The method for determining the nature of the flow of scoliotic illness
(57) Abstract:The invention relates to medicine, orthopedics. Conduct topographic evaluation of the deformation of the body with the module definition of the twisting angle. At the same time perform electro-diagnosis method riodoraku. Calculate the coefficient of variation electric conductivity as the ratio of the average electric conductivity VII acupuncture channel to the average value of the total electric conductivity of the patient. And direction of deviation coefficient electric conductivity and modulus of twisting angle in the range of their measurements is judged on the nature of the flow of the scoliotic spinal deformity. The method improves the accuracy of diagnosis. 3 table. The invention relates to medicine, namely to biomechanics, reflec-adiagnostic, orthopedics, and can be used to assess the nature of the flow and progression of scoliotic illness.Scoliotic spinal deformity is one of the most difficult problems of modern orthopedics. Determination of prognostic criteria as the progression of the disease, and the stabilization process allows the physician to choose pravilno is operational), timely, corethrogyne, and to determine under what conditions (outpatient or inpatient), it is necessary to treat the patient.There is a method of x-ray assessment of the degree of deformation of the spine and the nature of the flow of scoliosis. However, during x-ray examinations, the patient receives a dose of radiation that makes restrictions on the multiplicity of the survey and does not allow control of the process as often as required. Recently, with the aim of estimating the deformation of the spine implemented a screening method using a computer optical topography, characterized by complete harmlessness to health of the patient. This method is based on computer image processing and build topogram back surface in three dimensions. In the evaluation of spinal deformity draws attention to the lateral deviation and paravertebral rotation, and rotation of the shoulder and pelvic girdles relative to the X-axis of the three-dimensional coordinate system, which represents the module of the angle of twist (GPH).For the prototype of the present invention is selected topographic evaluation of the deformation of the body in patients with scoliosis /S. N. Moldova, L. P., MAXIMO the ke module twisting angle of the shoulder belt relative to the pelvic girdle in the horizontal plane. Unidirectional increase module twisting angle of the shoulder belt relative to the pelvic determines the increase of the degree of deformation of the spine. However, such a pattern is clearly recorded topographic method only if there is S-shaped deformation of the spine, accompanied by decompensation. At the same time when the S-shaped curvature of the spine when one arc of curvature is located in the thoracic (Th) and the second in the lumbar (L) of the spine, no significant difference in GPH is determined solely in cases of severe scoliosis (III-IV) and with the initial degrees of the method is not sufficiently precise, since the difference values of the modulus of the twisting angle in these cases, unreliable. This fact is explained by a compensatory process that occurs due to the formation of arc protivopostavlenie with the lowest and uniform engagement of the shoulder and pelvic girdles.The task of the invention is improving the accuracy of the method.This problem is solved due to the fact that simultaneously with the topographic computer study was conducted with the electro-relaxationtime by the method riodoraku - measurement of electric conductivity (RPC) in the points-poortenga channel (bladder) are paravertebral. According to the physiological interpretation of the acupuncture channels (G. Bachman, 1963), VII function channel reflects the functional state of the spinal column. When processing results obtained by electroacupuncture of reflexodiagnostics, calculate the value of the ratio RPC VII acupuncture channel to the average value of the total RPC particular patient (total value EKP all channels, divided by the number of measurement points), expressed as a percentage.The dynamics of topographic parameters on coefficient of variation of the module of the twisting angle is calculated in absolute units and is expressed in degrees.If the coefficient of variation RPC and module unidirectional twisting angle differs from the previous figures upwards, the nature of the flow of the scoliotic spinal deformity is defined as progressive. The opposite, when the coefficient of variation RPC and module twisting angle has not changed or has decreased, indicates stabilization and fixation of scoliotic deformities.The method is as follows.A patient is placed on the installation location back to a television camera with a fully naked DNAs patient projector projects at a given angle image vertical parallel strips, which are deformed on the patient's body in accordance with the surface topography. The image of these bands using the TV camera is inserted into the computer, which is a three-dimensional digital surface model. According to this model using dedicated her anatomical landmarks of the bone structures are output forms a topographic survey, describing the condition of the dorsal surface and shape of the spine in three dimensions (vertical, horizontal, and sagittal).For registration of electro-diagnostic patient measured value