Pub Date : 2023-12-11DOI: 10.29413/abs.2023-8.5.12
A. E. Medvedchikov, E. Anastasieva, V. Prokhorenko, I. Kirilova
Distal biceps tendon injuries mainly occur in men from the active groups of population. Among the athletes and military personnel, the incidence rate is 2–10 % of the upper limb tendon injuries. Comparative studies have shown the achievement of better functional results in surgical treatment, while maintaining overall complication rate of 4.6–25 %. The aim. To demonstrate a new reinsertion technique with two cortical buttons in case of complete rupture of distal biceps tendon as part of a clinical case. Materials and methods. The article presents a clinical case of surgical treatment of a patient with complete rupture of dominant limb distal biceps tendon which was more than 2 weeks old and was accompanied by lacertus fibrosus provocation and persistent muscle retraction. Results. We obtained the following clinical results by the week 24 after the surgery: VAS (Visual Analogue Scale) score – 1 cm, ASES (American Shoulder and Elbow Surgeons) score – 99 points, DASH (Disabilities of the Arm, Shoulder and Hand) score – 15 points. Dynamometry results: Dex. 85; sin. 90 (2daN); range of motion corresponds to the same of a healthy joint. MRI at 1.5 T shows no signs of synostosis or heterotopic ossification; MSCT shows no signs of migration of cortical buttons in comparison with intraoperative X-ray control. Discussion. Extracortical methods of distal biceps tendon positioning in anatomical reinsertion have lower strength indicators, comparable with the use of transosseous sutures and anchor fixators. A larger area of contact of the studied zone in case of minimal tendon compression in the area of proximal radioulnar space or inside the formed radial bone canal provides high strength indicators and reduces the risk of repeated injury. Conclusion. The scores of the scales (VAS, DASH, ASES) turned out to be better than when using other common methods. The technique of dipping distal biceps tendon stump into the formed oval canal of the “anatomical impression” using the proposed method meets the objectives of careful attitude to the tendon and provides the largest area of its contact with the bone.
肱二头肌远端肌腱损伤主要发生在活跃人群中的男性身上。在运动员和军人中，上肢肌腱损伤的发生率为 2-10%。比较研究表明，手术治疗能取得更好的功能效果，但总体并发症发生率仍为 4.6%-25%。目的是作为临床病例的一部分，展示在肱二头肌远端肌腱完全断裂的情况下使用两个皮质纽扣重新插入的新技术。材料和方法。文章介绍了一例对支配肢体肱二头肌远端肌腱完全断裂患者进行手术治疗的临床病例，该患者的肱二头肌远端肌腱完全断裂已超过 2 周，并伴有纤维肌束激惹和持续性肌肉回缩。结果我们在术后第 24 周获得了以下临床结果：VAS（视觉模拟量表）评分--1厘米，ASES（美国肩肘外科医生）评分--99分，DASH（手臂、肩部和手部残疾）评分--15分。动力测定结果：Dex.85；sin.90（2daN）；活动范围与健康关节相同。1.5 T 磁共振成像显示没有关节突触或异位骨化的迹象；MSCT 与术中 X 光对照组相比，没有发现皮质钮扣移位的迹象。讨论。在解剖复位中采用皮质外方法定位肱二头肌远端肌腱的强度指标较低，可与使用经骨膜缝合和锚固定器相媲美。在桡骨近端间隙或已形成的桡骨管内肌腱压迫最小的情况下，研究区域的接触面积较大，可提供较高的强度指标，并降低重复损伤的风险。结论量表（VAS、DASH、ASES）的评分结果优于其他常用方法。使用所建议的方法将肱二头肌远端肌腱残端浸入 "解剖印模 "形成的椭圆形管道中的技术达到了仔细对待肌腱的目的，并提供了肌腱与骨骼的最大接触面积。
{"title":"Clinical case of the surgical treatment of complete rupture of distal biceps tendon using two cortical buttons","authors":"A. E. Medvedchikov, E. Anastasieva, V. Prokhorenko, I. Kirilova","doi":"10.29413/abs.2023-8.5.12","DOIUrl":"https://doi.org/10.29413/abs.2023-8.5.12","url":null,"abstract":"Distal biceps tendon injuries mainly occur in men from the active groups of population. Among the athletes and military personnel, the incidence rate is 2–10 % of the upper limb tendon injuries. Comparative studies have shown the achievement of better functional results in surgical treatment, while maintaining overall complication rate of 4.6–25 %. The aim. To demonstrate a new reinsertion technique with two cortical buttons in case of complete rupture of distal biceps tendon as part of a clinical case. Materials and methods. The article presents a clinical case of surgical treatment of a patient with