METHOD OF PREDICTING DEGREE OF RISK OF FIBROSIS DEVELOPMENT IN EPIDURAL SPACE AFTER SURGERY OF HERNIAS OF LUMBAR INTERVERTEBRAL DISCS Russian patent published in 2011 - IPC A61B10/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to neurosurgery. Values of 20 prognostic signs, which contain 12 anatomo-anthropometric parameters separately for men and women, 8 immunologic and immunogenetic indices, selected by methods of principal components and expert evaluation, are estimated. By Bayesian algorithm in Genkin-Gubler modification found are corresponding prognostic coefficients: for anthropometric parameters in men with body length: less than 168.6 cm equal +3, from 168.6 to 177.2 cm equal - 1, more than 177.2 cm equal 0; with body weight: less than 67.5 kg equal 0, from 67.5 to 85.9 kg equal - 1, more than 85.9 kg equal +4; with fat fold of hip: less than 8.4 mm equal +19, from 8.4 to 18.3 mm equal -6, more than 18.3 mm equal -6; with fat fold of chest: less than 8.0 mm equal +5, from 8.0 to 17.9 mm equal 0, more than 17.9 equal -3; with girth of shoulder: less than 27.9 cm equal +1, from 27.9 to 33.0 cm equal 0, more than 33.0 cm equal -1; with distal diameter of shoulder: less than 6.6 cm equal -9, from 26.6 to 7.4 cm equal +1, more than 7.4 cm equal +1; with transverse diameter of chest: less than 28.4 cm equal +2, from 28.4 to 33.3 cm equal -1, more than 33.3 cm equal +1. When values of Tenner's index are: less than 93.1 equal -7; from 83.7 to 93.1 equal +3, more than 83.7 equal +6; when values of index of relative width of shoulders is: less than 20.6 equal 0, from 20.6 to 23.5 equal -3, equal -3, more than 23.5 equal +6; when values of index of relative width of pelvis are: less or equal 15.9 equal +6, from 16.0 to 17.9 equal -5, more or equal 18.0 equal -2. When values of Ketle's index are: less than 18.5 kg/m² equal 0, from 18.5 to 30.0 kg/m² equal -1, from 25.0 to 30.0 kg/m² equal -1, more than 30.0 kg/m² equal +7; for anthropometric parameters in women: with body length: less than 156.5 cm equal 0, 156-165 cm equal 0, more than 164.7 cm equal -1; with body weight: less than 63.7 kg equal -1, from 63.7 to 83.8 kg equal - 1, more than 83.8 kg equal +3; with fat fold of shoulder on the front: less than 11.3 mm equal +1, from 11.3 to 20.6 mm equal -1, more than 20.6 mm equal +2; with fat fold of shoulder on the back: less than 19.6 mm equal +2, from 19.6 to 29.9 mm equal -1, more than 29.9 mm equal +1; with fat fold of hip: less than 14.5 mm equal+19, from 14.5 to 25.2 mm equal -2, more than 25.2 mm equal -11; with girth of hip: less than 55.7 equal +1, from 55.7 to 64.3 cm equal -3, more than 64.3 cm equal +14; with distal diameter of ankle: less than 5.8 cm equal -3, from 5.8-6.8 cm equal +1, more than 6.8 cm equal -1. When values of Rees-Eisenck index are: more or equal 107 equal -3, from 106 to 97 equal +2, less or equal 96 equal +4; when values of index of relative width of shoulders is: less than 20.6 equal +16, from 20.6 to 23.5 equal -5, more than 23.5 equal -6; when values of index of relative width of pelvis are: less or equal 15.9 equal+3, from 16.0 to 17.9 equal -2, more or equal 18.0 equal 0; when values of pelvic-shoulder index is: less or equal 69.9 equal 0, from 70.0 to 74.0 equal -1, more or equal 75 equal 0. When values of Ketle's index are: less than 18.5 kg/m² equal +3, from 18.5 to 25.0 kg/m² equal -2, from 25.0 to 30.0 kg/m² equal-1, more than 30.0 kg/m² equal +2. For immunologic and immunogenic parameters with relative content of CD₃₊: less than 67% equal 0, from 67 to 76% equal +1, more than 76% equal 0. With relative content of CD₈₊: less than 28% equal +4, from 28 to 40% equal -1, more than 40% equal -5. When values of immunoregulatory index (CD₄₊/CD₈₊) are: less than 1.2 equal -1, from 1.2 to 2.0 equal +2, more than 2.0 equal +3. When level of IgA is: less than 1.4 g/l equal -1, from 1.4 to 4.2 g/l equal 0, more than 4.2 g/l equal +6; when level of IgM is: less than 0.5 g/l equal 0, from 0.5 to 1.3 g/l equal 0, more than 1.3 g/l equal +1; when level of IgG is: less than 8.0 g/l equal -7, from 8.0 to 16.6 g/l equal 0, more than 16.6 g/l equal +6. When level of CIC is: from 0 to 100 c.u. equal 0, more than 100 c.u. equal +7; with HLA B27 phenotype: HLA B27(+) equal +7, HLA B27(-) equal -7, which are summed up, and if obtained value is +13 and higher, high degree of risk of developing fibrosis in epidural space is predicted, if value is 13 and lower - insignificant risk of development, in cases, when total prognostic coefficient is less than +13 and higher than -13 prognosis is estimated as indefinite.

EFFECT: method makes it possible in preoperative period of standard microdisectomies to determine degree of risk of developing fibrosis in epidural space after surgery of hernias of lumbar intervertebral discs and thus increase efficiency of its prevention.

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