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One of the main causes of pain in the cervical spine, which causes the development of neurological deficit, is the stenosing process of the spinal canal with compression of the neurovascular structures. To determine the tactics of treatment, to predict the consequences of the disease, timely diagnosis of the functional state of neural structures is of great importance.Materials and methods. An informative method for diagnosing stenosing processes of the cervical spine, along with radiography and MRI, is electroneuromyography (ENMG). The analysis was based on 35 patients with a stenosing process of the spinal canal at the cervical level (17 men, 18 women), the average age of patients was 47.7 ± 9.9 years.Results. In the study of changes in the functional state of the axillary, radial, ulnar and median nerves, with stenosing processes, a unidirectional deviation of the entire ENMG complex of indicators of the limb with pain syndrome and contralateral limb was noted. A decrease in the amplitude of the maximum M-responses is recorded due to damage to the peripheral motor neuron and axon degeneration. Selective damage to the slow-conducting anterior motoneurons does not cause a decrease in the speed of impulse conduction due to demyelination. Bilateral changes in late electroneuromyographic phenomena (F-wave) are possibly caused by a general reaction of the peripheral and central nervous systems.Conclusion. In patients with a stenosing process of the cervical spine with severe clinical manifestations, ENMG values can be used both to determine indications for surgical treatment and to assess the dynamics of changes in the postoperative period.

The aim of this research was to study the most important problems in diagnosing a socially significant problem - osteochondrosis of the cervical spine. According to some authors, in the structure of disability and disability associated with pathology of the spine, diseases of the cervical spine occupy one of the leading positions.The paper analyzes data from 41 sources of literature on the pathogenesis and diagnosis of osteochondrosis of the cervical spine. Due to the complexity and ambiguity of the approaches to the diagnosis of osteochondrosis of the cervical spine, this paper analyzes the most important research methods in the diagnosis of this pathology. Attention is focused on the main pathogenetic prerequisites for the occurrence of pain.According to literature data, the main attention in the diagnosis of osteochondrosis of the cervical spine is given to the basic methods: clinical and neurological examination, where the severity of the disorders is determined using scales that include not only an assessment of the intensity of the pain syndrome, but also the determination of a number of neurological disorders. The authors propose the use of a DN4 questionnaire, LANSS scales, neurological impairment scales (N1S); radiation research methods, such as survey spondylography of the cervical spine in direct and lateral projections, functional spondylography of the cervical spine in the position of maximum flexion and extension, multispiral computed tomography, magnetic resonance imaging data, and neurophysiological studies. Radiation research methods can determine pathological changes in the bone tissue itself. Magnetic resonance imaging indices make it possible to assess the degree of pathological changes in the soft tissue anatomical structures of the spinal canal and intervertebral discs. According to the literature, much attention is paid to functional research methods, in particular, electroneuromyography, which allows to assess the level and degree of damage to nerve fiber, the dynamics of the pathological process. Attention is paid to the allocation of marker indicators. All methods are significant, evidence-based, objective and modern and do not exclude the possibility of using data from other research methods.The analysis of the presented literature once again convinces clinicians of the ambiguity and heterogeneity of approaches to the issues of pathogenesis and diagnosis of the cervical spine, which requires further improvement of the proposed methods for clarifying and objectifying the pathological process. An important andjustified is a pathogeneti-cally grounded approach to their study.

