and subdural spaces in the formation of connective tissue. This fact must be taken into account when preventing the development and formation of epidural fibrosis, because during surgery, damage to the dura mater is detected from cell-molecular to tissue levels, which are not always visualized during surgery using microsurgical technologies and equipment.

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Objective. To analyze clinical manifestations of cervicobrachial syndrome and identify their relationship with sagittal imbalance using data of MRI and radiological examination.Material and Methods. Clinical manifestations of cervicobrachial syndrome associated with degenerative changes in the spine were studied in 22 patients. Clinical examination, radiography of the cervical spine, electroneuromyography of the upper extremities, and MRI study were performed. The intensity of the pain syndrome was assessed by VAS, and the quality of life – by the NDI questionnaire. The sagittal balance of the cervical spine was evaluated according to the following characteristics: angle of T1 slope, atlantoaxial (C1–C2) angle, degree of shift of the center of gravity of C2–C7, and Cobb angle.Results. The pain intensity in cervicobrachial syndrome correlates with sagittal balance changes in the C2–C7 Cobb angle (r = 0.656; p < 0.05), the angle of T1 vertebra slope (r = 0.520; p < 0.05), and in the degree of shift of the center of gravity of C2–C7 (r = 0.756; p < 0.02). Differences between MRI and radiological results of the sagittal balance measurement are not significant (p < 0.04).Conclusion. The study of the sagittal balance can be included in the algorithm for diagnosing osteochondrosis of the cervical spine. The MRI, along with spondylography, can be used to assess the state of sagittal balance. Understanding the identified relationships can help in determining the program of etiopathogenetic treatment of patients with cervicobrachial syndrome with obligatory including the sagittal balance correction in the program.

The article presents clinical profile of patients with cervical osteochondrosis and cervicobrachial syndrome, results of cliniconeurological examination including X-ray diagnostics (plain frontal and lateral radiography of cervical spine, functional tests, frontal and lateral X-ray imaging of large joints of upper limbs), MRI of cervical spine, stimulation electroneuromyography and osteodensimetry. Statistical processing with definition of nonparametric test and correlation coefficient was performed using SPSS 22.0.0 software. Pearson and Spearman nonparametric tests were used for correlation analysis. Examination of patients with cervicobrachial syndrome revealed that bone tissue condition of a limb with pain syndrome slightly differs from the bone tissue condition of a healthy limb and is within normal range. Neuromyography showed that abnormality of a functional condition of studied nerves of upper limbs was not pronounced and was registered on both limbs. As a result of our research we can suppose that asymmetric abnormal focus inhibits peripheral and central chains of locomotor system both on injured and healthy limbs. Differences in functional condition of peripheral nerves of upper limbs in patients with cervicobrachial syndrome and healthy people are statistically significant and allow us to consider them as a sign of decompensation which prevent healthy performance.

The aim of the research was to develop an algorithm of complex conservative treatment of patients with cervical osteo-chondrosis. We examined and provided conservative treatment to 40patients with cervical osteochondrosis in periods I–II with severe pain syndrome. The treatment was mainly aimed at pain management. For this purpose, we assigned non-steroidal anti-inflammatory drugs (NSAID) to the patients. NSAID are the most effective medicinal agents, first of all due to their analgesic effect. Also, the treatment included physiotherapy and acupuncture. As a result of the treatment, neurological manifestations were reduced. Number of cervicalgia cases decreased from 12 (before the treatment) to 6 (after the treatment), number of cervical cranialgia cases – from 12 to 7, number of cervicobrachialgia cases – from 16 to 8 correspondingly. Developed complex of conservative treatment measures al-lows to obtain successful treatment results in most cases. It is important to note that proposed treatment regimen is available, simple and can be applied in all neurological and neurosurgical units and hospitals.