complete rupture of dominant limb distal biceps tendon which was more than 2 weeks old and was accompanied by lacertus fibrosus provocation and persistent muscle retraction. Results. We obtained the following clinical results by the week 24 after the surgery: VAS (Visual Analogue Scale) score – 1 cm, ASES (American Shoulder and Elbow Surgeons) score – 99 points, DASH (Disabilities of the Arm, Shoulder and Hand) score – 15 points. Dynamometry results: Dex. 85; sin. 90 (2daN); range of motion corresponds to the same of a healthy joint. MRI at 1.5 T shows no signs of synostosis or heterotopic ossification; MSCT shows no signs of migration of cortical buttons in comparison with intraoperative X-ray control. Discussion. Extracortical methods of distal biceps tendon positioning in anatomical reinsertion have lower strength indicators, comparable with the use of transosseous sutures and anchor fixators. A larger area of contact of the studied zone in case of minimal tendon compression in the area of proximal radioulnar space or inside the formed radial bone canal provides high strength indicators and reduces the risk of repeated injury. Conclusion. The scores of the scales (VAS, DASH, ASES) turned out to be better than when using other common methods. The technique of dipping distal biceps tendon stump into the formed oval canal of the “anatomical impression” using the proposed method meets the objectives of careful attitude to the tendon and provides the largest area of its contact with the bone.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"11 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138980683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-11DOI: 10.29413/abs.2023-8.5.11
L. K. Skuratova, S. M. Gudi, M. D. Luchshev, S. K. Zhidkov, F. V. Prokaev, I. A. Pakhomov
The problem of aseptic talus necrosis consists of the following features: a) manifestation of the disease in the form of acute articular syndrome without typical symptoms; b) inevitable serious consequences in the form of disfiguring deforming arthrosis of the ankle joint, development of gross deformities of the rearfoot, etc., resulting in disability. The lack of methods for monitoring the dynamics of the disease also plays an important role. This is particularly so with such an important issue as the substantiation of stopping immobilization and allowing the load on the foot in order to avoid collapsed talus and subsequent complications. It is believed that treatment started before radiographic changes helps to avoid severe complications, but for a number of reasons patients arrive already at the stage of late severe destructive changes. All of the above explains the high relevance of the problem of treatment of patients with aseptic talus necrosis. The importance of the presented clinical case and the value of this information can be considered several points: its example demonstrates the possibility of early diagnosis of severe talus damage cause by aseptic necrosis; based on objective data, a substantiation was made for allowing the load on the leg with body weight in the complex of rehabilitation measures; the possibility of regression of pathological changes associated with aseptic talus necrosis and the dynamics of the course of aseptic talus necrosis with a favorable outcome were demonstrated, which is confirmed by modern research methods. Thus, the need for magnetic resonance imaging has been confirmed for all referred patients with a clinical picture of local articular syndrome in the ankle joint, the possibility of complete regression of avascular necrosis symptoms in case of conservative treatment at the early stages and the possibility of resolving the load on the leg in the complex of rehabilitation treatment have been demonstrated.
