Background/Objectives: Spinal excitability may undergo adaptive modulation in response to training load, sport-specific demands, and fatigue. While high-impact sports are known to influence reflex responsiveness, the extent to which these changes differ from athletes in lower-impact disciplines remains unclear. This study aimed to investigate post-exercise changes in Hmax/Mmax ratio among trained runners with varied sport backgrounds, and to identify emergent physiological profiles that may reflect differential spinal adaptation to fatigue. Methods: Twenty-two trained athletes underwent unilateral H-reflex testing before and after treadmill running performed to voluntary exhaustion. Amplitudes of the H-reflex and M-wave were recorded, and Hmax/Mmax ratios were analyzed. Based on a physiologically relevant threshold commonly used to distinguish normal from suppressed reflex amplitudes, participants were post hoc classified into three groups: Group A (pre- and post-test ratios above threshold), Group B (pre above, post below), and Group C (both below). A two-way repeated-measures ANOVA was used to assess between-group effects. Results: Significant differences were found across groups and conditions (p < 0.001). Group A maintained reflex ratios above the threshold, indicating stable excitability. Group B showed the greatest suppression (approximately 66%), transitioning from normal to subthreshold values. Group C remained consistently below-threshold. A significant interaction (p < 0.0001) confirmed that reflex modulation varied by physiological profile. A small but statistically significant reduction in H-reflex latency was also observed; however, this change remained within normal physiological variability. Conclusions: Postexercise H-reflex modulation revealed heterogeneous neuromuscular responses among athletes. These findings may contribute to understanding how sport-specific demands and fatigue shape spinal excitability and may help identify individuals with adaptive or potentially pathological profiles relevant to sports diagnostics.

Calcium (Ca²⁺) release from the sarcoplasmic reticulum is central to excitation–contraction coupling and plays a critical role in the development of skeletal muscle fatigue. Altered Ca²⁺ dynamics may affect not only contractile function but also neuromuscular excitability. This study examined the effects of pharmacological modulation of Ca²⁺ channels on fatigue development and spinal reflex activity in rats. Using the Hoffmann reflex (H-reflex) as an indicator of motoneuron excitability, we evaluated the effects of Ca²⁺ channel blockers (Amiloride, Nifedipine) and an activator ((−)-Bay K8644) on the reflex responses of the plantar muscle before and after fatigue induction. The ratio of the maximum H-reflex to maximum M-wave (H_max/M_max) was used to assess alterations in spinal excitability. Compared with the control, both Amiloride and Nifedipine markedly reduce the H_max/M_max ratio (77% and 60%, respectively), whereas (−)-Bay K8644 elicited a robust 129% increase. These findings demonstrate that pharmacological modulation of Ca²⁺ channels has distinct and divergent effects on spinal excitability during fatigue. These results highlight the close interaction between intramuscular Ca²⁺ regulation and reflex pathways and suggest potential strategies for enhancing muscle performance through targeted Ca²⁺ channel modulation.

The aіm of the study іs to evaluate the results of surgіcal treatment usіng the method of bіportal unіlateral іnterlamіnotomy wіth bіlateral decompressіon (ULBD) and to analyze complіcatіons іn patіents operated on for degeneratіve lumbar spіnal stenosіs. Materіals and methods. A total of 51 patіents were analyzed wіth the average age of 58±16.4 years, who had lumbar spіnal stenosіs and underwent bіlateral decompressіon usіng unіlateral іnterlamіnotomy (ULBD) at the Spіne Surgery Clіnіc of the State Іnstіtutіon "ІTO NAMS of Ukraіne". Results. Accordіng to the study results, іmmedіately after ULBD surgery, the level of paіn syndrome іn the back and lower lіmbs sіgnіfіcantly decreased. Іn the post-operatіve perіod, the paіn score іn the back by VAS decreased from 4.9 ± 2.3 cm to 3.2 ± 0.5 cm, and іn the lower lіmbs from 5.6 ± 2.1 cm to 1.2 ± 0.7 cm. However, the hіgh level of back paіn stіll remaіns due to the paіn іn the operated segment and the wound. After 3 months, the paіn score by VAS (back) was 1.1 ± 0.7 cm and 1.4 ± 0.4 cm іn the legs (p < 0.05). Posіtіve dynamіcs of VAS (back) contіnued after 6 months and 12 months wіth scores of 1.3 ± 0.5 cm and 0.9 ± 0.6 cm, respectіvely (p < 0.05). Paіn syndrome reductіon іn the lower lіmbs maіntaіned at the level of 0.9 ± 0.7 cm and 0.8 ± 0.6 cm after 6 months and 12 months, respectіvely (p < 0.05). The evaluatіon of results by MRІ іn the preoperatіve and post-operatіve perіod (the next day after the surgery) showed that the cross-sectіonal area іncreased from 1,01±0,05 cm2 to 2,01±0,02 cm2 on average. The average length of hospіtal stay for patіents was 2±1,2 days. Conclusіons. The ULBD technіque іs an effectіve method for decompressіon of the spіnal canal іn patіents wіth lumbar spіnal stenosіs. Unіlateral lamіnotomy wіth bіlateral decompressіon technіque (ULBD) allows reducіng muscle dіssectіon and decreasіng the degree of damage to the posterіor structures of the spіne.

