Preview

Laser Medicine

Advanced search

Laser therapy in the complex treatment of patients with compression-ischemic neuropathy

https://doi.org/10.37895/2071-8004-2021-25-1-36-44

Abstract

Material and methods. Twenty-two patients with compression-ischemic neuropathy were included into the study. Low-level laser device “ALOK-1” was used for laser therapy. Its beam impacts tissues directly; its power is 1 mW, wavelength – 0.63 μm, spot diameter – 0.8 mkm.

Results. Subjective, objective and instrumental findings became significantly better, if to compare with the pre-operative period.

Conclusion. The developed technique has shown its good efficiency. The intraoperative laser therapy CIN patients decreased the severity of symptoms up to their complete regression; patients were highly satisfied with their postoperative outcomes.

About the Authors

M. V. Shpagin
Fraerman Nizhegorodsky Neurosurgical Center
Russian Federation

Shpagin Maxim – MD, Cand. Sc. (Med.), Neurosurgeon

Nizhny Novgorod



A. V. Yarikov
Privolzhsky District Medical Center
Russian Federation

Yarikov Anton – MD, Cand. Sc. (Med.), Neurosurgeon

Nizhny Novgorod



S. S. Pavlov
Privolzhsky District Medical Center
Russian Federation

Pavlov Sergey – MD, Neurosurgeon

Nizhny Novgorod



A. A. Sokolov
Privolzhsky Research Medical University
Russian Federation

Sokolov Artyom – 3rd year student

Nizhny Novgorod



References

1. Fedyakov A.G., Dubrovina O.N., Dreval O.N., et al. Application of intraoperative electrophysiological monitoring during decompression of the ulnar nerve in the elbow joint area. Voprosy neyrokhirurgii im. N.N. Burdenko. 2014; 78 (6): 43–49. [In Russ.].

2. Novikov A.V., Shchedrina M.A., Motyakina O.P. Modern concepts of the etiology and mechanisms of pathogenesis of compression-ischemic neuropathies of the upper limb (literature review). Voprosy travmatologii i ortopedii. 2012; 3 (4): 35–39. [In Russ.].

3. Mukhina O.V., Kuznetsov A.V., Dreval O.N. Cubital canal syndrome: Diagnosis and choice of treatment tactics. Sovremennaya nauka: aktual’nye problemy teorii i praktiki. Seriya: Estestvennye i tekhnicheskie nauki. 2020; 8: 187–193. [In Russ.].

4. Orlov A.Yu., Komkov D.Yu., Dzhiganiya R., et al. To the question of the state of blood fl ow along the microvascular bed of peripheral nerves of the extremities in tunnel neuropathies. Rossiyskiy neyrokhirurgicheskiy zhurnal im. professora A.L. Polenova. 2018; 10 (3–4): 55–60. [In Russ.].

5. Yusupova D.G., Suponeva N.A., Zimin A.A., et al. Validation of the Boston Carpal Tunnel Questionnaire in Russia. Nervnomyshechnye bolezni. 2018; 8 (1): 38–45. [In Russ.].

6. Golovacheva V.A., Parfenov V.A., Golovacheva A.A., et al. Syndrome of the cubital canal: Modern principles of diagnosis and treatment. Nevrologiya, neyropsikhiatriya, psikhosomatika. 2019; 11 (S1): 89–97. [In Russ.].

7. Vershinin A.V., Gushcha A.O., Arestov S.O., et al. Method of surgical treatment of carpal tunnel syndrome using endoscopic control and electrophysiological monitoring. Annaly klinicheskoy i eksperimental’noy nevrologii. 2017; 11 (3): 41– 46. [In Russ.].

8. Shtok A.V., Konovalov N.A., Onoprienko R.A., et al. Results of surgical treatment of patients with carpal tunnel syndrome by the method of decompression with the use of endoscopic assistance. Rossiyskiy neyrokhirurgicheskiy zhurnal im. professora A.L. Polenova. 2017; 9 (4): 54–63. [In Russ.].

9. Bashlachev M.G., Evzikov G.Yu., Parfenov V.A. et al. Dynamic neuropathy of the common peroneal nerve at the level of the fi bular head (clinical observation and literature review). Neyrokhirurgiya. 2019; 21 (1): 54–59. [In Russ.].

10. Mendoza J.L., Salgado A.A. Compression neuropathies. Ed. N. Souayah. 2013; P. 103.

11. Belova N.V., Yusupova D.G., Lagoda D.Yu., et al. Modern concepts of diagnosis and treatment of carpal tunnel syndrome. RMZh. 2015; 23 (24): 1429–1432. [In Russ.].