Osteoporosis and osteochondrosis have common clinical manifestations: poor posture, reduced flexibility and mobility of the spine, joint pain, fatigue, weakness; both diseases appear most often in old age. Having a lot in common in symptoms, osteoporosis and osteochondrosis differ in etiology, treatment and prognosis.The development of osteoporosis is based on impaired bone remodeling, but it has been established that this process is also important in the pathogenesis of osteochondrosis. The results of previous studies indicate that there is a relationship between the functional state of the neuromotor apparatus and the violation of the structure of bone tissue in the spinal canal stenosis of the lumbar spine. There is data on the study of the nerve conduction and bone mineral density in patients with osteochondrosis of the cervical spine in a small sample.To study the functional state of peripheral nerves and the presence of disorders of bone tissue structure in 2018, 25 patients of the neurosurgical department of Irkutsk Scientific Centre of Surgery and Traumatology were observed with the diagnosis "Dorsopathy, Osteochondrosis of the cervical spine" (М50.1) and 25 volunteers of the control group, representative of the main sex and age. As a result of the examination, all patients of the main group showed sufficiently deep afferent-efferent dysfunctions of the segment apparatus of the cervical spine, while in the control group changes in ENMG indicators showing initial changes in the function of the neuromotor apparatus were observed in 20 % of the examined. The change in bone density was observed in most of the main group examined (72 %), in the control group the decrease in bone density was less frequent (54 %, of which 29 % registered osteopenia). The results of the examination indicate the existence of a relationship between osteochondrosis and osteoporosis - the more symptoms of sensory-motor dysfunction of the root increase in osteochondrosis of the cervical spine, the more often the change in bone density - osteoporosis or osteopenia - is diagnosed.

To evaluate the effectiveness of the developed method of acupuncture in the complex of conservative treatment of pain in patients with osteochondrosis of the cervical spine in the neurosurgical Department of Irkutsk Scientific Centre of Surgery and Traumatology, 58 patients were under observation, 38 of whom were treated with acupuncture. The results of treatment were evaluated by the applying VAS testing and conducting stimulation electroneuromyography. The patients had 9–10 sessions of corporal and auricular acupuncture. Acupuncture was carried out according to 1st or 2nd variants of inhibitory action. When selecting points, the locally segmental principle was used, and the effect was carried out on symmetric points of general action (P7, GI4, GI 11 , E36 , RP6, VB34), on local pain ah shi points, in “near” and “far” points from the pain zone; on standard points of meridians of calming action: sympathetic, sedative and analgesic (points-cracks). Specific pain points were used: in pain in the area of the shoulder girdle – R5, E37, R4: in the rear surface of the chest and region of the scapula – T26, V43, V11; in neuralgia – V60, TR5, VB41. Corporal reflexology “enhance” auricular, we used impact on АТ55, АТ13, АТ22, АТ51, АТ34. In cases of severe pain and musculotonic syndromes, treatment was initiated with effects on auricular points: АР37 point of the cervical spine and АР55 point Shen Men. When comparing the results of VAS testing before and after the treatment, in all patients we noted a decrease in the intensity of pain, and 16 of patients went into the category of “mild cases”. The positive dynamics is confirmed by the data of electroneuromyographic studies: an increase in the amplitude of the M-response and a decrease in latency, a change in the characteristics of the F-wave. The obtained data indicate the high efficiency of acupuncture in the treatment of pain and muscle-tonic syndromes in patients with spinal osteochondrosis.

The article presents clinical profile of patients with cervical osteochondrosis and cervicobrachial syndrome, results of cliniconeurological examination including X-ray diagnostics (plain frontal and lateral radiography of cervical spine, functional tests, frontal and lateral X-ray imaging of large joints of upper limbs), MRI of cervical spine, stimulation electroneuromyography and osteodensimetry. Statistical processing with definition of nonparametric test and correlation coefficient was performed using SPSS 22.0.0 software. Pearson and Spearman nonparametric tests were used for correlation analysis. Examination of patients with cervicobrachial syndrome revealed that bone tissue condition of a limb with pain syndrome slightly differs from the bone tissue condition of a healthy limb and is within normal range. Neuromyography showed that abnormality of a functional condition of studied nerves of upper limbs was not pronounced and was registered on both limbs. As a result of our research we can suppose that asymmetric abnormal focus inhibits peripheral and central chains of locomotor system both on injured and healthy limbs. Differences in functional condition of peripheral nerves of upper limbs in patients with cervicobrachial syndrome and healthy people are statistically significant and allow us to consider them as a sign of decompensation which prevent healthy performance.