{"title":"The possibility of a favourable outcome and reversibility of severe ankle joint damage on the example of a clinical observation","authors":"L. K. Skuratova, S. M. Gudi, M. D. Luchshev, S. K. Zhidkov, F. V. Prokaev, I. A. Pakhomov","doi":"10.29413/abs.2023-8.5.11","DOIUrl":"https://doi.org/10.29413/abs.2023-8.5.11","url":null,"abstract":"The problem of aseptic talus necrosis consists of the following features: a) manifestation of the disease in the form of acute articular syndrome without typical symptoms; b) inevitable serious consequences in the form of disfiguring deforming arthrosis of the ankle joint, development of gross deformities of the rearfoot, etc., resulting in disability. The lack of methods for monitoring the dynamics of the disease also plays an important role. This is particularly so with such an important issue as the substantiation of stopping immobilization and allowing the load on the foot in order to avoid collapsed talus and subsequent complications. It is believed that treatment started before radiographic changes helps to avoid severe complications, but for a number of reasons patients arrive already at the stage of late severe destructive changes. All of the above explains the high relevance of the problem of treatment of patients with aseptic talus necrosis. The importance of the presented clinical case and the value of this information can be considered several points: its example demonstrates the possibility of early diagnosis of severe talus damage cause by aseptic necrosis; based on objective data, a substantiation was made for allowing the load on the leg with body weight in the complex of rehabilitation measures; the possibility of regression of pathological changes associated with aseptic talus necrosis and the dynamics of the course of aseptic talus necrosis with a favorable outcome were demonstrated, which is confirmed by modern research methods. Thus, the need for magnetic resonance imaging has been confirmed for all referred patients with a clinical picture of local articular syndrome in the ankle joint, the possibility of complete regression of avascular necrosis symptoms in case of conservative treatment at the early stages and the possibility of resolving the load on the leg in the complex of rehabilitation treatment have been demonstrated.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"209 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139010160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. A. Melkostupov, I. E. Komogortsev, V. G. Vinogradov, E. G. Angarskaya
The article provides a theoretical review of scientific publications devoted to the rehabilitation of patients with unstable pelvic ring injuries; the features of pelvic ring damage are considered based on the specifics of the traumatic injury, the frequency of occurrence and the severity of the consequences. It is emphasized that prolonged pain syndrome due to pelvic ring injuries and the duration of the rehabilitation period negatively affect the physical and psycho-emotional state of a patient. At the same time, pelvic ring injuries are most relevant among the working population, and their consequences are quite serious, including disability and death. Consequently, the possibility of optimizing rehabilitation measures for patients with unstable injuries, aimed at restoring the functions of the musculoskeletal system in static conditions and while walking, is currently one of the urgent tasks of theoretical and practical traumatology. The possibilities of verticalization of patients and the use of axial load on the lower limbs in the postoperative period are considered as the main rehabilitation measures. It is noted that in the case of resolving the issue of axial load in case of unstable pelvic ring injury, the intensity of such load and the timing of the start of its use should be determined individually, depending on the physical condition of a patient, the characteristics of the injury and the presence of concomitant injuries. Treatment for unstable pelvic ring injuries most commonly is carried out in most cases through the use of various methods of surgical treatment and restoration of the pelvic anatomy. Based on the results of the theoretical study, it is necessary to state that, despite the obvious significance of postoperative treatment, the adequate organization of which largely determines its final result, it was revealed that the material for studying this issue is insufficient due to specific approaches to verticalization and axial load on the lower limbs, depending on type of pelvic ring injury, taking into account the individual characteristics of the injury in a particular patient.
{"title":"Verticalization of patients and axial load on the lower limbs after surgical treatment of unstable injuries of the pelvic ring (brief review of the literature)","authors":"A. A. Melkostupov, I. E. Komogortsev, V. G. Vinogradov, E. G. Angarskaya","doi":"10.29413/abs.2023-8.5.9","DOIUrl":"https://doi.org/10.29413/abs.2023-8.5.9","url":null,"abstract":"The article provides a theoretical review of scientific publications devoted to the rehabilitation of patients with unstable pelvic ring injuries; the features of pelvic ring damage are considered based on the specifics of the traumatic injury, the frequency of occurrence and the severity of the consequences. It is emphasized that prolonged pain syndrome due to pelvic ring injuries and the duration of the rehabilitation period negatively affect the physical and psycho-emotional state of a patient. At the same time, pelvic ring injuries are most relevant among the working population, and their consequences are quite serious, including disability and death. Consequently, the possibility of optimizing rehabilitation measures for patients with unstable injuries, aimed at restoring the functions of the musculoskeletal system in static conditions and while walking, is currently one of the urgent tasks of theoretical and practical traumatology. The possibilities of verticalization of patients and the use of axial load on the lower limbs in the postoperative period are considered as the main rehabilitation measures. It is noted that in the case of resolving the issue of axial load in case of unstable pelvic ring injury, the intensity of such load and the timing of the start of its use should be determined individually, depending on the physical condition of a patient, the characteristics of the injury and the presence of concomitant injuries. Treatment for unstable pelvic ring injuries most commonly is carried out in most cases through the use of various methods of surgical treatment and restoration of the pelvic anatomy. Based on the results of the theoretical study, it is necessary to state that, despite the obvious significance of postoperative treatment, the adequate organization of which largely determines its final result, it was revealed that the material for studying this issue is insufficient due to specific approaches to verticalization and axial load on the lower limbs, depending on type of pelvic ring injury, taking into account the individual characteristics of the injury in a particular patient.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"99 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138983717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-07DOI: 10.29413/abs.2023-8.5.10
