follows.

According to the invention, study of structural and optical properties of native and liquor in saline medium polarized light, determine the transmission coefficient, calculate the index of the functional condition (ANDf) as the difference between the transmittance of native CSF and CSF in saline medium, and when the value off0,035 determine rapidly progressive disorders of the functional state of the spinal cord, and a value off< a 0.035 evaluate processes of disorders of the spinal cord of the patient as stable.

Structure-optical property is simple in execution, does not require expensive reagents, allows the quantification of structural-optical properties in a minimal volume of liquor only 0.02 ml (in the prototype 2.0 ml).

The accuracy and information content of the method is proved by the authors experimentally on 18 patients in the Ural research Institute of traumatology and orthopedics.

Patients with rapidly progressing processes of violations of the functional state of the spinal cord (ANDfa 0.035) in the early and acute periods of cerebrospinal trauma (PSMT), was carried out by urgent surgical intervention. The function of the spinal cord was fully restored, allowing the patient to return to the earlier work.

Patients who have functional state of the spinal cord, the proposed method was defined as stable (ANDf< a 0.035) - the treatment of choice was conservative or operative, aimed at the destruction of pain, to increase the motor activity of the patient, the stimulation of the lost functions of the spinal cord, orthopedic correction and stabilization of damaged spine with elements closed decompression of the spinal cord and meningoradiculitis.f) as the difference between the transmittance of native CSF and CSF in saline medium, and when the value offequal to or greater than 0,035 determine quickly progressing processes of disorders of the spinal cord. In this case, the patient urgent surgical treatment. When the value offless than 0,035 evaluate processes of functional disorders of the spinal cord as a stable and decide about the choice of tactics of treatment.

Example 1. Patient K., IB N 81520.

The diagnosis: comminuted fracture of the L1 vertebral body. Entered 4 days after injury. The analysis of CSF - 0,090 opt.ed. The index of the functional state amounted to 0.10.

Decided to urgent surgical intervention, which led subsequently to a favorable outcome with complete regression of neurological symptoms.

Example 2. Sick So IB N 90733.

Diagnosis - compression penetrating fracture of the L1 vertebra. Entered 4 years after injury. The transmittance of native liquor equal 0,097 opt. unit , and CSF in saline - 0,087 opt.ed. The index of the functional status was ANDf= 0,01. The decision about surgical intervention, as previously conducted conservative treatment was not effective. Conducted Troubleshooting of spinal deformity, anterior decompression of the spinal cord, the spinal fusion. After the operation, when the surviving pathology disappeared back pain, restored the function of the bladder, increased power of the lower limbs.

Thus, the method is informative, simple and standard. Can be successfully used in clinics vertebrology, neurosurgery and neuropathology to provide timely care to patients with disorders of the spinal cord. Using the proposed method improves the quality of dia can prevent disability.

The method of evaluation of the spinal cord through the study of physico-chemical properties of CSF in saline medium, characterized in that the study of structural and optical properties of CSF in saline solution and native liquor in victims with a spinal injury in polarized light, determine the index of the functional condition (ANDf) as the difference between the transmittance of native CSF and CSF in saline environment and the importance of ANDf0,035 determine rapidly progressive disorders of the functional state of the spinal cord, and a value off< a 0.035 evaluate processes of disorders of the spinal cord of the patient as stable.

 

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