Method for treating juvenile dystrophic osseous cysts in children

FIELD: medicine.

SUBSTANCE: through puncture opening in proximal and distal directions one should perform osseous tunnels being coaxial to osseous log to connect, thus, the cavity of osseous cyst with medullary canal. Through the parts of healthy bone at the distance of 1-2 cm against cyst's edge in oblique direction one should implant rigid electrodes at the angle of 45 deg. against its center by applying beck's needles with dielectric covering. Subcutaneously one should implant elastic electrodes in projection of lesion focus and connect an electrostimulating unit to cutaneous ends of electrodes. Onto intraosseous electrodes one should supply impulse current of negative polarity, and onto elastic ones - of positive polarity at 10-20 mcA power and frequency of 0.5 Hz, of total duration and front of rectangular impulses cut being 200 mcsec, not more.. One should affect with impulse electric currents on the 24-h basis till complete covering the osseous defect observed.

EFFECT: higher efficiency of therapy.

2 ex

 

The invention relates to medicine, in particular to surgery, and can be used for the treatment of juvenile degenerative bone cysts in children.

There is a method of treatment of youth degenerative bone cysts (Waikerie “Treatment of degenerative bone cysts in children. PhD thesis, 1998, Moscow, S. 46-49), including an introduction to pathological focus, with the goal of decompression kanilirovannaya screws. After 2-3 weeks in the cyst cavity is injected injected allograft in the form of mist demineralized bone chips, which gradually resolves within 6-12 months and replaced by native bone tissue.

The disadvantage of this method is a lot of stages of surgical intervention. The terms of the restoration of bone structure are long. Often after treatment remain a bone cavity, which requires repeated interventions.

As the closest analogue is adopted a method of treating degenerative juvenile bone cysts in children by the method of microwave-destruction (“Pathogenetic aspects of treatment of degenerative bone cysts in children by the method of microwave-destruction”. Vybornov DO, Shafranov CENTURIES, Morgunova E.N., Koroteev V.V., Petrov, M.A. Materials XXYI scientific-practical conference of pediatric orthopedists-traumatologists. Moscow, 2003, pp.28-29). The method consists in the fact that the implementation of Aut puncture degenerative bone cyst, then using the trocar in its cavity probe is introduced with a fixed microwave emitter. Mode osteodistraction make processing of the inner walls of bone cyst in order to achieve a shallow cell necrosis. This preserves the fibroarchitectonics bone frame, which further serves as a material for bone regeneration in a period of 6 months to 1 year depending on the size of bone cyst.

However, the known method has a number of disadvantages. Restoration of bone structure passes through the stage of avascular necrosis, and therefore the filling of bone cyst is within 6-12 months, and the bone cavity remains isolated from normally developed vascular network that can lead to relapse.

The objective of the invention is to provide a method of treatment of youth degenerative bone cysts in children, allowing you to accelerate the closure of bone defects, to reduce the treatment time and to prevent the development of disease recurrence.

The invention consists in that in the method of treatment of youth degenerative bone cysts in children, including puncture of the cyst through the puncture hole in the proximal and distal direction perform coaxially with clinicom bone bone tunnels, giving thus a bone cyst cavity with bone-marrow channel, then black is C areas of healthy bone at a distance of 1-2 cm from the edge of the cyst in an oblique direction at an angle of 45° her heart hard implanted electrodes, which use needles Beck with a dielectric coating, and then subcutaneously implanted elastic electrodes in the projection of the lesion, cutaneous ends of the electrodes connect the pacemaker, intraosseous electrodes serves pulse current of negative polarity, and the elastic electrode positive polarity power from 10 to 20 µa with a frequency of 0.5 Hz, the total length and the front cut rectangular pulses is not more than 200 µs and carry out impact of pulsed electric currents around the clock to complete closure of bone defects.

The use of the invention allows to obtain the following technical result.