М. V. Makarova, М. Y. Valkov, А. М. Grjibovski
The aim. To compare the incidence of knee arthroplasty in patients receiving standard treatment with non-steroidal anti-inflammatory drugs (NSAIDs) in combination with symptomatic slow acting drugs for osteoarthritis (SYSADOA), or combination of NSAIDs and SYSADOA with low-dose radiation therapy (LDRT) in patients with stage 0–2 knee osteoarthritis (OA). Materials and methods. The article presents the results of randomized controlled study of 292 patients with confirmed knee OA according to Altman’s criteria (1991) and Kellgren – Lawrence radiographic stages 0–2 who were randomized into two groups. The control group (n = 146) received standard therapy of NSAIDs + SYSADOA. Patients of the study group (n = 146) received combination of standard therapy and LDRT up to a total dose of 4.5 Gy. The cumulative risk of knee arthroplasty was assessed using actuarial analysis and the Kaplan – Meier method. Attributable (AF) and population attributable (PAF) fractions were calculated to assess LDRT preventive potential. Results. The total observation period was 2131.2 person-years. Knee arthroplasty was performed in 4.1 % (n = 6) of patients in the study group against 7.5 % (n = 11) in the control group. The incidence density ratio was 0.60 (95% CI: 0.18–1.88), which corresponds to a risk reduction by 67 %, but the differences were not statistically significant due to the small number of cases (p = 0.340). The AF was 40 % while the PAF was 21 %. Conclusions. The use of LDRT reduces the risk of knee arthroplasty by two-thirds and has the potential to prevent 21 % cases of knee arthroplasty in patients with knee OA. A study on a larger sample is required.
{"title":"Effects of low-dosage radiotherapy for knee osteoarthritis on the incidence of knee arthroplasty: Results of a randomized controlled trial with 9-year follow-up","authors":"М. V. Makarova, М. Y. Valkov, А. М. Grjibovski","doi":"10.29413/abs.2023-8.5.10","DOIUrl":"https://doi.org/10.29413/abs.2023-8.5.10","url":null,"abstract":"The aim. To compare the incidence of knee arthroplasty in patients receiving standard treatment with non-steroidal anti-inflammatory drugs (NSAIDs) in combination with symptomatic slow acting drugs for osteoarthritis (SYSADOA), or combination of NSAIDs and SYSADOA with low-dose radiation therapy (LDRT) in patients with stage 0–2 knee osteoarthritis (OA). Materials and methods. The article presents the results of randomized controlled study of 292 patients with confirmed knee OA according to Altman’s criteria (1991) and Kellgren – Lawrence radiographic stages 0–2 who were randomized into two groups. The control group (n = 146) received standard therapy of NSAIDs + SYSADOA. Patients of the study group (n = 146) received combination of standard therapy and LDRT up to a total dose of 4.5 Gy. The cumulative risk of knee arthroplasty was assessed using actuarial analysis and the Kaplan – Meier method. Attributable (AF) and population attributable (PAF) fractions were calculated to assess LDRT preventive potential. Results. The total observation period was 2131.2 person-years. Knee arthroplasty was performed in 4.1 % (n = 6) of patients in the study group against 7.5 % (n = 11) in the control group. The incidence density ratio was 0.60 (95% CI: 0.18–1.88), which corresponds to a risk reduction by 67 %, but the differences were not statistically significant due to the small number of cases (p = 0.340). The AF was 40 % while the PAF was 21 %. Conclusions. The use of LDRT reduces the risk of knee arthroplasty by two-thirds and has the potential to prevent 21 % cases of knee arthroplasty in patients with knee OA. A study on a larger sample is required.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"114 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138983787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. E. Krivosсhein, S. V. Kolesov, A. Kalinin, V. Konev, A. I. Kazmin, S. Moskovskiy, V. Byvaltsev
Background. The development of the adjacent level syndrome and, as a consequence, adjacent segment degenerative disease are currently the most common complications of decompression and stabilization surgery with the development of segmental instability. The aim of the study. To conduct a comprehensive neuroimaging assessment of the proximal adjacent segment after rigid fixation and dynamic stabilization in degenerative lumbar disease. Materials and methods. We conducted a prospective multicenter study of the results of surgical treatment of 274 patients with degenerative-dystrophic diseases of the lumbar spine, who underwent monosegmental decompression and stabilization surgery using the TLIF (transforaminal lumbar interbody fusion) technique and open transpedicular rigid fixation, as well as open hemilaminectomy with stabilization of the operated segments with nitinol rods. The study included radiography, diffusion-weighted magnetic resonance imaging and computed tomography (dualenergy mode) of intervertebral discs and isolated facet degeneration of the upper adjacent level. Results and discussion. Combination of the initial proximal segment degeneration in the form of facet joints degeneration (density of cartilaginous plate – 163.5 ± 14.2 HU, density of external facet – 709.35 ± 13.6 HU, density of internal facet – 578.1 ± 12.1 HU), Pfirrmann III, IV grade degeneration of intervertebral disc and a measured diffusion coefficient of less than 1300 mm2/s cause high risks of developing adjacent segment degenerative disease, which regulates the use of monosegmental dynamic fixation with nitinol rods, or preventive rigid fixation of the adjacent segment. Conclusion. Using complex neuroimaging in the preoperative period makes it possible to predict the results of surgical treatment, take timely measures to prevent degenerative diseases of the adjacent segment, and to carry out dynamic monitoring of processes in the structures of the spinal motion segment.
