RU1805945C - Method of treating vertebrogenic insufficiency of brain blood circulation and apparatus for performing the same - Google Patents

Abstract

Usage: in medicine, in vertebrology in the treatment of vertebrogenic insufficiency of cerebral circulation. The goal is to improve cerebral circulation by increasing the pulse flow of blood. Essence: the method consists in stretching the cervical spine at the optimal parameters achieved by changing the thrust vector in the sagittal plane from 0 to 20 °. To implement this method, there is provided a device comprising a chair, a vertical stand with a horizontal bar attached thereto, movable in a vertical plane, and a Glisson loop connected through a block to a load platform. The horizontal rod has a groove in which a slider with a block is placed, provided with a fastening element and connected through a flexible rod with a Glisson loop, 1 s. and 1 C.p. f-ls, 1 ill. (L s

Description

The invention relates to medicine, is intended for vertical extension of the cervical spine and can be used to treat vertebrogenic insufficiency of cerebral circulation.

The purpose of the invention is to improve cerebral circulation by increasing the pulse flow of blood in the vessels of the vertebral-basal pool.

The device for carrying out the method comprises a chair, a vertical rack with a horizontal arm attached to it, movable in a vertical plane, a Glisson loop connected via a flexible link to a load platform. Gori-. The full-length horizontal bar has a groove,

in which a slider with an additional unit and a fastening element is connected, connected through a flexible rod with a Glisson loop.

The drawing shows a device for implementing the method:;

The device comprises a chair 1 with a rigidly attached to its back rack 2 hollow inside, in which a movable column 3 with a horizontal rod 4 is attached. The column 3 is fixed in a fixed position coupling 5 and screw 6. A limiter 7 for the horizontal rod is attached to the vertical column 4. The pin 8 is connected to the tape 9, fixing. electrodes 10 on the patient’s head. The horizontal bar 4 has a lengthwise groove with

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with

rape-shaped cross section, in

The slider is located with the block 11, a screw 12 securing the slider in the desired position. A cable 24 is thrown through blocks 1f and 13, one end of which is connected to a dynamometer 15 and a crossbeam 16, at the ends of which the Glisson loop rings 17 are fastened. The other end is connected to a platform 18 on which the load 19 is located.

The device operates as follows.

The patient is seated in chair 1, a rheograph and an electrocardiograph are connected, a rheoencephalogram and an ECG are recorded in the initial state, then a Glisson loop 17 is put on the head, it is fixed on the crossbar 16, and using the slider 11 the thrust vector is set to zero position. The lower point of the axis (vector) is in the lower vertebral-motor segment of the cervical spine. After that, gradually (with an interval of 30 s) the load is increased -0.1; 0.2; 0.5; 1.0; 1.5; kg, I control the thrust force by a dynamometer 15. While maintaining the thrust force of 2 kg, use the slider to change the thrust vector forward by 5, 20, 15, 20 °, recording the rheoencephalogram in the excision-mastoidal lead ( intracranial division of the vertebral-basilar basin) and ECG - in each position of the slider in the 1st standard lead and in all standard six leads with the optimal traction parameters found. After determining the optimal traction parameters by the value of the maximum increase in pulse blood supply to the arteries, the procedure of cancer is carried out for 10-15 minutes, after which the thrust force is gradually reversed every 30 seconds, reduced to zero. Then record the rheoencephalogram and ECG. At every stage

studies interrogate patient well-being. In the subsequent procedure, it is carried out daily at the established optimal parameters not earlier than 1-1.5 hours after eating and with an interval of 1.5-2 hours with other procedures, for a course of

12 extensions.

