SU1367944A1 - Method of topical diagnosis of hernia of intervertebral disc in case of discogeneous lumbosacral radiculitis - Google Patents

Description

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05

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The invention relates to medicine, namely to neuropathology and neurosurgery.

The purpose of the invention is to improve the accuracy of diagnosis.

The method is carried out as follows.

Thermotopografyu deep tissue temperature examined in srednegru Nom.otdele in the projection of the intervertebral disk, | , in the projections of the disk "[s], /,;,. y, - sf. The depth temperature in each of these points is compared with the temperature of the tissues of the intact (mid-thoracic) part of the spine. In case of herniated discs, an increase in the depth temperature in the projection area of the disc is noted, and a temperature difference of 0.3-0.5 G is taken to diagnose the level of localization of the hernia.

Example 1. Patient M.V.F., 42 years old, was admitted to the neurosurgical department on 03/15/84 with complaints of persistent pain in the lumbosacral region and in the right leg, aggravated by walking and leaning anteriorly.

For the first time, lumbar pains appeared about 5 years ago. In December of the year I983, after lifting the body, pain in the lumbar region increased sharply and, moreover, severe pain appeared in the right leg. For three months he was treated at the district hospital where he lived. However, complex drug and physiotherapy treatment was ineffective and therefore the patient was sent for surgical treatment.

Objectively: smoothing of the lumbar lordosis, sharp limitation of movements in the lumbar spine due to pain - does not reach to the floor by hands 40 cm, pain of the intersostatic ligament S, and paravertebral HblX

Y v - I

points at the same level on the right.

In neurological status: symptoms of tension are pronounced - Lasegue's symptom is positive on the right with an angle of 10, on the left - with an angle of 30, hypotension in the zonak of the innervation of the roots of a / 5 and S, on the right, a decrease in the force of unbending of the big toe, lack of Achilles reflex to the right.

On radiographs of the lumbosacral spine, a narrowing of the intervertebral fissure of о (| - ||. |, And regional growths of osteophytes in the same vertebrae) was found.

Thus, the clinical picture showed a biradical syndrome with a lesion of o and S roots on the right. His discogenous nature of doubt did not arise. According to spondylography, the signs of an intervertebral disc lesion are also at two levels, however, the lesion levels of the discs do not fully coincide with the localization of the affected roots. In connection with this, there was no question of the level of the herniation of the intervertebral disc and, therefore, of the site of the surgical intervention.

To clarify the location of a herniated disc, the proposed method has been applied.

A decimeter radio thermometer (operating wavelength 30 cm) and temperature standards are included in the network. Pos. When the patient's equipment is warming up, the patient is placed on a couch; in the position on the abdomen, the localization of four points of investigation, located at the projection of the intervertebral discs D-y-j,, is determined. 0 ,

iv-v, Sj. Then, in turn, the contact antenna is tightly applied to the indicated points, ensuring reception of its own thermal electromagnetic radiation from the tissue layer. A radiometer connected by a cable to the antenna amplifies the signal that

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0

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It is recorded on a KSP-4 potentiometer and the depth of the tissues is determined by the signal magnitude. The duration of temperature measurements at one point is about 0.5 minutes. To carry out measurements in one patient, therefore, spending not more than 2 minutes.

Patient M-va V.F. the deep temperature turned out to be equal in the place of the projection of disks D 34.6 ° С

L-, y - 34.7 S., o /,;. 9 35 ,,

 S j - 34 ,.

Thus, the maximum increase in the depth temperature is noted in the place of the projection of the disk o /, y - v the temperature limit in this point along

3

compared with the temperature of the tissues in the mid-thoracic spine of 0.4 ° C and indicates the localization of the herniated intervertebral disk at the same level, namely at

 f y - V

03.26.84 a hemilaminectomy was made to the patient d. on right. An operation has a disc herniation about iv-Y that has been removed. After surgery, the pain syndrome was significantly reduced. The postoperative period was uneventful. On the 15th day after surgery, the patient was discharged with improvement.

PRI mme R 2. Patient R.N.V., 60 years old, entered the neurosurgical department on 03/19/84 with complaints of persistent severe pain in the lumbosacral region and on the back side of the non-lateral surface of the right thigh and shins. The pains are aggravated by walking and bending anteriorly.

Pain in the lumbosacral region first appeared about 30 years ago. During the last three years, pains in the right leg also began to bother. The last exacerbation of pain began from January 1984 and lasts until the time of admission to the clinic, i.e. observed for more than three months. Conducted conservative treatment did not have a significant effect; therefore, the patient was referred for surgical treatment to the neurosurgical department.

Examination: at the time of walking, sparing the right leg, movements in the lumbar spine are painful and sharply limited, do not reach the floor with hands 40 cm, lumbar lordosis is smoothed, muscles in the lumbar region are strained, the symptom of Lasegue is positive on the right from an angle of 30, hypoesthesia in the zone of innervation of the roots 0 / and SJ on the right, a significant decrease in muscle strength in the dilator of the 1st toe of the right, the absence of the Achilles reflex on the right

On radiographs of the lumbar-1 sacral spine, a narrowing of the intervertebral fissure .v and o / f is determined. S J.

In the cerebrospinal fluid: cytosis - 3 cells in I mm, protein - 0.39%.

Based on the clinical picture of the disease, it is possible to express

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affection of two spinal roots, (/ y and S, which could be caused by a hernia of the cuspidus, or 0 by the ST at the same time by two hernias of the indicated localization.

Due to the fact that the clinical and radiological pictures did not allow to solve the problem with confidence

10 on the level of lesion of the intervertebral disc, the diagnosis of herniation of the intervertebral disc by the proposed method was carried out. The patient measured the depth

15 temperature of tissues at four points: in the place of the projection of the disks D, .-, d / - -.,, O.-S.B is indicated “W - (V IV - y

The points of the decimeter radio thermometer were located at the points and the temperature of the tissue layer was recorded from the KSP-4 potentiometer readings.

When measuring the depth temperature of a patient, R.V. N.V. The following results were obtained: in the mid-thoracic region, the temperature was 34 ,, in the area of the projection of disks 34.4 ° С, 35, ГС, q S - 34.7 ° С. Compared with the temperature in the projection of the disk D y-; At the point corresponding to the projection of the disk of | v-v, the temperature was increased by about 0 ° C. On the basis of these data, an indicator of 20 has been made.

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35

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kalizatsii hernia disk level

From f V - 1

28.03.84, the patient was operated. Produced hemilaminectomy, - with / vertebrae on the right. A lateral hernia of the intervertebral disc was found and removed. During revision at other levels of the intervertebral disc pathogenesis was not detected. The postoperative period was uneventful. The patient was discharged with significant improvement.

Claims (1)

Invention Formula Method for topical diagnosis herniated intervertebral disk in dyscogenic by lumbosacral radiculitis by spinal thermometry, characterized in that, in order to improve the diagnostic accuracy, determine the depth temperature of the spinal tissues in the place of the projection of one of the interstitial disks of the thoracic from 513679446 the case and in the place of projection of the intervertebra at 0.3-0.5 ° C in one of the indicated disks on the lumbo-sacral points in the lumbosacral department,: “ly. v Y G cases diagnose the level of localization, and with an increase in the depth temperature of the herniated intervertebral disk.