There is much less trauma to the soft tissues due to the fact that manipulation of the trocar and the electrodes is performed through punctures in the skin. During the electrode does not violate the anatomical integrity of the bones as the body, because the electrodes are implanted under the control of fluoroscopy. This method allows the first day of treatment to stimulate natural osteoreparative processes in bone, does not require additional expenses for allografts, as for bone regeneration are natural plastic resources of the organism.

The method enables the norm is Ino developed vessels bone marrow channel and angosto to proliferate in the cavity degenerative bone cysts by creating a tunnel messages between polotu bone cysts and bone marrow channel. Perform trephination bone cyst of the trocar has a decompression effect on nutricote pressure.

The method involves the installation of metal electrodes at an angle of 45 degrees to the axis of the bone in the cavity degenerative bone cyst in the immediate vicinity formed between the bone cavity and the bone-marrow channel of the tunnels that allows you to stimulate osteogenesis by pulsed electric currents in terms of improved blood circulation. If necessary, the end of the treatment by the method of electrical stimulation may simultaneously remove electrodes without the use of anaesthesia and analgesia.

The duration of treatment is reduced in 2 times in comparison with accepted methods and are on average 1-2 months by accelerating the rate of recovery of normal bone structure in the affected area of the bone. The method allows to avoid recurrence of the disease, due to the stimulation of natural bone formation.

Furthermore, the method does not require high material costs and can be applied in the outpatient setting.

The technical result is achieved due to the proposed by the authors of the new technologies of treatment of youth degenerative bone cyst. Running coaxially with clinicom bone tunnels, telling cavity bone cyst with medullar channel is m, normalizes blood circulation in the bone marrow cavity and creates conditions for proliferation of normally developed vessels in the bone cavity of the cyst, which in turn promotes normal oxygenation of osteogenic tissue in conditions of stimulation of growth of pulsed electric currents.

Stable fixation of the metal electrodes by conducting them through areas of healthy bone at a distance of 1-2 cm from bone cyst in an oblique direction at an angle of 45 degrees to the center of the cyst allows to achieve the optimal location of the working end of the electrode relative to the formed between the bone cyst bone marrow and the channel tunnel and prevents the development of inflammatory complications in the place of installation of the electrode.

The subcutaneous implantation of elastic electrodes in the projection of the lesion allows subsequent to optimally concentrate the energy of the electric fields in bone cyst in the conduction of electrical stimulation weak pulse currents.

The course of stimulation of osteogenesis weak pulse currents in the regime of 10 to 20 µa with a frequency of 0.5 Hz, a voltage of 8.8 V with the total length of the front and cut rectangular pulses of 200 µs clock allows you to optimally achieve the formation of actively regenerating osteogenic tissue in the cavity to the local cysts.

The method is as follows. The patient under General anesthesia and under the control of the x-ray screen in aseptic conditions perform puncture bone cyst using a standard trocar. In proximal and distal direction by means of a curved medical sewing needle through the hole in the thinned cortical bone cysts perform coaxially with clinicom bone bone tunnels, giving thus a bone cyst cavity with bone-marrow channel. Then, in the cavity of bone cyst implanted two are rigid electrode, which is inserted through the areas of healthy bone at a distance of 1-2 cm from the edge of bone cyst in an oblique direction at an angle of 45° to its center. As intraosseous electrodes used needles Beck with a dielectric coating made by the method of plasma spraying of ceramics or ultrapure silicon. Electrical insulation of the wires is carried out in such a way that their ends remained conductive surface, free from dielectric at a distance of 1 cm (the working surface of the electrode). Then to create an electric field through the trocar subcutaneously in the projection cysts implanted elastic electrode PEOU-1 (length 600 mm) or PEOU-2 (length 900 mm). To skin the ends of the electrodes connected to the stimulator EOS-20-01 “Osteochon-2”. On vnutrirossijskie the electrodes pulse current of negative polarity, and subcutaneous elastic electrode positive polarity power from 10 to 20 µa with a frequency of 0.5 Hz, the total duration and front cut rectangular pulses of 200 μs. Impact of pulsed electric currents carry out round-the-clock within 28-60 days to complete closure of bone defects. The method allows to accelerate the formation of bone regeneration and to prevent the development of disease recurrence.

