Courses of electrical stimulation for paralysis of the sciatic nerve due to pelvic fractures
Abstract
To date, the issue of neurorehabilitation of patients with neuropathies of the sciatic nerve resulting from a fracture of the pelvic bones has not been completely resolved. One of the solutions to this problem is to conduct a course of electrical stimulation using implanted electrodes.
PURPOSE OF THE STUDY: to develop and substantiate the indications for conducting a course of electrical stimulation in patients with sciatic nerve palsy due to trauma to the pelvic bones.
MATERIAL AND METHODS: minimally invasive surgery was performed on 26 patients. Depending on the initial neurological deficit associated with damage to the sciatic nerve, predominantly of the peroneal portion, from 1 to 6 courses of electrical stimulation were performed, 55 implantations of single-channel electrodes were analyzed. The dynamics of recovery of the sciatic nerve function in patients with the consequences of acetabular trauma was assessed.
RESULTS. When comparing the results of treatment depending on gender, it was not possible to establish statistically significant differences (p = 0.056). With an increase in muscle strength by 1 point, a decrease in the patient’s age by 3.4 ± 0.5 years and an increase in the number of hospitalizations by 0.6 times should be expected, the resulting model explains 10.5 % of the observed differences in the population. Depending on the start of treatment “before the course of electrical stimulation”, an increase in muscle strength by 1 point should be expected to increase “after the course of electrical stimulation” in 84.4 % of cases.
CONCLUSION. In the absence of indications for revision interventions aimed at decompression of the sciatic nerve, a course of direct epidural electrical stimulation using implanted single-channel electrodes should be preferred.
About the Author
I. A. Mescheryagina
Federal State Budgetary Institution “National Medical Research Center for Traumatology and Orthopedics named after Academician G. A. Ilizarov” of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Meshcheryagina Ivanna Alexandrovna
Kurgan
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For citations:
Mescheryagina I.A. Courses of electrical stimulation for paralysis of the sciatic nerve due to pelvic fractures. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2022;14(2):92-97. (In Russ.)
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