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Biomedical subjects

I N Shevelev

Publications and source records attributed to I N Shevelev.

At least 19 recordsLinked to original sources
PubMed1991

[Pathologic muscle coactivation after injury of the brachial plexus].

As many as 58 patients with injury to the nerve trunks of brachial plexus were examined. As a consequence of the generation of nerve fibers after injury to brachial plexus or after surgical treatment, marked coactivation of muscles including antagonistic ones may not infrequently occur in patients at voluntary efforts. That coactivation may give rise to a noticeable decrease of the power effect of limb muscles. It may turn out at the same time that the same motoneurons act as representatives in different muscles. The most probable mechanism of pathological coactivation is the branching of axons during their branching into separate little branches each of which can, via the nerve membranes, grow towards different muscles including antagonistic ones. The branching of nerve fibers towards different muscles is likely to occur at anastomoses of the nerve trunk membranes. Thus, peculiar "nerve anastomoses" may occur. Via those anastomoses, nerve impulses have a possibility of "flowing" from one nerve to the other one. The phenomenon described should be taken into consideration in reconstructive surgery on brachial plexus.

Arm↗
PubMedDate not supplied

[Changes in the somatosensory evoked potentials of patients with complicated spinal trauma after an omentomyelopexy operation].

The purpose of the study was to record somatosensory evoked potentials (SSEP) to objectify the results omentomyelopexy in late spinal cord injury. SSEP were recorded in 25 patients in leads of three levels of the somatosensory tract (from the popliteal fossa, from the lumbar enlargement of the spinal cord, and from the surface of the skull in the region of projection of leg presentation in cerebral hemispherical cortex) before and after surgery. The study indicated that there were no pre- or postoperative records of cortical evoked potentials. At the same time there was improvement in the magnitude of SSEP at the level of the lumbar enlargement (36%). In 4 (16%) and 5 (20%) cases of them SSEP changes were clear and unclear, respectively. The assessment of SSEP changes requires consideration of cases with unclear SSEP. Comparison of the results with clinical findings shows a correlation mainly with urological and urodynamic evidence. Thus, there are minor positive changes in the magnitude of SSEP after omentomyelopexy in the lumbar enlargement lead with unclearly pronounced evoked potentials.

Evoked Potentials, Somatosensory↗
PubMedDate not supplied

[A posterolateral approach to the area of the craniovertebral transition].

The paper presents a stepwise surgical technique of transcervical craniospinal posterolateral approach to the bulky processes of the craniovertebral region and the historical background. The access was modulated on cadavers (the head-neck region) in the project of a surgical intervention. In 1995-1998, clinical tests were made in 11 patients, 6 of whom had ventral craniospinal meningiomas, 2 cases had sand watch neuromas of the C2 root with extradural growth and 3 cases presented sand watch neurofibroma at the C1-C levels. The advantages and disadvantages of the approach are described.

Cadaver↗
PubMedDate not supplied

[New possibilities in the surgical treatment of lower thoracic and lumbar spinal injuries].

The paper presents new current approaches to surgically treating the lower thoracic and lumbar spinal injuries. By using new procedures for spinal stabilization, the authors propose algorithms for surgical treatment of spinal injuries in relation to the neurological symptomatology and the severity of fracture and its pattern. The study was performed in the clinical setting. Seventy patients with lower thoracic and lumbar spinal injuries were operated on. The outcomes of their surgical treatment are analyzed. Indications for nerve structural decompression, for approaches to vertebral bodies are defined.

Adult↗
PubMedDate not supplied

[The effect of selective dorsal rhizotomy on motor function in patients with infantile cerebral palsy].

The authors analyze the outcomes of surgical treatment in 15 CP patients with lower paraparesis who had been treated with selective dorsal rhizotomy at the L2-S2 level. All the patients were examined by neurological study, EMG, EEG, visual evoked potential (VEP) recording and motor reaction time estimation. Based on the findings, it is suggested that SPR lumbosacral spinal level may affect cerebral function. Some motor functional changes are associated with this impact. Possible mechanisms of these changes are discussed.

Adolescent↗
PubMedDate not supplied

[The characteristics of epidural analgesia during the removal of lumbar intervertebral disk hernias].

Epidural analgesia (EA) was used in 29 patients undergoing surgical removal of lumbar discal hernia. Marcain EA with controlled medicinal sleep and non-assisted breathing allowed to perform the whole operation in 27 patients. EA may be ineffective in combination of sequestrated disk hernia with scarry adhesive process. The technique of the operation demands a single use of the anesthetic drug which is potent enough to make blockade throughout the operation up to the end.

Adult↗
PubMedDate not supplied

[Epidural anesthesia in surgical interventions on the spine and spinal cord. I. Comparative analysis of the effectiveness of anesthesiological protection under conditions of epidural anesthesia and neuroleptanalgesia in surgery of the spine and and spinal cord].

The study was carried out in 22 patients operated on for vertebral disk hernias and spinal tumors at lumbosacral level. The patients were divided in 2 groups depending on the type of anesthesia (epidural or neuroleptanalgesia-EA and NLA). In the test group all patients were operated under EA with local anesthetics combined with intravenous sedative drugs (diprivan + relanium) under conditions of spontaneous respiration and O2 inhalation through a mask. In the control group combined total intravenous anesthesia by myorelaxants and tracheal intubation were carried out (relanium + diprivan: induction dose 1.95 +/- 0.5 mg/kg, maintenance dose 5.3 +/- 0.4 mg/kg/h, and phentanyl). The purpose of the study was to compare the efficiency of anesthesiological protection under EA and traditional NLA in interventions on the spine, when surgical injury is inflicted in the immediate vicinity to the central structures responsible for pain impulsation. Only EA ensured adequate protection of the patients from surgical stress, as was seen from hemodynamic (arterial pressure and heart rate) and endocrine metabolic parameters (glucose, epinephrine, norepinephrine, hydrocortisone, and prolactin levels). Hence, EA fully demonstrated its protective properties during operations on the spine, and therefore can be regarded as a method of choice in this patient population.

Adjuvants, Anesthesia↗
PubMedDate not supplied

[Epidural anesthesia in surgical interventions on the spine and spinal cord. II. Effects of epidural anesthesia on somatosensory evoked potentials].

Effects of epidural anesthesia (EA) on early components of somatosensory evoked potentials (SSEP) were studied and the objectiveness and efficiency of SSEP monitoring during interventions on the spine under EA were evaluated. Evoked potentials were studied in 21 patients operated on for vertebral disk hernias and extra-intradural tumors of the spine (lower thoracic and lumbar levels) under bupivacaine EA. Cortical SSEP were recorded and analyzed on a Viking IV neuroaverager (Nicolet, USA) stimulating n. tibialis posterior for obtaining a greater amplitude of evoked potentials. The following SSEP characteristics were measured: latency of PI (P37), NI (N45), and PII (P60) peaks, amplitude of PINI peak, and inter-peak latency of PI-NI and PI-PII. The major changes in cortical SSEP caused by EA (local anesthetic 0.5% bupivacaine) involve only PI and NI components which reflect the entry of information on an external stimulus into the cortex and objective physical parameters of this stimulus; this helps predict the onset of full-value epidural block and its duration. General anesthetic (propofol) affect mainly a later component of response, PII peak, which is responsible for processing of primary information about an external stimulus and reflects the activation of associative areas of the brain. Hence, SSEP regulation can be used together with traditional methods (pin prick test and Bromage scale) for evaluating epidural block in patients with spinal diseases.

Adult↗