The method has been clinically tested at the Tushino children's hospital on 20 patients aged from 7 to 14 years with a diagnosis of degenerative bone cyst (any bones and it Department); pathological fracture on the background of degenerative bone cyst (any bones and it Department). In the treatment and monitoring of sick children relapses of the disease is not observed. The maximum period of sick children after treatment 3 years.

Example 1. Child S., age 7 was treated with a diagnosis of extensive youth degenerative bone cyst in the lower third of the left bedernau bones. Under General anesthesia and under the control of the x-ray screen is made to puncture bone cyst. The trocar is formed tunnel, indicating bone cyst with bone-marrow channel. In the cavity of bone cyst implanted 2 rigid electrode (spokes Beck with a dielectric coating). The electrodes are oriented is ovale in the cavity so that to the conductive surface located in the vicinity of the center of the bone cyst. Two subcutaneous electrode PEOU-1 introduced subcutaneously using a trocar just above the site of lesion of bone and fixed to the skin with interrupted sutures. The immobilization of the limb exercises on skeletal traction. Cutaneous ends of the electrodes connected to the generator weak pulse currents EOS-20-01 “Osteochon-2”. The clock was applied pulse current with a frequency of 0.5 Hz, the power of 10 µa and the total length of the front and cut a rectangular pulse is not more than 200 µs. For intraosseous electrodes was applied currents of negative polarity, subcutaneous positive polarity (cathode mode). On the 28th day of the electrodes removed. On radiographs was determined by the formation of bone regenerate throughout the volume of bone cysts. The allowable load on the affected limb. During the time of observation during the year relapse was not observed.

Example 2. Child S., 14 years old, was admitted to hospital with a diagnosis of a pathological fracture of the upper third of the right femur amid youthful degenerative bone cyst. For stabilization of the fracture imposed skeletal traction. After the consolidation of the fracture through month of treatment in the absence of dynamics in the closing of the bone defect, under the General obisbo ywaniem made puncture and channelizate bone cyst forming messages cavity and the bone-marrow channel of the femur. In the cavity of the cyst implanted 2 metal electrode. Subcutaneously implanted electrode 2, PEOU-2. Within 60 days produced stimulation of osteogenesis weak pulse currents in the cathode mode with a frequency of 0.5 Hz and a power of 20 μa, with a total length of the front and cut a rectangular pulse is not more than 200 µs. At the end of stimulation on radiographs determine the complete filling of the cavity of the cyst osteogenic tissue. The child is allowed full weight-bearing on the affected leg. Monitor patients during the year revealed no recurrence of the disease.

Method of treatment of youth degenerative bone cysts in children, including puncture bone cyst, characterized in that the needle through the hole in the proximal and distal direction perform coaxially with clinicom bone bone tunnels, giving thus a bone cyst cavity with bone marrow channel, then through the areas of healthy bone at a distance of 1-2 cm from the edge of the cyst in an oblique direction at an angle of 45° its center hard implanted electrodes, which use needles Beck with a dielectric coating, and then subcutaneously implanted elastic electrodes in the projection of the lesion, cutaneous ends of the electrodes connect the pacemaker, intraosseous electrodes serves pulse current of negative polarity and the elastic electrode positive polarity power from 10 to 20 µa with a frequency of 0.5 Hz, the total length and the front cut rectangular pulses is not more than 200 µs and carry out impact of pulsed electric currents around the clock to complete closure of bone defects.



 

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FIELD: medicine.