The method and apparatus are illustrated by the following examples. . Patient K-s, medical history No. 101, 49 years old, repairman. He entered the Kislovodsk Cardiology Clinic named after V.I. Lenin, January 15, 1990, was discharged on February 7, 90. Complaints on the day of admission for pain in the neck, chest, in the sternum and left shoulder blade, discomfort and noise in the head, general weakness, pain in the lumbar region

0

5

0

0

spine. Everyday complaints of recurrent migratory headaches, fainting (like headache) during overwork, pain in the neck, chest and lumbar spine, in the heart region with psycho-emotional stress, meteorological oscillations of a pressing nature, lasting up to 5 minutes, accompanied by shortness of breath and arrested by nitroglycerin, for shortness of breath with moderate physical exertion, visual impairment, especially noticeable in the last two years, memory loss in the last 5 years, convulsive muscle contractions, but especially shins.

. Anamnesis. Smoke for 8 years at least 1 pack per day. From a young age, systematic use of alcohol in moderation. He suffered Botkin's disease in 1964. In 1979, suturing of multiple gastric ulcers. In youth, 7 years worked in a mine. Then in the chemical shop of the plant and at present - time. Work is associated with significant physical, temperature (from 300 to

5 ° C) overloads and a chemical factor. . Married. The psychological climate in the family is unsatisfactory, at work relatively calm. Since 1985, he began to feel pain in the cervical spine, somewhat later in the lumbar region. In 1986, a brain concussion without loss of consciousness (untreated), in the same year, a sharp exacerbation of cervicolumbalgia. Since then, 1-2 times a year was treated in a dispensary. Last thing

5. exacerbation in 1989 in March after hypothermia. - there was general stiffness and pain throughout the spine. He used the sick leave from November 28, 1984 to January 14, 1990. In 1978, he had severe stress, against which there was a sharp lack of air, and then there were pains in the sternum, He did not go to the doctors. Until now, he did not know any diagnoses; he did not receive coronary-active preparations. In 1988, in

5, during the starting physical activity, severe shortness of breath and slight compression behind the sternum appeared, which was stopped by taking 1 tablet of nitroglycerin. On January 22 and 23, 1990, pain in the legs and

0 groin when walking. From the place of selection (Kemerovo) was diagnosed with cervicothoracic. osteochondrosis, cervicalgia, thoracalgya. Cerebral atherosclerosis.

Objectively. Normasthenic body type, somewhat excessive nutrition. Pulse 76 in min, satisfactory properties. Blood pressure (BP) 120/80 mm Hg Heart sounds are muffled. Percussion sound over the lungs with a box-tint. Liver at the edge of the costal arch.

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Neurological status, Temporal AL 100mm Hg right 90-left. Turning the head to the side is limited, due to pain it is possible only by 35 °, backward it is sharply limited, extension is 10 °. Soreness at points: Naderbowsky on the right, vertebral artery on the right, upper Erb, Grinshteyn on the right, the pronounced symptom of the intervertebral foramen is larger on the right. Soreness of the spinous processes and paravertebral points (cutting) in the thoracic and lumbar spine, especially from the fifth thoracic to the third lumbar vertebra. On palpation in the sixth to eighth thoracic vertebrae, the pain radiates deep into the chest and along the spine. Hypesthesia of the type of half-jacket on the left. The pupils are wide, the reaction to light is diminished, the tongue deviates to the left, the phonation of the palatine curtain on the left is diminished. Proboscis reflex, tendon reflexes are depressed on the arms and legs on both sides. Muscle tone in the hands is reduced. When a plantar reflex is caused, a symptom of a fan on the right. Abdominal reflexes are absent. In the groove of Romberg staggering. The finger-nasal test performs satisfactorily. Dermographism white with a red border. The pulsation of a.popliteal is weakened on two sides. Pulsation of the femoral arteries is good, but on the left is weaker. The pulsation of the superficial arteries of the feet is reduced. Psychomotor reactions are slowed down. Criticism is slightly reduced. The inertia of a mindless process.

