Transcranial magnetic stimulation in the rehabilitation complex for patients with cervical spine hernia

B. R. Shodmonov, A. R. Sattarov, S. S. Saidov, G. A. Boymurodov
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Abstract

The purpose of the study is to analyze the results of using TMS in patients in the early period after removal of herniated discs of the cervical spine. Material and methods. The study was based on the analysis of 51 patients with cervical spine hernias (30 (58.8 %) men, 21 (41.2 %) women aged 23–72 years, with mean age of 42.8 years). All patients underwent discectomy of the cervical spine in the self-supporting department of the National Center for Rehabilitation and Prosthetics of the Disabled during the period of 2018–2022. The patients were divided into two groups. The first group consisted of 31 (60.7 %) patients who underwent discectomy of cervical hernias followed by TMS in the early postoperative period. The second group included 20 (39.3 %) patients who underwent discectomy without using TMS. Results and discussion. The results of open surgical interventions were assessed in two groups, according to the surgical intervention performed and the use of TMS. The first (study) group of 31 (60.7 %) patients underwent «discectomy with decompression of the spinal cord and subsequent stabilization with an improved cylindrical cage and the use of TMS in the early postoperative period». The second group of the patients underwent discectomy using cylindrical cages, laminectomy from the posterior approach, and laminectomy using transpedicular or transarticular stabilization without subsequent TMS. Conclusions. The use of an improved cylindrical cage for herniated cervical spine is justified and timely; the application of transcranial magnetic stimulation in the early postoperative stage in patients with a herniated disc of the cervical spine restores neurological deficits and awakens long-lost functions of a group of muscles and, in some cases, of entire organs.
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经颅磁刺激在颈椎疝患者康复综合治疗中的应用
本研究旨在分析对颈椎椎间盘突出症切除术后早期患者使用 TMS 的效果。材料和方法。研究分析了 51 名颈椎疝患者(男性 30 人(58.8%),女性 21 人(41.2%),年龄 23-72 岁,平均年龄 42.8 岁)。所有患者均于 2018-2022 年期间在国家残疾人康复和假肢中心自力更生部接受了颈椎椎间盘切除术。患者被分为两组。第一组包括31名(60.7%)接受颈椎疝椎间盘切除术的患者,他们在术后早期接受了TMS治疗。第二组包括 20 名(39.3%)未使用 TMS 而接受椎间盘切除术的患者。结果与讨论。根据手术干预和 TMS 的使用情况,对两组开放手术干预的结果进行了评估。第一组(研究)31 名患者(60.7%)接受了 "椎间盘切除术,同时进行脊髓减压,随后使用改良的圆柱形骨架进行稳定,并在术后早期使用 TMS"。第二组患者接受了使用圆柱形保持架的椎间盘切除术、后路椎板切除术,以及使用跨关节或跨关节稳定的椎板切除术,术后未使用 TMS。结论。颈椎椎间盘突出症患者术后早期应用经颅磁刺激治疗,可恢复神经功能缺损,唤醒一组肌肉长期丧失的功能,在某些情况下还可唤醒整个器官的功能。
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