12. Pham K., Gupta R. Understanding the mechanisms of entrapment neuropathies. Neurosurgical focus. 2009; 26 (2): E7.

13. Mackinnon S.E. Pathophysiology of nerve compression. Hand clinics. 2002; 18 (2): 231–241.

14. Tomita K., Kubo T., Matsuda K. et al. Myelin-associated glycoprotein reduces axonal branching and enhances functional recovery after sciatic nerve transection in rats. Glia. 2007; 1498–1507.

15. Thatte M.R., Mansukhani K.A. Compressive neuropathy in the upper limb. Indian J Plast Surg. 2011; 44 (2): 283.

16. Baytinger A.V., Cherdantsev D.V. Carpal tunnel syndrome: Current state of the art. Voprosy rekonstruktivnoy i plasticheskoy khirurgii. 2018; 65 (2): 12–18. [In Russ.].

17. Baytinger A.V. Experience of using endoscopic decompression of the median nerve in the carpal canal. Sovremennye tekhnologii lecheniya patsientov s travmoy opornodvigatel’nogo apparata i tsentral’noy nervnoy sistemy: sb. st. nauchn.-prakt. konf. 2019: 34–38. [In Russ.].

18. Gilweg A.S., Parfenov V.A., Evzikov G.Yu. Diagnosis and treatment of carpal tunnel syndrome. Nevrologiya, neyropsikhiatriya, psikhosomatika. 2019; 11 (S1): 46–51. [In Russ.].

19. Yarikov A.V., Tutkin A.V., Boyarshinov A.A., et al. Carpal tunnel syndrome: Clinical picture, diagnosis and modern approaches to treatment (brief review). Meditsinskiy al’manakh. 2020; 3 (64): 27–35. [In Russ.].

20. Yusupova D.G., Zimin A.A., Grishina D.A. Carpal tunnel syndrome: Assessment of the need for rehabilitation and rehabilitation treatment after endoscopic decompression of the median nerve in the late and late postoperative periods. Nervno-myshechnye bolezni. 2019; 9 (4): 34–43. [In Russ.].

21. Nysanbaeva G.A. Features of the complex treatment of patients with neuropathies of the upper extremities. Vestnik KazNMU. 2014; 1: 232–233. [In Russ.].

22. Gilweg A.S., Parfenov V.A., Evzikov G.Yu. Problems of diagnosis and treatment of median nerve compression neuropathy: Analysis of typical medical practice. Zhurnal nevrologii i psikhiatrii im. C.C. Korsakova. 2018; 118 (11): 30–34. [In Russ.].

23. Mukhina O.V., Kuznetsov A.V., Dreval O.N. Surgical treatment of cubital canal syndrome (literature review). Rossiyskiy neyrokhirurgicheskiy zhurnal im. professora A.L. Polenova. 2018; 10 (3–4): 98–108. [In Russ.].

24. Dang A.C., Rodner C.M. Unusual compression neuropathies of the forearm. Part I: Radial Nerve. J Hand Surg. 2009; 34A: 1906–1914.

25. Dong Q., Jacobson J.A., Jamadar D.A., et al. Entrapment neuropathies in the upper and lower limbs: Anatomy and MRI features. Radiol Res Pract. 2012; 2012: 230673. DOI: 10.1155/2012/230679

26. Bismak О. Effectiveness of the program for restoring the function of the upper limb in traumatic and compression-ischemic injuries of the peripheral nerves and brachial plexus. Slobozhanskyi Herald of Science and Sport. 2020; 8 (1): 17–22.

27. Leiderman N.E., Shchekina R.V., Zayonchkovskaya I.M. Experience in the treatment of compression-ischemic neuropathies on an outpatient basis. Meditsinskiy vestnik MVD. 2015; 6 (79): 35–38. [In Russ.].

28. Merkulova D.M., Merkulov Yu.A., Nikitin S.S. Tunnel neuropathies. Diagnostics and principles of pathogenetic therapy. Consilium medicum (nevrologiya, revmatologiya). 2012; 2 (14): 32–38. [In Russ.].

29. Harder K., Lukschu S., Dunda S.E., et al. Results after simple decompression of the ulnar nerve in cubital tunnel syndrome. GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW. 2015; 4. DOI: 10.3205/iprs000078

30. Wojewnik B., Bindra R. Cubital tunnel syndrome – Review of current literature on causes, diagnosis and treatment. J Hand Microsurg. 2009; 1 (2): 76–81.