Additional research. Biochemical blood counts

at the beginning of treatment at the end of treatment 22.01.90 07.02.90

cholesterol 5.4 mmol / L 6.0 mmol / L

phospholipids 3, 3.4 mmol / l

beta lipoproteins

48 conventional units 60 conventional units

triglycerides 1.1 mmol / l 1.7 mmol / l

pre-beta lipoproteins

absent

recalcification time

87s 100s

plasma tolerance

to heparin 250 ms310s

fibrinogen 3.3 g / l 3.1 g / l

fibrinolytic active

240 min. 240 min.

fibrinogen B +++

thrombotest Ustep.VI stel,

prothrombin

index of 94%. : 85%

sugar 5 mmol / L 4.6 mmol

Clinical blood test without abnormalities, urinalysis: white blood cells 1012 in the patient's ECG (01/19/90) without pathological changes. REG (01/18/90) significantly reduced pulse blood supply in the baseline of the internal carotid artery (ICA), as well as in the 5th intracranial section of the vertebral-basilar basin (WBB). High tone in the arteries of medium and small caliber, especially expressed in WBB (cm, REP), REG from 6.02.90 (see REG 4), pronounced positive dynamics of pulse blood filling in the ICA and WBB basins. Decreased arterial tone, especially in the left ICA (before its normalization) and the left side of the WBB, EEG (01/19/90) in mono-15 polar leads, an irregular alpha rhythm with a frequency of 8 counts / s, amplitude up to 15-40. μm, with weak modulation, zonal differences are weakly expressed. EEG reactivity to mental stress is poorly expressed.

0 A sample with hyperventilation / 2 min slightly improves the regularity of the alpha rhythm. In bipolar leads - desynchronous type of EEG (flat record), zonal differences are almost not expressed, EEG - areactivity. EEG

5 (6.02.90). Mildly pronounced positive dynamics - improved ZhESh - reactivity to stimuli. On the rheoencephalogram of January 18, 1990 (see REG 1), pulse blood filling (PC) was significantly reduced in the ICA pool on the right (d) 0.64 on the left (s) 0.52, and in the intracranial department of WBB -d 0.28, s- 0 , 26. High tone (a / T) in the arteries of medium and small caliber in the ICA basin - 22.6% from 2 sides, c.

5 B5Bd-25.4%, s-25%, REG from 6.02.90 (see REG 4) - pronounced positive dynamics of PC in the ICA basins (d - 0.81, s - 0.87) and WBB (d - 0.49, s - 0.66). Decreased arterial tone, especially in the left basins 0. HaxBCA-s9.2 (d-22.6%) nB5Bs-24.0% (d

- 24.0%). X-ray of the cervical spine from 22.01.90 (projection standard 3/4 turn on the left, maximum flexion). Moderate hyperlordosis in the upper 5 non-cervical region with a slight straightening of it in the lower cervical region in the spine. Flattening of the body C 12. Reducing the height of the intervertebral discs with IV-VII, especially C V-VI. Seal

0 end plates C II-VII, especially C V-VI. Sealing closures. stinks C II-VII, especially with C V-V1, where they are sclerosed. moderately thickened. Coarse pointed osteophytes along anterior 5 contour C VI-VII. In the left oblique projection, short posterolateral osteophytes (up to 2 mm) are seen against the background of unco-vertebral arthrosis, moderate concentric narrowing of the intervertebral foramen C V-V + and vertical moderate C VI-VII, In the projection

maximum bending in the middle and lower neural regions; limitation of mobility. In the left oblique projection at level C V-VI, moderate bending (S-shaped curvature). Conclusion: cervical osteochondrosis C IV-VII V degree according to Zeker.

