| Popis: |
The paper analyzes the experience of using epidural spinal cord stimulation in tonic and burst stimulation modes in 71 patients with the consequences of damage to the central nervous system, who underwent treatment and rehabilitation at the Research Institute of Rehabilitology named after professor I.V. Pryanikov, FSCC RR, from 2020 to 2021. The efficacy of epidural stimulation in the indicated modes for clinical manifestations of pyramidal syndrome in the extremities, chronic disorders of consciousness, neuropathic pain, and paresis of the extremities without spasticity has been studied. The use of invasive spinal cord stimulation in the burst mode in patients with spasticity and chronic disorders of consciousness is described for the first time. The impact of various factors on the effectiveness of stimulation has also been analyzed. The average age of patients in the study group was 47 ± 17 years, the average duration of test epidural stimulation was 4.3 ± 1.6 days. Twenty-eight patients (39.5%) were stimulated in the tonic mode, twenty-two patients (31%) were stimulated in the burst mode, and the remaining patients were stimulated in the combined mode. Results: positive dynamics after the use of epidural stimulation was observed in 39 patients (54.9%). The spasticity regressed in 32 patients (52.5%); in addition, an increase in the active range of motion was observed in 23 patients (37.7%) from this subgroup. The decrease in the severity of spasticity in the extremities ranged from 0.33 ± 0.1 to 0.63 ± 0.13 points (p |
