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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">r-n-j</journal-id><journal-title-group><journal-title xml:lang="ru">Российский неврологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Russian neurological journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2658-7947</issn><issn pub-type="epub">2686-7192</issn><publisher><publisher-name>МИА</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.30629/2658-7947-2023-28-2-73-82</article-id><article-id custom-type="elpub" pub-id-type="custom">r-n-j-417</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ЛЕКЦИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LECTURE</subject></subj-group></article-categories><title-group><article-title>Инструментальные методы оценки состояния паравертебральных поясничных мышц у пациентов с пояснично-крестцовой радикулопатией и неспецифической скелетно-мышечной болью</article-title><trans-title-group xml:lang="en"><trans-title>Instrumental methods for assessing the state of the paravertebral lumbar muscles in patients with lumbosacral radiculopathy and nonspecific muscle-skeletal pain</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9652-1457</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Селиверстова</surname><given-names>Е. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Seliverstova</surname><given-names>E. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Селиверстова Екатерина Геннадьевна</p><p>Москва</p></bio><bio xml:lang="en"><p>Ekaterina G. Seliverstova</p><p>Moscow</p></bio><email xlink:type="simple">e.seliverstova.md@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0448-7402</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Войтенков</surname><given-names>В. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Voitenkov</surname><given-names>V. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Saint Petersburg</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2646-9790</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Команцев</surname><given-names>В. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Komantsev</surname><given-names>V. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Saint Petersburg</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5026-0060</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Синкин</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Sinkin</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3515-8329</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гринь</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Grin</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»<country>Россия</country></aff><aff xml:lang="en">N.V. Sklifosovsky Research Institute of Emergency Medical Care<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">ФГБУ Детский научно-клинический центр инфекционных болезней Федерального медико-биологического агентства России; Академия постдипломного образования ФГБУ Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства<country>Россия</country></aff><aff xml:lang="en">Pediatric Research and Clinical Center for Infectious Diseases; Academy of Postgraduate Education of Federal Scientifi c Research Center<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">ФГБУ ДПО Санкт-Петербургский институт усовершенствования врачей-экспертов Минтруда России<country>Россия</country></aff><aff xml:lang="en">St. Petersburg Institute of Advanced Training of Doctors-Experts<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru">ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»; ФГБУ «Московский государственный медико-стоматологический университет им. А.И. Евдокимова»<country>Россия</country></aff><aff xml:lang="en">N.V. Sklifosovsky Research Institute of Emergency Medical Care; A.I. Yevdokimov Moscow State University of Medicine and Dentistry<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>18</day><month>05</month><year>2023</year></pub-date><volume>28</volume><issue>2</issue><fpage>73</fpage><lpage>82</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Селиверстова Е.Г., Войтенков В.Б., Команцев В.Н., Синкин М.В., Гринь А.А., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Селиверстова Е.Г., Войтенков В.Б., Команцев В.Н., Синкин М.В., Гринь А.А.</copyright-holder><copyright-holder xml:lang="en">Seliverstova E.G., Voitenkov V.B., Komantsev V.N., Sinkin M.V., Grin A.A.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.r-n-j.com/jour/article/view/417">https://www.r-n-j.com/jour/article/view/417</self-uri><abstract><p>В диагностическом процессе при радикулопатиях, помимо неврологического осмотра, который является определяющим для тактики ведения, и при необходимости выбора уровня и характера нейрохирургического вмешательства важную роль играют инструментальные методы диагностики морфологического и функционального состояния паравертебральных мышц. Паравертебральные мышцы — симметричные мышцы спины, окружающие позвоночный столб и участвующие в его движениях, образуют медиальные и латеральные продольные мышечные тракты. Для инструментальной диагностики состояния паравертебральных мышц используют методы магнитно-резонансной томографии (МРТ), а также игольчатую электромиографию и ультразвуковое исследование (УЗИ). Представляются данные литературы по изучению паравертебральных мышц при радикулопатиях и неспецифических болях в спине. «Золотым стандартом» диагностики остается МРТ, однако эта методика отличается высокой стоимостью, невозможно ее проведение при наличии магнитных объектов в организме пациента. Кроме того, существует ряд психологических состояний, которые резко ограничивают проведение МРТ. В свою очередь, игольчатая электромиография и УЗИ паравертебральных мышц не позволяют напрямую судить о важном для прогнозирования состояния параметре — степени замещения мышечной ткани жировой. Наиболее информативным остается комплексный подход, при котором инструментальные методы целесообразно применять в сочетании друг с другом. Показанием к такому обследованию могут явиться трудные случаи течения заболевания, анатомические аномалии расположения спинномозговых корешков, стертая клиническая картина. Также данное обследование обосновано с точки зрения оценки прогностической ценности различных инструментальных методов для исходов заболевания и хирургического лечения.</p></abstract><trans-abstract xml:lang="en"><p>Neurological examination plays the main role in diagnostic and management of radiculopathies. In addition, the instrumental methods could be used for diagnosis of the morphological and functional state of paraspinal muscles. Paraspinal muscles are symmetrical back muscles surrounding the spinal column and supporting it. Magnetic resonance imaging (MRI) as well as needle electromyography (EMG) and ultrasound are used for instrumental diagnosis of paraspinal muscles conditions. We provide the review on the current scope of studies on radiculopathies and non-specific back pain. MRI is the principle standard for radiculopathy diagnosis, but other methods such as muscle ultrasound and needle electromyography are also used here. MRI is characterized by a high cost, and it is impossible to carry it out if there are magnetic objects present in the patient’s body. EMG and ultrasound both are not sufficient enough to study the level of the fatty replacement of the paraspinal muscle, while this parameter is quite significant for measuring a radiculopathy outcome. Thus, we consider it rational to recommend using these methods in combination. Indications for the combined examination may be such complex cases as anatomical anomalies of spinal roots, atypical disease pattern.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>радикулопатия</kwd><kwd>нейрофизиология</kwd><kwd>электромиография</kwd><kwd>ультразвуковое исследование</kwd><kwd>паравертебральные мышцы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>radiculopathy</kwd><kwd>neurophysiology</kwd><kwd>needle electromyography</kwd><kwd>ultrasound imaging</kwd><kwd>paraspinal muscles</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Mansfield M, Smith T, Spahr N, Thacker M. Cervical spine radiculopathy epidemiology: A systematic review. Musculoskeletal Care. 2020;18(4):555–567. https://doi.org/10.1002/msc.1498</mixed-citation><mixed-citation xml:lang="en">Mansfield M, Smith T, Spahr N, Thacker M. Cervical spine radiculopathy epidemiology: A systematic review. 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