X-ray of the thoracic and lumbar spine from 12/20/1990 (brought with him to the patient). Moderate S-shaped scoliosis in the mid-thoracic spine, moderate hyperkyphosis of the mid-lower thoracic region (possible styling). Decreased height of the intervertebral disc Th IV-Xtl, especially Th VIII-X. Sealing of the closure n, lamellae, especially TH IIHV (3x9 mm), as well as moderate upward prolapse of the lower posterior edge of the T. L-1. S 1. Conclusion :, thoracic osteochondrosis II-IH Art., Hernia Schmorl Th. VII-VIII (formation of hernia Schmorl at the level of Th X-XI is not excluded). According to lumbar osteochondrosis II Art. Consulted (24.01.) Head of the Scientific and Clinical Department, Cardiologist, Ph.D. (see diagnosis) and head, neurological department, leading researcher, Ph.D .; (see diagnosis) by a urologist (01.30.) - data for a urological disease have not been identified. 01/18/90 the patient underwent a study - a test of the tracheal spine under REG and ECG control. With a pull force of 2 kg (s, REG 2, 3, 4). As can be seen on REG 2 with a zero vector and a traction force of 2 kg, the increase in pulse blood flow to the brain through the WBB vessels was ЈPU (d + s) / 33.33% on the reorganization index (RI) on both sides. With the same thrust, but with a change in the bottom vector 5 ° forward, the pulse blood flow increased to 105.55%; in comparison with the initial one, up to an extension in magnitude, with a vector of 10 ° ahead it is somewhat; decreased to 98.15%, and with a vector of 15 ° forward it increased again and amounted to 125.91% above the initial level (see REGZ). The increase in blood flow to the brain was achieved by improving the conditions for hemodynamics (reducing compression of arteries and their spasms) in the WBB, and not due to the redistribution of blood across the vascular pools of the brain, since the robbery phenomenon was not observed in the carotid pool, , with a thrust force of 2 kg and a 0 vector, the increase in RI in the carotid basin was 21.36%, and with a thrust force of 10 °, it was 24.7%. In general, in both vascular basins, the indicator of pulse blood flow ЈPU / FM (d + s) + 0 -M (d + h) increased with a 0 vector and a pull force of 2 kg by 25.14% and by 15 ° forward - by 56 , 72%. At a thrust vector of 20 °, the pulse blood supply to vessels in BVV decreased from 125.91% to 90.74% (at 15 °) higher than the initial one, after unloading it decreased even more, to 22.22% higher than the initial one (see REG 3). During and immediately after the test procedure, cerebro-cardiac symptoms did not occur. The optimal parameters of cervical traction were determined, traction force from 1.5 to 2 kg with a traction vector 15 ° forward, 10 min BP before traction 135/85 mm Hg, after - 135- / 90 mm Hg. 30 minutes after the trial extension, moderately intense pains appeared in the left paravertebral region of the neck, which then decreased, the nose was slightly pulling, 19, P1 pulse 80 for 1 min of satisfactory properties, blood pressure 110/80 mm Hg. Soreness in the paravertebral region C IV-VI is greater on the left and with irradiation in the direction of the thoracic spine. On January 22, they were concerned about the average intensity of pain in the cervical and, especially, mid-thoracic spine with irradiation into the chest through the sixth intercostal space and pain in the upper thoracic spine with irradiation to the left upper arm. This condition began on January 21 after cooling / However, headaches decreased. 02.02, at the time of the examination, the body is more concerned about the cervical-supraspinatal region on the right (maximum pain at the projection point inclsural scapulae). Objectively: pulse 68 in 1 min, beats. St. Petersburg, blood pressure 115/80 mm Hg, sharp pain paravertebral from 1 to 12 of the thoracic vertebra with epicenters (ring symptom) at the level of Th III-V on the left, Th Xl-ZXM on the left with radiation to the region of the heart and to the region abdominal cavity. Hypalgesis from D 3 to D 12 on the left. 02/03. The attending physician performed cervical traction in a chair in compliance with all necessary rules. After the traction, the patient noted a clear improvement - there was lightness in the head, in the body, drowsiness in the eyes, pain in the neck disappeared, which lasted for several hours, and a feeling of lightness appeared in it, 05.02. the final traction of the cervical spine was carried out - the state of health remained unchanged. HELL to traction 100/70 mm Hg (on the right hand), temporal blood pressure 70 mm Hg on both sides, after traction HELL 110/80 mm Hg, temporal HELL on the right 75, left 60 mm Hg. Dynamics of rheoencephalographic indicators1 of cerebral circulation under the influence of the course of traction of the cervical spine, included in the total