of electric conductivity (RPC) symmetrically at right and left representative acupuncture points-the collaborators: 1.9, IX.7; V. 7; VI.4; H. 4; II.4; IV.3; XII.3; VIII.3; VII.64 XI.40; III.42.The results obtained are treated with PAK "Stigma". This calculates the average value of the electric conductivity of the patient (sum RPC measured at all points and divided by 24), and the average value of the RPC at the VII-th acupuncture channel (sum of RPC, measured in the right and left reperesentatives points, divided by two).The coefficient of variation RPC (RPC) are calculated according to the formula:The dynamics module plexogenic and computer optical topography, compare among themselves, analyzing the unidirectionality of recorded changes.The proposed method, we examined 20 children with 8-shaped scoliosis of the II degree of progressive trends in age from 8 to 14 years with a rate of examinations 2 times a year. In the course of analysis of the Association of clinical topographic and refleksodiagnostika characteristics of the survey was the direct dependence and mutual correlations between the values of the module of the twisting angle and the degree of Hyper - or hypofunction electric conductivity. The degree of correlation was 76%. The results were compared with the data of x-ray examination. Taken into account the generally accepted parameters of the magnitude of the angle Kobu in the thoracic (Th) and lumbar (L) spine. Used x-ray classification of degrees of scoliotic deformities in the Century Chalino. The obtained data made it possible to implement dynamic prediction of the nature of the flow of scoliotic deformities according to the results of topographic and replicationschedule research, which later was confirmed rentgenograficheski.Clinical example No. 1.Sick Totemic Tatiana, age 11, is alias of the thoracolumbar spine with kyphotic component, subcompensated.As can be seen from the table, the arc curvature of the spine (thoracic level Th 3-4 vertebrae, and lumbar - at the level of L1 vertebra) within three years increased by 14 and 20, respectively. Unidirectional negative trend recorded and according to a computer topography (module twisting angle increased by 1,1), and the deviation of the electric conductivity at the VII acupuncture channel according to the punctual reflexodiagnostics increased by 7.1%. Such unidirectional negative dynamics of the received data together with the clinical picture of the disease indicates the progressive nature of the scoliotic spinal deformity.Clinical example 2. Zagoranski I., 13 years old, medical History, No. 192223. Observed in NIETO diagnosed with slowly progressive congenital S-shaped thoracolumbar kyphoscoliosis, uncompensated.Data dynamic survey are presented in table.2.These tables indicate the absence of disease progression and stabilization of the process in a given period of observation of the patient. Clinically the diagnosis fixed theWhen analyzing cases of severe deformation, we noted that the proposed method correctly and helps to establish the indications for surgical treatment. As a clinical example, given the following data.Clinical example No. 3. Patient Anna Krutova, 13 years old, the case History No. 198043. Observed in NIETO since 2001 with a diagnosis of Rapidly progressive S-shaped thoracolumbar scoliosis, subcompensated, unfixed. Data dynamic survey are presented in table.3.As can be seen from the table, unidirectional expressed negative speaker presents data allows you to set rapidly progressing nature of scoliotic deformities with the worsening of the arc of scoliosis in the thoracic spine in less than 10 months on the 24th. This gave the basis for sending the patient for surgical treatment. The method for determining the nature of the flow of scoliotic illness by topographic evaluation of the deformation of the body in patients with scoliosis with subsequent determination module twisting angle, characterized in that simultaneously with the topographic computer study conducted electro reflex is wearing average electric conductivity VII acupuncture channel, reflecting the functional state of the spinal column, to the average value of the total electric conductivity of the patient and if the coefficient of variation electric conductivity and modulus of unidirectional twisting angle differs from the previous figures upwards, the nature of the flow of the scoliotic spinal deformity is defined as progressive, and if the coefficient of variation electric conductivity and the modulus of the twisting angle has not changed or has decreased, the nature of the flow of scoliotic deformities are regarded as non-progressive, which indicates the stabilization process.
SUBSTANCE: method involves carrying out urological examination for determining hydrodynamic resistance of ureter calculated from formula Z=8Lμ/(πR4), where Z is the hydrodynamic resistance of ureter, L is the ureter length, R is the ureter radius, μ is the urine viscosity. Angle α at which the ureter enters the urinary bladder is determined from formula cosα = 8l1μ/(ZπR4), where l1 is the perpendicular drawn from the upper edge of the ureter to the its exit projection line, μ is the urine viscosity, Z is the hydrodynamic resistance of ureter, R is the ureter radius. Vesicoureteral reflux recidivation is predicted when the angle of α+90° is less than 120°.
EFFECT: enhanced effectiveness in reducing the number of recidivation cases.
2 dwg, 1 tbl