Clinical and digital parameters determine the surgical appointment of cervical osteochondrosis

RESUME. Multivariate analysis of information on 457 patients with cervical osteochondrosis made it possible to form a database of various diagnostic factors to identify indications for surgical treatment and quantify them.

PURPOSE OF THE STUDY: To improve the results of complex treatment of neurological complications of cervical osteochondrosis by studying the clinical manifestations of the disease at various stages of treatment and timely identification of indications for surgical treatment.

MATERIALS AND METHODS: The work is based on the analysis of the results of a comprehensive clinical examination, treatment and follow-up of 457 patients who underwent surgical treatment for cervical osteochondrosis. The age of patients is from 22 to 64 years. There were 186 men (40.7 %), women — 271 (59.3 %). The duration of the anamnesis before surgical treatment ranged from 2 to 11 years, but in the vast majority (296 observations 64.8 %) the duration of the disease was from 3 to 5 years. All 457 patients underwent high-tech surgical interventions.

RESULTS. Based on the identified diagnostic factors, a method was developed for “Clinical and digital determination of indications for surgical treatment of cervical osteochondrosis” depending on the severity of these factors. The method is carried out individually by identifying the positive, zero or negative significance of the digital total quantitative value of the expression of the clinical manifestation of cervical osteochondrosis, including the assessment of clinical and neuroimaging manifestations of the disease (MRI — a picture of the severity of the maximum amount of protrusion of the intervertebral disc or osteophyte in the focus of osteochondrosis, the intensity of the pain syndrome, impaired motor functions, the duration of the last exacerbation), functionally significant impairments in vital activity (the patient’s ability to self-service) and violations of the patient’s physiological conditions (sleep disorders, rest).

CONCLUSION. The criterion of a positive total quantitative numerical value of all diagnostic factors is an indication for surgical treatment of cervical osteochondrosis, the criterion of a zero total quantitative numerical value of all diagnostic factors is a relative indication for surgical treatment and requires dynamic monitoring, the criterion of a negative total numerical value of all diagnostic factors is an indication for conservative treatment.

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