SUBSTANCE: through puncture opening in proximal and distal directions one should perform osseous tunnels being coaxial to osseous log to connect, thus, the cavity of osseous cyst with medullary canal. Through the parts of healthy bone at the distance of 1-2 cm against cyst's edge in oblique direction one should implant rigid electrodes at the angle of 45 deg. against its center by applying beck's needles with dielectric covering. Subcutaneously one should implant elastic electrodes in projection of lesion focus and connect an electrostimulating unit to cutaneous ends of electrodes. Onto intraosseous electrodes one should supply impulse current of negative polarity, and onto elastic ones - of positive polarity at 10-20 mcA power and frequency of 0.5 Hz, of total duration and front of rectangular impulses cut being 200 mcsec, not more.. One should affect with impulse electric currents on the 24-h basis till complete covering the osseous defect observed.

EFFECT: higher efficiency of therapy.

2 ex

FIELD: medicine; cosmetics.

SUBSTANCE: method involves preparing and applying electrically activated cosmetic therapy substance. Preparation process involves passing alternating electric current through electrolyte material. The alternating current is applied for at least 10 min with preferential time being 4-8 h long for changing physical properties of the substance. Then the current is switched off. The active substance is administered as inhalation in pulmonary tract or as injections into human or animal body. The substance properties are retained for some limited time.

EFFECT: enhanced effectiveness of treatment; excluded electric current passage through patient tissues; excluded drug concentration in the vicinity of electrodes.

50 cl, 13 dwg

FIELD: medicine.

SUBSTANCE: method involves concurrently acting with stimulating electric pulses and back pressure pulses upon the prostate from the large intestine side synchronized with the stimulating electric pulses under excessive rinsing solution pressure into posterior urethra region. Device has pneumatic massage unit as elastic shell enveloping hollow cylindrical casing having a row of radial holes for supplying compressed air into the shell and periodic pulsating pressure source having at least one unit for producing electric pulses and pneumo-electromagnetic valve which electromagnet anchor is connected to electric pulse production unit outputs. Unit for electrically stimulating perineal muscles and prostate having stimulating catheter electrode and reservoir containing rinsing solution attached to catheter electrode are available in the device. Electric stimulation unit output is connected to input of unit for producing pressure pulses. Periodic pulsating pressure source is manufactured as elastic pneumatic chamber brought in continuous mechanical engagement with electromagnet anchor of the pneumo-electromagnetic valve and tightly joined via tube, cylindrical tube cavity and radial holes therein to the elastic shell of the massage member.

EFFECT: enhanced effectiveness of treatment; accelerated treatment course.

3 cl, 10 dwg

FIELD: medicine.

SUBSTANCE: method involves carrying out endoscopic operation. SCENAR-therapy is additionally administered with pulsating bipolar electric current being used without constant component as pulses at succession frequency from 10 to 350 Hz including swinging frequency mode within 30-120 Hz bandwidth with 2 to 8 pulses formed as batches at succession rate of 540 Hz to 4.5 kHz. The signal is modulated by varying ratio of action time to pauze duration within 1:1-1:5. 1-3 SCENAR-therapy courses are administered with 1-3 months long pauses. The first course begins at the first menstrual cycle occurred after endoscopic operation. Each course is carried out according to a scheme. 15-20 sessions are administered during the first menstrual cycle and 7-10 sessions are administered during the second menstrual cycle. The 25-40 min long sessions are applied daily.

EFFECT: enhanced effectiveness of treatment.

FIELD: medicine.