31. Bartels R.H., Verhagen W.I., van der Wilt G.J. et al. Prospective randomized controlled study comparing simple decompression versus anterior subcutaneous transposition for idiopathic neuropathy of the ulnar nerve at the elbow: Part 1. Neurosurgery. 2005; 56 (3): 522–530. DOI: 10.1227/01.neu.0000154131.01167.03

32. Caliandro P., La Torre G., Padua R., et al. Treatment for ulnar neuropathy at the elbow. Cochrane Database Syst Rev. 2016; 11 (11): CD006839. DOI: 10.1002/14651858.CD006839.pub4.

33. Bochkarev P.N., Gorshkov R.P., Melamud E.E., et al. Longterm experience of direct electrical stimulation of nerve stems in the treatment of compression and traction injuries of peripheral nerves. Sovremennye aspekty elektroneyrostimulyatsii i novye tekhnologii v neyrokhirurgii i nevrologii. 1998: 61–63. [In Russ.].

34. Rochkind S. Review of 30-years experience: Laser phototherapy in neuroscience and neurosurgery. Part I – muscle and nerve. Laser Therapy. 2009; 18 (1): 27–38.

35. Rochkind S. Review of 30-years experience: Laser phototherapy in neuroscience and neurosurgery. Part II – nerve cells, brain and spinal cord. Laser Therapy. 2009; 18 (3): 127–136.

36. Bae C.S., Lim S.C., Kim K.Y., et al. Effect of Ga-As laser on the regeneration of injured sciatic nerves in the rat. In Vivo. 2004; 18 (4): 489–495.

37. Bagis S., Comelekoglu U., Coskun B. Effect of GaAs (904 nm) laser irradiation on the intact skin of the injured rat sciatic nerve. Lasers Med Sci. 2003; 18 (2): 83–88.

38. Bersnev V.P., Tyshkevich T.G., Yakovenko I.V., Shukri A., Yashtykov B.A. Method for treating nerve damage: Patent N 2185214 of the Russian Federation. [In Russ.].

39. Rokhind S. An innovative approach to laser phototherapy for the treatment of peripheral nerve damage and the preservation of denervated muscle. Lazernaya meditsina. 2014; 18 (4): 69–70. [In Russ.].

40. Eskin N.A., Golubev V.G., Pripisnova S.G. Modern possibilities of diagnosis and treatment of tunnel syndromes of the upper limb. Aktual’nye voprosy ortopedii i travmatologii. Kiev: AMN Ukraini; 2004: 464–469. [In Russ.].

41. Dzhiganiya R., Orlov A.Yu., Korotkevich M.M., et al. Analysis of unsatisfi ed results of surgical treatment of patients with cubital canal syndrome. Materialy Vserossiyskoy nauchno-prakticheskoy studencheskoy konferentsii s mezhdunarodnym uchastiem. Saint-Petersburg; 2018: 160. [In Russ.].

42. Baytinger A.V., Cherdantsev D.V., Rybakov V.E. Comparative analysis of the effectiveness of open and endoscopic decompression of the median nerve in primary carpal tunnel syndrome. Voprosy rekonstruktivnoy i plasticheskoy khirurgii. 2019; 22 (2 (69)): 71–78. [In Russ.].

43. Hudak P.L., Amadio P.C., Bombardier C. Development of an upper extremity outcome measure: The DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996; 29 (6): 602–608.

44. Levine D.W., Simmons B.P., Koris M.J., et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am. 1993; 75 (11): 1585– 1592.

45. Gilweg A.S., Parfenov V.A., Evzikov G.Yu. Immediate and long-term results of median nerve decompression in carpal tunnel syndrome. Nevrologiya, neyropsikhiatriya, psikhosomatika. 2018; 10 (3): 79–85. [In Russ.].

46. Jeon I.-H. Simple in situ decompression for idiopathic cubital tunnel syndrome using minimal skin incision. Med Pregl. 2010; 63 (9–10): 601–606.

47. Kang H.J., Koh I.-K., Chun Y.-M., et al. Ulnar nerve stabilitybased surgery for cubital tunnel syndrome via a small incision: A comparison with classic anterior nerve transposition. J Orthop Surg Res. 2015; 10. DOI: 10.1186/s13018-015-0267-8

48. Djigania R. Personalized choice of the method of surgical treatment of ulnar nerve neuropathy at the level of the cubital canal: Dissertation thesis of Candidate of Medical Sciences. Saint-Petersburg, 2019. [In Russ.].


Review

For citations:


Shpagin M.V., Yarikov A.V., Pavlov S.S., Sokolov A.A. Laser therapy in the complex treatment of patients with compression-ischemic neuropathy. Laser Medicine. 2021;25(1):36-44. (In Russ.) https://doi.org/10.37895/2071-8004-2021-25-1-36-44

Views: 1656


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2071-8004 (Print)
ISSN 2686-8644 (Online)