Currently, insufficient attention is being paid to an issue of the necessary anti-osteoporotic therapy after percutaneous vertebroplasty for vertebral fractures associated with osteoporosis, which leads to premature termination of medical treatment and worsening of the treatment results in this group of patients. An objective of the research is to study the results of treatment of patients with vertebral fractures associated with osteoporosis, depending on the use of anti-osteoporotic therapy. The results of percutaneous vertebroplasty of 91 postmenopausal women aged 50-90 years, depending on the use of anti-osteoporotic therapy during the postoperative period were analysed. An assessment was made according to the dynamics of pain syndrome using the Visual Analogue Scale (VAS), the Quality of Life Scale by J.R. Gaughen to estimate the patient's mobility and a need for pain medication. The results of the treatment were assessed 3 and 6 months after the percutaneous vertebroplasty. Bone mineral density was measured using Dual-energy X-ray absorptiometry 6 month after the treatment. Anti-osteoporotic therapy, which was prescribed for all patients comprised calcium supplements, antiresorbents and in D-hypovitaminosis – alfacalcidol or cholecalciferol. Only half of the patients followed the recommendations – 46 (50.6%), while the rest of the patients stopped the therapy in 2-3 months due to the improvement of their condition. In the main group of patients, where necessary anti-osteoporotic therapy was administered, significant reduction of pain syndrome and increase in quality of life during 3 and 6 months’ observation period were revealed. In the group of patients where prescribed anti-osteoporotic therapy was not adhered, significant reduction of pain syndrome and increase in quality of life in the observation period 3 months was revealed but deterioration in the form of pain syndrome increase and decrease in quality of life in the observation period of 6 months occurred. Effectiveness of anti-osteoporosis therapy, with regard to measuring bone mineral density can be reliably confirmed only in the main group. Intraoperative and postoperative complications occurred up to 5.5%, and generally did not require further treatment and did not affect the overall treatment result. Thus, it was revealed that to ensure a stable effect after the surgery, long-term prescription of anti-osteoporosis therapy is needed.

Introduction. The relations between quantitative MRI parameters and the severity of clinical symptoms in lumbar spinal stenosis (LSS) have not been sufficiently studied. Assessing this correlation may help determine the adequacy of the surgical technique being used. Aim. To investigate the relationship between the dural sac cross-sectional area (DCSA) measured on MRI and the severity of clinical symptoms in lumbar spinal stenosis. Materials and methods. The cross-sectional area of the dural sac was measured at four levels (upper endplate, disc level, lower endplate, and 2 mm above the upper endplate); the analysis was performed at the most stenotic level. The main clinical indicators used to evaluate the patients’ preoperative condition were as follows: the intensity of pain according to the visual analogue scale (VAS) in the back and lower limb, the Oswestry Disability Index (ODI), and walking distance (m). Both clinical and radiological parameters were statistically analyzed. Results. The study analyzed data from 28 patients with lumbar spinal stenosis prior to admission to the clinic. The mean age was 43.9±9.5 years. The mean dural sac cross‐sectional area (DCSA), measured on axial T2 images at the most stenotic segment, was 128.6 ± 59.6 mm² (range: 41 to 281 mm²). Pre-operative clinical parameters were: pain intensity on the Visual Analogue Scale (VAS) in the back 5.03±2.4 and in the lower limb 7.03±1.6; Oswestry Disability Index (ODI) 24.8±6.3; walking distance 1,275.6±1,681.72 m. The MRI parameter DCSA (mm²) demonstrated a direct correlation with walking distance (r=0.261; p0.05). Conclusions. When comparing most clinical indicators with MRI parameters, a weak or no correlation was observed relative to generally accepted clinical assessments. A statistically significant direct correlation was found only between DCSA and walking distance. Poor MRI findings do not necessarily correspond to poor clinical outcomes in lumbar spinal stenosis; therefore, MRI parameters should play a supplementary role, and excessive reliance on them in the management of lumbar spinal stenosis should be avoided.

The aim of the study was to compare the results of surgical treatment of lumbar spinal stenosis in men operated on by different methods. The data of examination and treatment of men (n=21) who underwent surgical intervention for lumbar spinal stenosis were analyzed. The intensity of the pain syndrome was assessed using a visual analog pain scale (VAS, cm), patient satisfaction and quality of life were assessed using the Oswestry low back pain disability questionnaire (ODI). The Oswestry questionnaire (version 2.0) allowed us to determine the level of impairment of patients' quality of life in terms of points and in the form of the Josw disability index. The data analysis showed that the indicators of pain in the n/limbs and back, as well as the quality of life in the early and long-term postoperative period differed little in group I (endoscopic decompression (UBE/UBLD)) and group II (open decompression). Decompression laminectomy with transpedicular stabilization requires additional surgical interventions for patients to fully recover. Assessment of the results after surgery in terms of quality of life and self-care ability according to the ODI questionnaire showed recovery with minimal disorders (less than 20% according to the ODI) in the first and second groups after one month. Decompressive laminectomy with transpedicular stabilization requires additional rehabilitation measures for patients to fully recover.