SUBSTANCE: method involves concurrently acting upon patient auditory system with acoustic signal produced by a musical composition selected on basis of patient health state and electric signals of the same musical composition acting upon patient skin. The electric signals amplitude-modulated with depth of 15-85%, act upon the patient via adhesive skin electrodes during 15-40 min. Hearing-add device is subjected to acoustic signals amplitude-modulated with depth of 15% and higher. Amplitude-modulation frequency is selected within the limits of 1.2-9.8 Hz. Modulation is carried out with frequency corresponding to patient disease frequency and action power is chosen on basis of subjective patient sensations. Device has unit for performing musical composition, the first and the second power amplifier, matching unit, adhesive electrodes and electroacoustic converter as well as electrostimulation modulator, acoustic modulator, the first and the second modulation depth regulator, the first and the second power control unit. Musical signal reproduction output unit is connected to the first inputs of electrostimulation modulator and acoustic modulator, which second inputs are connected to input of introduced controllable modulation frequency oscillator and modulation depth regulators are connected to their third inputs. Electrostimulation modulator output is connected to adhesive electrodes via the first power amplifier and matching unit. Sound modulator is connected to the electroacoustic converter via the second power amplifier. The first and the second power regulator are connected to the second inputs of the first and the second power amplifier. Unit for recording sessions is additionally introduced for replicating therapeutic sessions, its first input being connected to the electrostimulation modulator and the second one to the sound modulator output.

EFFECT: enhanced effectiveness of treatment.

4 cl, 1 dwg

FIELD: medicine.

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EFFECT: enhanced effectiveness of treatment; prolonged remission period.

6 cl

FIELD: medicine, neurosurgery.

SUBSTANCE: the present innovation deals with surgical treatment of neurological complications in patients with degenerative-dystrophic vertebral lesion and partial disorder of conductor-segmental spinal functions. One should surgically remove spinal compression due to resecting anterior departments of affected osseous-cartilaginous structures of vertebral-motor segment. One should apply electrodes: one pair - intraoperationally epidurally upon dura mater above anterior spinal departments being above the level of its lesion; then another pair of electrodes - by puncturing into area of posterior departments being below the level of its lesion to conduct electrostimulation. Moreover, therapy should be supplemented with phonophoresis with neuroprotector preparations. Electrostimulation of posterior spinal departments starts on the 2nd d, and that of anterior departments - on the 3d or 4th d after operation. Parameters of curative electrostimulation should be matches for every patient individually with the help of electroneuromyography. The innovation enables to decrease postoperative complications.

EFFECT: higher efficiency of therapy.

2 cl,1 ex

FIELD: medicine, traumatology, neurosurgery, microsurgery, neurotraumatology.

SUBSTANCE: one should fulfill autoneuroplasty of nervous defect, implantation of wire electrodes epineurally for both ends of contact areas of nerve's affected part at arranging insulation-free electrodes with their opened active ends along the direction of affected nerve. Moreover, before implantation of wire electrodes one should divide their ends into fibers to obtain filamentous wires and embrace nerve trunk and autoneurotransplant along their circumference. Electrodes should be placed at distal and proximal ends of affected nerve being about 5-10 mm above and below neurorhaphy area to perform electrostimulation. The method enables to accelerate regeneration of nervous fiber and decrease lesions of nervous tissue.

EFFECT: higher efficiency of therapy.

1 cl, 5 dwg, 1 ex

FIELD: medicine, physiotherapy.

SUBSTANCE: at the first stage, one should affect with magnetic field upon vertebral reflexogenic areas - volar surfaces - located at colored plates as straps. At the second stage, one should affect with magnetic field upon the area of vertebral column that helps to improve psychoemotional state in patients.

EFFECT: higher efficiency of therapy.

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FIELD: medicine, neurology, psychiatry.

SUBSTANCE: one should affect with amplipulsephoresis of "Berlition" preparation in rectified mode. One should apply types III and V of operations at modulation frequency being 130-150 Hz, modulation depth of 50-75%, impact duration for every type of operation lasts for 5-7 min. During the 1st d electrode-cathode should be located in inferior cervical - superior thoracic department of vertebral column, and electrode-anode - at anterior and posterior surfaces of forearms. During the 2nd d - in inferior thoracic - superior lumbar department of vertebral column and at anterior-lateral and posterior surfaces of shins, correspondingly. The present method improves clinico-electrophysiological and biochemical parameters.

EFFECT: higher efficiency of therapy.

5 ex, 8 tbl

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