DIAGNOSTIC TECHNIQUE OF LEVEL OF DAMAGE OF ISCHIAL NERVE Russian patent published in 2020 - IPC A61B5/484 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to neurosurgery, and can be used in diagnosing the level of sciatic nerve damage of various etiology. That is ensured by electroneuromyography of tibial and fibular nerves with recording of amplitude of M-responses from foot and shin muscles. If the M-response amplitude is absent or decreased below 4.0 mV, the presence of sciatic nerve damage is stated. To specify the level of damage, magnetic stimulation is performed to determine the presence of induced muscle responses (IMR) of each portion of sciatic nerve. Discharge electrodes are placed on the calf muscle for the tibial portion, and for the fibular portion – on the anterior tibial muscle. It is followed by stimulation with a magnetic pulse on the posterior surface of the thigh in the projection of the ischial nerve at the following points: at the point of the ischial nerve exit from the crotch-like opening, in the upper third of the thigh, in the lower third of the thigh. In absence of registration IMR from the shin muscles, the discharge electrodes are transferred to the hip muscles: for the tibial portion – on the long biceps head, for the fibular portion – for the short head of the ham bicep. It is followed by magnetic stimulation on the posterior surface of the thigh, alternately at the level of the middle, upper third of the thigh and in the point of the nerve exit from the foramen infrapiriforme. Obtained data are analyzed and diagnosed level of damage, corresponding to point, in which for the first time there was decreased amplitude IMR from shin or hip muscles below its previous value fixed on corresponding muscles by 15 % and more.

EFFECT: method provides higher accuracy of determining the level of sciatic nerve damage by activating nerve trunks even in deep bedding without causing pain sensations in patients with the possibility of performing diagnostic procedures in the early post-traumatic period and providing timely and adequate selection of the therapeutic approach.

1 cl, 1 ex