With osteochondrosis of the lumbar spine and L3, L4 lesions, local overloads of the spinal-motor segment lead to disruption of the functioning of the biokinematic chain "spine-lower limbs". Gonarthrosis is considered as an independent disease requiring surgical treatment. We have not found on the functional state of the peripheral neuromotor apparatus, with taking into account segmental radicular manifestations in patients with grade 3-4 gonarthrosis. We examined the tibial and peroneal nerves, and H-reflex in 51 patients undergoing treatment at the clinical department of traumatology and orthopedics of ISCST In all examined patients we revealed changes in the function of the peripheral nerves of the lower limbs (increase in the threshold values of the M-response to 24.8 mA (norm - 16 mA), a decrease in the direct muscle response amplitude to an average of 0.6 mV (norm - 2.0 mV), a decrease in the rate impulse up to 37-39 m/s (norm - 40 m/s), all changed were more pronounced on the affected limb. The revealed changes in ENMG indices could be due to both degenerative changes in periarticular tissues and radicular syndrome in lumbar osteochondrosis. Changes in reflex excitability were observed in combination with prolapse of the H-reflex in the majority of patients. The data obtained indicate damage to the roots and spinal motoneurons in L3-L4-L5 and a change in the functional state of the peripheral nerves of the lower limbs, indicating a single pathogenetic mechanism of degenerative processes in the knee and spine.

1n 2015-2016 in Scientific-Clinical Department of Neurosurgery of 1rkutsk Scientific Center of Surgery and Traumatology, 22 patients (11 men and 11 women) were examined for osteochondrosis of the cervical spine and neck and upper extremity pain syndrome. Patients underwent clinical and neurological examination, radial methods of investigation (cervical survey radiography in the direct and lateral projections), functional tests (flexion and extension) and functional tests with weights, MSCT and MR1 of the cervical spine, radiographs of large joints of the upper extremities in two projections, stimulation electroneuromyography and osteodensitometry. The article presents the general clinical characteristics of the data of 22 patients with degenerative-dystrophic pathology of cervical spine and shoulder joint syndrome, and a moderate and severe neck and upper extremity pain syndrome. 1n the evaluation of clinical and neurological symptoms, unilateral cervicobrahialgia syndrome was detected in 19 (86 %) patients, cervicobrachialgia syndrome was noted on both sides in 3 patients, the syndrome of cervicocranialgia was noted in 4 patients. All radiographs showed deforming osteoarthritis of the clavicular-acromial joint (11 persons), shoulder (10 persons), elbow joint (4 persons). MR1 revealed a multilevel pathology of intervertebral discs. According to ENMG, there was a disturbance of the functional state of the peripheral nerves of the upper limbs, which manifested itself on both sides. The state of bone tissue of the limb with the pain syndrome was not significantly different from that of the healthy limb, and generally corresponded to the norm. Thus, the materials presented in the article represent the initial data of the examination of patients with the neck and upper extremity pain syndrome in the department of neurosurgery according to the algorithm developed in 1rkutsk Scientific Center of Surgery and Traumatology.

Manifestations of cervical osteochondrosis are largely predetermined by degenerative changes in the most mobile lower cervical spine (CV-CVI, CVI-CVII). Clinical picture of cervical osteochondrosis depends not so much on the presence of hernial protrusions as on the changes in bone structures with the formation of arthrosis with pain syndrome. In this regard, we found interesting to study relation of electroneuromyographic parameters and bone mineral density in patients with cervical osteochondrosis. A survey of 38 patients with cervical osteochondrosis localized predominantly in the segments CIII-CIV, CIV-CV, CV-CVI CVI-CVII there were 20 men and 18 women. Subjective and objective examinations showed pronounced muscular-tonic syndrome (with cervicalgia, cervicocranygia, cervicobrachialgia) in all patients. We studied threshold values, M-response amplitude, nerve conduction in motor fibers of the axillary, radial, medial and ulnar nerves, as well as amplitude and frequency indices characterizing the functional state of the deltoid and trapezius muscles. When studying the state of bone tissue, we measured the speed of sound velocity (SV, m/sec) in the radial bones, determined the T-index - the number of standard deviations from mean for healthy young people, and the Z-index - the number of standard deviationsfrom mean for the age group. Comparative analysis of the results of studies by electroneuromyography and osteodensitometry in patients with cervical osteochondrosis of I-II periods, in the presence of neurotrophic disorders have not revealed changes in bone density. At the same time, in patients with cervical osteochondrosis of the III period in the presence of both protrusions and hernias of CVI-CVII CVII-CVIII discs, a reduction in threshold values of direct muscle response, an increase in the amplitude of evoked potentials, and a shortening of the latent period were recorded in the ENMG. Mineral density in patients with this pathology differed from the norm, indicating the presence of osteopenia.

