: Yusupova D.G., Suponeva N.A., Zimin A.A. et al. Validation of the Boston Carpal Tunnel Questionnaire in Russia. Nervnomyshechnye bolezni = Neuromuscular Diseases 2018;8(1):38-45.

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Objective: Degenerative diseases of the spine are the most common disorder seen in the practice of the neurosurgeon. According to many surgeons, microdiscectomy is the “gold standard” of surgical treatment. Analyzing the current literature, it is seen that the use of endoscopic techniques in spinal surgery is increasing. However, due to the lack of detailed information on the advantages and disadvantages of these methods, there is a need for continuing research in this area. Work to clarify the features of these methods, their specificity and algorithmization will increase the effectiveness of surgical treatment. Methods: This study included patients with herniated lumbar intervertebral discs, the presence of pain in the leg, and failed of conservative therapy. In the period 2014 to 2017, 172 endoscopic lumbar discectomies were performed, using microendoscopic discectomy and percutaneous endoscopic lumbar discectomy. The effectiveness of each technique was evaluated through comparative analysis. Results: In both groups, the methods used obtained high efficacy rates. Comparative analysis showed the advantages of the percutaneous technique in terms of shortening the return to normal activity time, hospitalization time, and disability, and reducing back pain in the early postoperative period. On the other hand, the microendoscopic discectomy enabled greater radicality to be achieved in cases with herniated disc ossification and complex anatomy of the vertebral segment. Conclusions: Analysis of the data obtained led to the formulation of an algorithm for selecting the optimum endoscopic method for achieving positive results of surgical treatment. Level of Evidence II; Therapeutic studies, investigating the results of treatment.

The hydrogalvanic baths provide a tool for the combined application of warm fresh water and low frequency electric current. These procedures are suitable for both systemic and local treatments. The mechanism behind their therapeutic action is based on synergistic effect of two therapeutic agents. This article presents the literature and historical review of the method as well as the current concept of hydrohalvanic therapy. The history of its development is associated with the improvement of the technical equipment and accumulation of clinical experience. Numerous studies carried out up to the present time have demonstrated that hydrohalvanic therapy can be effectively applied for the treatment of diabetic angiopathy, rheumatoid and gouty arthritis, fibromyalgia, ankylosing spondylitis. At the same time, the high potential of this method remains underestimated. At present, one of the most promising approaches to its clinical applications is the treatment of lumbosacral radiculopathy caused by degenerative vertebral disk lesions. The hydrogalvanic baths have analgesic, anti-inflammatory, and decongestant effects, improve microcirculation, and reduce sensory impairment. It is necessary to continue clinical investigations to obtain further evidence of the effectiveness of the method under consideration for the treatment of lumbosacral radiculopathy and to evaluate its short- and long-term effects. Their results will hopefully provide an opportunity to include the hydrogalvanic baths in the programs of medical rehabilitation of the patients presenting with lumbosacral radiculopathy.

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The paper presents a review of the current literature devoted to estimation of outcomes of surgical treatment for degenerative changes in the spine using scales, tests and questionnaires. The literature search in domestic and foreign bibliographic databases has been carried out, and the use of scales, tests and questionnaires in spinal surgery was analyzed. The review presents requirements for scales, tests and questionnaires, examines the evaluation of clinical and patient-reported outcomes, and describes the advantages of multifactorial outcome evaluation. The multifactorial evaluation of outcomes is illustrated by the example of degenerative changes in the cervical spine, and includes a clinical case of surgical treatment for cervical myelopathy. The limitations of scales, tests and questionnaires are also discussed.

Objectives. To determine the efficacy of various procedures of precise differentiated surgical decompression for elimination of prevailing clinical manifestations of degenerative stenosis depending on a character and localization of morphological changes (degenerative or posttraumatic) in the cervical spine, the expediency and necessity of application of various fixation and stabilization techniques. Material and Methods. Eighteen patients included in the study were examined for degenerative stenosis in the cervical spine. All of them underwent decompressive surgery. International representative scales were used to estimate results depending on basic clinical syndrome. Results. The increase in latency and central sensory conduction time (according to somatosensory evoked potentials data) indicates that ischemic compression lesion is mainly caused by dorsal compression. In this case a laminectomy according to Hirabayashi was performed. The increase in central motor latency time (according to central transcranial magnetic stimulation) greater by 30 % than a norm indicates that ischemic lesion is caused by anterior vertebral artery compression. In this case a corporectomy was performed. Conclusion. Compression lesions in cervical spine stenosis have local ischemic character and correspond to blood supply basin of compromised spinal or segmental artery. There is a correlation of ischemic compression focus localization with a character of electrophysiological conduction and responses. Differential character of surgical decompression provides observation of minimal invasive principles and better neurological restoration of patients.

Portal endoscopic discectomy is highly efficient in treatment of herniated cervical discs and enables achieving clinical outcomes associated with much less surgical trauma. The study demonstrates not only the efficacy of the suggested technique but also its safety compared to that of traditional anterior microsurgical techniques that usually involve interbody fusion. This surgery surpasses other interventions in the rate of rehabilitation and social adaptation of patients as well as reduces postoperative hospital stay.