Complex Restorative Treatment of Patients with Post-Traumatic Tetraparesis

Summary. Despite the rapid development of medical technologies, the problem of restoration the functions of the spinal cord remains unsolved. Objective: to improve the quality of life of patients with the consequences of traumatic damage to the spinal cord. Materials and Methods. The study is based on an analysis of the treatment results of 95 patients with the consequences of traumatic damage to the cervical segments of the spinal cord. Depending on the severity of the spinal cord injury, the patients were distributed as follows: group ASIA A – 43 patients, group B – 37 patients, and group C – 15 patients. Reconstructive surgery was performed on patients from 6 months to 2 years after the injury. Among the methods of rehabilitation treatment, chronic epidural electrical stimulation of the spinal cord (as the first stage of rehabilitation treatment) was used in all patients, neurotization of the anterior interosseous nerve (anterior interosseous nerve AIN) by the branch of the muscular cutaneous nerve – in 38 patients, transposition of the tendon of the deltoid muscle to the tendon of the triceps of the shoulder – in 8 patients. Results. The ASIA impairment scale, SCIM (Spinal cord independence measure scale) and MRC (Medical Research Council scale) were used to evaluate treatment outcomes. The results were evaluated 18 months after reconstructive surgery. In the ASIA A group, the quality of life improved in 74.4% of patients, due to an improvement of the upper extremity function. In the ASIA B group, an improvement in the quality of life was noted in 83.7% of patients, both due to improved self-care and mobility, and due to improved control of the function of the pelvic organs. In the ASIA C group, improved quality of life was mainly due to improved mobility. Conclusions. Complex restorative treatment of patients with incomplete cervical spinal cord injury allowed to improve the quality of life due to correction of segmentary and conductive violations of the spinal cord. In patients with complete spinal cord injury, only segmentary violations are suitable for correction.