The aim of the research was to study electrophysiological values in patients with blade-humerus pain syndrome at cervical osteochondrosis and posttraumatic shoulder injuries. We managed 71 patients: 33 patients with cervical osteochondrosis and brachialgia getting conservative treatment in the neurosurgical unit of Irkutsk Scientific Center of Surgery and Traumatology (group 1) and 38 patients with injuries of shoulder joint capsules and ligaments getting treatment in the unit of traumatology and orthopedics (group 2). Comparison of electroneuromyographic values in patients of both groups showed unidirectional changes in the values and accentuated decrease in electroneuromyographic parameters on both affected and unaffected extremities. In both cases median nerve was affected most. We registered the decrease in conduction velocity of motor fibers of intact nerves in patients of both groups. Lack of clinical signs of lesion of these nerves can be indicative of functional changes in nerve conduction which reflect generalized reaction on the lesion of certain nerve stems.

As the results of complex examination of patients with compressive syndromes accompanied by spinal stenosis we determined main factors and types of compression of spinal cord roots. We analyzed electroneuromyography of 64 patients who had in their anamnesis osteochondrosis of the 2-3rd gestation period complicated with diskogenic lumbosacral radiculitis with clinical and neurological manifestation and pain syndrome of different severity level. It was established that demyeliniation is accompanied with segmental disorders expressed in the deficiency of supraspinal and suprasegmental influences that manifested as a result of ischemic process of conduction tract of spinal cord at the stenosis. Decrease of the range of reflex response (H-reflex) and afterpotential (F-wave) or their fallback is possibly connected with hypostasis of the root without its local demyeliniation. Increase of latent period of H-reflex and F-response and also band broadening of the rate of conduction of excitation correspond to the moderate changes at the pathology of proximal segment of the nerve that is the sign of local demyeliniation of the root at the absence of peripheral axonopathy. Expressed disorders correspond to the dissociation of impulse conduction velocity on the proximal segment and to the signs of axonal neuropathy of distal segment of neuromotor apparatus. Thus, the changes of such electroneuromyographic indices as impulse conduction velocity and inflammability that correspond to the manifestations of L-spinal stenosis of are caused by the compression of roots and their vessels both on injured and intact limb with development of their ischemia. Rate of conduction of excitation significantly decreases at demielinising processes caused by stenosis. Obtained data allows the clinicians to develop adequate and pathogenetically caused scheme of treatment of patients with spinal stenosis.

At the analysis of neuromyographic indices of patients with central spinal stenosis it was determined that evident decrease of electroneuromyographic parameters corresponds to the clinical manifestations of stenosis, that give an indication offunctional suppression of motoneurons in consequence of metastasis ad nervos. Obtained data allows the clinicians to develop an adequate and pathogenetically proved scheme of treatment of patients with spinal stenosis.

