[The effect of age on the degree of strength restoration of the lower limb musles in the long-term period after surgical treatment of adult patients with spondylolisthesis.]

The purpose of the work was to study the effect of age on the degree of isometric strength restoration of the lower limb muscles in the long-term period after surgical treatment of adult patients with spondylolisthesis. 36 patients with spondylolisthesis of I and II displacement degree and 50 normal subjects at the age of 41-66 years were included in the study. Maximum moments of the femur and leg isometric strength were studied using dynamometric stands. The pain syndrome was evaluated in all the patients (VAS scale), as well as their functional condition (Oswestry scale). The investigations were performed before treatment and 75-99 months after surgical intervention. The presented reliable reverse correlation of the patient's age and the pattern and magnitude of changes in the strength of the lower limb muscles was identified in adult patients with spondylolisthesis in the long-term period after surgical treatment. At the younger age (41-59 years) positive dynamics of the muscle strength prevailed - an increase in 56,3% cases, conformity to the preoperative level was observed in 6,3% patients, a decrease in muscle function - in 37,4% cases. In the age-related group of 60-74 years the muscle strength growth was recorded only in 16,7% cases, there was no dynamics relative to the initial level in 8,3% patients, and a decrease in maximum moment of strength was observed in 75% cases. Thus, in case of large intervals of the follow-up period of the results of surgical treatment of adult patients with spondylolisthesis it is impossible to avoid evaluating the effect of age changes in muscles on the degree of restoring isometric strength of the lower limb muscles. As far as age increases, the reserves for muscle function improvement after surgical treatment are reduced significantly.

[ENMG-assessment of efficiency of temporal epidural electroneurostimulation in combined with robotic kinesotherapy in the treatment of patients with spinal cord injury consequences].

The goal of this study was to ENMG-assess effectiveness of the short combined neurorehabilitation course (temporal epidural stimulation of the spinal cord combined with a robotic kinesotherapy) in the restorative treatment of patients with traumatic spinal cord disease. Before and after completion of the combined instrumental neurorehabilitation (course duration--2-3 weeks) were tested 75 patients with spinal cord injury consequences. The authors used global and stimulation (H-reflex, M-response) electromyography methods. On the ENMG-data basis were calculated indices of sensorimotor deficit (ISD) and their postrehabilitation trends. ENMG-signs of sensorimotor deficit regression in the lower extremities were observed in 46.6% of events, in the upper extremities (if damaged cervical spine)--in 78.6% of events. The stabilizing effect of the used neurorehabilitation technology was identified an average of 24.0% of events. In 18.8% of events, the using of the combined neurorehabilitation technology has been ineffective. As indications for the use of combined neurorehabilitation courses series may be employed ENMG-signs of the partial corticospinal tracts conduction safety and a positive ISD trend after the each course completion.