the resort complex is presented in REG 4. By the end of the pulse treatment, the blood vessels in the vertebral-basil pool increased 75.0% on the right and 161.54% on the left as compared to the initial one, a total of 116.66% on both sides, an increase in the carotid basin pulse blood pressure was 25.61%, 67.3% and 43.5%, respectively. In total, in both vascular pools, the pulse blood supply to the vessels of the brain increased by 66.66% compared with the initial level. Vascular tone (according to the index of large and medium caliber SP decreased both in the carotid (to a greater extent) and in the WBP (see REG 4). At the final examination on 05.02. It was noted that the patient's condition improved during treatment: cerebral cardiac abnormalities, shortness of breath. The patient believes that for 24 days of treatment in the clinic he was clearly better compared to three months of treatment in the rehabilitation center of Kemerovo (but on December, December). for treatment, mineral carbonic baths (No. 10), DDT for projection arteries by the method of I.I. Velikanov (No. 7) and DDT by the cervicothoracic method (No. 6), magnetotherapy with an intermittent permanent magnetic field (from the Maglech apparatus) to the lumbar spine and lower limbs (No. 8), extension of the cervical spine in the chair (No. VI), did not take medication.

Objectively. Temporal BP 80 on both sides, pulse 72 in 1 min, beats. c. Turns of the head to the sides by 40-45 °, Soreness at points characteristic of cervical osteochondrosis, but to a lesser degree of severity, The symptom of the intervertebral foramen from 2 sides disappeared. Irradiation decreased when a call symptom was caused and the pain zone narrowed to T IH-IV segments. Hypesthesia of the type of half-jacket on the left is preserved, left hyperalgesia over the sternum. The reaction of the pupils to light of small amplitude is satisfactory, their shape is normal. Language Deviates to the left. Reflexes: styloradial, with 2 and 3 head muscles more reduced on the left. Muscle tone in the arms and legs is reduced. In the Romberg position is stable, the finger-nasal test is satisfactory. Abdominal reflexes are not caused; plantar reflexes are prominent. There are no pathological stop signs. The patient became more adequate, psychomotor reactions were moderately lively, the inertia of the excitatory process decreased. Testing on a modified Schulte table showed improved evidence. He was diagnosed with chronic cerebrovascular insufficiency (stage II encephalopathy dyscirculatory, mixed genesis atherosclerosis, intoxication, vertebrogenic cervicocranialgi) coronary heart disease, functional class 1 angina pectoris, stable course. Polysegmental osteochondrosis of the spine, including Zeker's degree IV cervical spine, left irritative sympathoganglionitis of the cervicothoracic spine of the border trunk. arterial insufficiency of the lower extremities.

The invention has also been invented. A method for the treatment of vertebrogenic insufficiency of cerebral circulation by stretching the cervical spine with a gradually increasing effort after an interval of 30 seconds under the control of a rheoencephalogram, characterized in that, in order to improve cerebral circulation by increasing pulse flow blood vessels in the vertebral-basilar basin, an extension of 0.5 kg is carried out at an angle of inclination of the rod forward from 0 to 20 °, with an interval of 5 °, at the maximum pulse blood flow share at optimum parameters set force and thrust vector.

2. A device for the treatment of vertebrogenic cerebrovascular insufficiency, comprising a chair, a vertical stand with a horizontal bar attached to it, movable in a vertical plane, a Glisson loop connected through a flexible rod with a load platform, characterized in that In order to improve cerebral blood circulation by increasing the pulse blood flow in the vessels of the vertebral-basilar basin, the horizontal bar has a groove in which a slider with an additional unit equipped with an electric an element - fasteners and connected through a flexible cable with a Glisson loop.