{"title":"Complex neuroimaging study of the proximal segment after rigid fixation and dynamic stabilization in patients with degenerative lumbar disease","authors":"A. E. Krivosсhein, S. V. Kolesov, A. Kalinin, V. Konev, A. I. Kazmin, S. Moskovskiy, V. Byvaltsev","doi":"10.29413/abs.2023-8.5.6","DOIUrl":"https://doi.org/10.29413/abs.2023-8.5.6","url":null,"abstract":"Background. The development of the adjacent level syndrome and, as a consequence, adjacent segment degenerative disease are currently the most common complications of decompression and stabilization surgery with the development of segmental instability. The aim of the study. To conduct a comprehensive neuroimaging assessment of the proximal adjacent segment after rigid fixation and dynamic stabilization in degenerative lumbar disease. Materials and methods. We conducted a prospective multicenter study of the results of surgical treatment of 274 patients with degenerative-dystrophic diseases of the lumbar spine, who underwent monosegmental decompression and stabilization surgery using the TLIF (transforaminal lumbar interbody fusion) technique and open transpedicular rigid fixation, as well as open hemilaminectomy with stabilization of the operated segments with nitinol rods. The study included radiography, diffusion-weighted magnetic resonance imaging and computed tomography (dualenergy mode) of intervertebral discs and isolated facet degeneration of the upper adjacent level. Results and discussion. Combination of the initial proximal segment degeneration in the form of facet joints degeneration (density of cartilaginous plate – 163.5 ± 14.2 HU, density of external facet – 709.35 ± 13.6 HU, density of internal facet – 578.1 ± 12.1 HU), Pfirrmann III, IV grade degeneration of intervertebral disc and a measured diffusion coefficient of less than 1300 mm2/s cause high risks of developing adjacent segment degenerative disease, which regulates the use of monosegmental dynamic fixation with nitinol rods, or preventive rigid fixation of the adjacent segment. Conclusion. Using complex neuroimaging in the preoperative period makes it possible to predict the results of surgical treatment, take timely measures to prevent degenerative diseases of the adjacent segment, and to carry out dynamic monitoring of processes in the structures of the spinal motion segment.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"25 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138984148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Sorokovikov, V. Potapov, A. Zhivotenko, A. V. Gorbunov, O. V. Sklyarenko, S. Larionov
The aim. To study the effectiveness of using monosegmental fixation systems in surgeries involving resection of part of the facet joint in patients with posterolateral and foraminal hernias in the lumbar spine. Materials and methods. The study included 40 patients with degenerative diseases of the lumbar spine who underwent medial facet resection and the removal of posterolateral or foraminal disc hernia. Among them, 10 patients underwent unilateral single-level transpedicular fixation with interbody fusion using titanium cage (UTPF cage group), and the other 10 patients underwent unilateral monosegmental transpedicular fixation (UTPF group). The remaining 20 patients underwent bilateral transpedicular fixation (BTPF group). The amount of intraoperative blood loss, duration of surgery and length of hospital stay, as well as the frequency of perioperative complications in the groups were assessed. Visual analogue scale (VAS) pain score, Oswestry index and McNab score were assessed before and 6 and 12 months after surgery. Results. Intraoperative blood loss in the UTPF cage and UTPF groups was less than in the BTPF group, as was the duration of surgery; the differences were statistically significant (p < 0.05). Indicators of VAS score and Oswestry Quality of Life Index in the studied groups indicated the effectiveness of the technology. Discussion. Unilateral decompressive and stabilizing surgeries in patients with posterolateral and foraminal hernias of the lumbar spine can reduce the duration of the surgery, the volume of blood loss and the severity of pain in the postoperative period due to adequate decompression of the neurovascular formations of the spinal canal and stabilization of the spinal motion segment, which prevents the relapse of the disease and provides early rehabilitation of patients. Conclusion. Unilateral transpedicular fixation is acceptable and safe for lumbar degenerative diseases and improves the quality of life of the patients.