In order to study the specific features of central nervous system reaction to restoration of the cranial vault bone defects by distraction, osteosynthesis method, the electroneuromyographic examination was performed in 28 patients of 16—62 years (average age — 40,1 ± 2,6 years) with pyramidal syndrome in late recovery or residual period, of the disease (severe brain injury cerebral stroke). The main trends in electroneuromyographic indice — "cerebrospinal index" — in patients during the replacement process of post-traumatic or simulated cranial vault bone defects using transosseous distraction osteosynthesis were analyzed. The specific features of the central nervous system responses to surgical treatment, age, etiology, the brain structures initial lesion severity and disease duration were studied. As the results of the research it was established that replacement of defects of calvarium bones by transosseous distraction osteosynthesis in patients with consequences of craniocerebral trauma or stroke had. more intensive positive influence on motor zones of cerebral cortex, that shows itself in increase of effectiveness of motor control, in middle age people, at traumatic etiology of disease, at moderate pyramidal insufficiency and. at remoteness of the disease up to 1 year. Obtained data is expedient to take into account at primary selection of patients for operative treatment.

The article shows the opportunity of use of biomonitoring in patients with exogenous toxic encephalopathy in the remote period of chronic mercury intoxication. (CMI) and with, vibration disease caused by local vibration. The efficiency of the biofeedback method was assessed on the basis of the data of electroencephalography, auditory, visual and somatosensoric generated potentials, electroneuromyography, thermometry, dosed cold test and. rheography. Biofeedback training in people with. CMI caused decrease of total brain changes in EEG, improvement of amplitude indices at of the brain generated potentials, in people with vibration disease it caused decrease of manifestation of angiodistonic syndrome and. restoration of neuromuscular conductivity.

There are direct and invert correlations between the indices of the electroencephalography and. electroneuromyography in the groups of patient with vibration-induced, diseases and. occupational neurosensoric dullness of hearing. Despite the fact that coincidence of correlation indices was observed in one case only, this fact may testify to the similar influence of physical factors (local vibration and. noise) on the employees' organisms and. it may confirm that the changes may be observed both in central and peripheral nervous system, that is, the whole neurosensoric complex is activated.

The aim. of the work was to estimate the degree of intensity of interhemispheric interaction with use of complex neurophysiological (electroneuromyography, electroencephalography) testing of 163 patients of 12—74 years in residual period, of ischemic (n = 108) and hemorrhagic (n = 22) hemispheric stroke and. severe craniocerebral injury with brain contusion (n = 33). Obtained, data testifies to the distinct negative influence of postinsult/ posttraumatic cerebral defect on functional characteristica of counter-lateral ("intact") hemisphere that is reflected in proportional changes of all the spectrum, of analyzed, neurophysiological signs. These changes affects all the tested, modules of neuromotor system, and. can be observed over a long period, after the stroke or craniocerebral injury.

The article describes the evaluation of efficiency of the temperature-myographic training in the patients with vibration-induced disease after the local vibration exposure based on the data of the thermometry, the dosed cold sample, the rheography of the upper extremities, the algesimetry, the pallaesthesimetry, the psychological examination to control the changes in the neuropathic pain, the electroneuromyography. It was shown that the training effectively influenced the manifestations of the angiodystonic syndrome as well as to restore the nervous-muscular conducti-vity at the upper and. the lower extremities.

Humeroscapular periarthritis makes 80 % of all «rheumatic» diseases of humerus. Tendons of muscles, attaching in the area of shoulderjoint, are constantly in a state of greatfunctional tension, connected with shoulder abduction and rotation, which brings to early development of degenerative process in them. Taking into consideration tendency of all kinds of primary periarthritis to persistent and long course caused by very slow resorption of degeneration foci and calcificates, the main condition of the right course of treatment is its persistence and perseverance. Together with all variety of existing methods of treatment of humeroscapular periarthritis this problem is not at all solved and prevalence of humeroscapular periarthritis does not reduce. Nowadays in treatment humeroscapular periarthritis of more and more attention is paid to the methods of traditional therapy: acupuncture, pharmacopuncture, osteopathy. It is doubtless that reflexotherapy provides impact on the most part of the links of pathological process, influencing local changes in tissues and organs, normalizing nervous regulatory processes and eliminating pain. Using neuroreflex approach in diagnostics and treatment of humeroscapular periarthritis we can perform grounded and selective choice of acupuncture points, providing influence on majority of links of pathological process, which rises the efficacy of treatment, prolongs remission period, eliminates pain.