{"title":"Experience of unilateral and bilateral transpedicular fixation in degenerative diseases of the lumbar spine","authors":"V. Sorokovikov, V. Potapov, A. Zhivotenko, A. V. Gorbunov, O. V. Sklyarenko, S. Larionov","doi":"10.29413/abs.2023-8.5.7","DOIUrl":"https://doi.org/10.29413/abs.2023-8.5.7","url":null,"abstract":"The aim. To study the effectiveness of using monosegmental fixation systems in surgeries involving resection of part of the facet joint in patients with posterolateral and foraminal hernias in the lumbar spine. Materials and methods. The study included 40 patients with degenerative diseases of the lumbar spine who underwent medial facet resection and the removal of posterolateral or foraminal disc hernia. Among them, 10 patients underwent unilateral single-level transpedicular fixation with interbody fusion using titanium cage (UTPF cage group), and the other 10 patients underwent unilateral monosegmental transpedicular fixation (UTPF group). The remaining 20 patients underwent bilateral transpedicular fixation (BTPF group). The amount of intraoperative blood loss, duration of surgery and length of hospital stay, as well as the frequency of perioperative complications in the groups were assessed. Visual analogue scale (VAS) pain score, Oswestry index and McNab score were assessed before and 6 and 12 months after surgery. Results. Intraoperative blood loss in the UTPF cage and UTPF groups was less than in the BTPF group, as was the duration of surgery; the differences were statistically significant (p < 0.05). Indicators of VAS score and Oswestry Quality of Life Index in the studied groups indicated the effectiveness of the technology. Discussion. Unilateral decompressive and stabilizing surgeries in patients with posterolateral and foraminal hernias of the lumbar spine can reduce the duration of the surgery, the volume of blood loss and the severity of pain in the postoperative period due to adequate decompression of the neurovascular formations of the spinal canal and stabilization of the spinal motion segment, which prevents the relapse of the disease and provides early rehabilitation of patients. Conclusion. Unilateral transpedicular fixation is acceptable and safe for lumbar degenerative diseases and improves the quality of life of the patients.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138984405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite the search and development of new antimicrobial drugs with antibiotic or antiseptic properties, the spread of multidrug-resistant strains of microorganisms remains a serious problem in the treatment and prevention of infectious diseases (wound, postoperative and burn infections, preoperative preparation of the surgical and injection fields, hygienic disinfection of the hands of surgeons, medical personnel, etc.). This review of modern domestic and foreign literature sources is devoted to the analysis of data on the prospects of using antiseptics with iodine and iodides as antimicrobial agents. In modern conditions, there is an increasing number of scientific works devoted to the study and development of various drugs, distinguished by their diversity and their specific application. Antimicrobial iodine-containing compounds can be applied to a wide range of materials such as textile, plastics, metals, ceramics to make them resistant to microbial and biofilm growth. The article summarized the literature data on the high antimicrobial activity of iodine both in neutral carriers and in synergy with substances already possessing similar properties. Such complex preparations lose their toxicity to a large extent, having prolonged action with the preservation of their properties. The main mechanisms of antimicrobial action of iodine and iodine compounds are determined by their strong oxidizing ability. Attention is drawn to the spectrum of activity of iodine preparations. Along with the antimicrobial effect, they can promote regeneration processes. In general, innovative iodine preparations with antibacterial and fungicidal properties are promising for medical and other purposes.
{"title":"Antimicrobial potential of iodine-containing substances and materials","authors":"A. V. Nevezhina, T. V. Fadeeva","doi":"10.29413/abs.2023-8.5.4","DOIUrl":"https://doi.org/10.29413/abs.2023-8.5.4","url":null,"abstract":"Despite the search and development of new antimicrobial drugs with antibiotic or antiseptic properties, the spread of multidrug-resistant strains of microorganisms remains a serious problem in the treatment and prevention of infectious diseases (wound, postoperative and burn infections, preoperative preparation of the surgical and injection fields, hygienic disinfection of the hands of surgeons, medical personnel, etc.). This review of modern domestic and foreign literature sources is devoted to the analysis of data on the prospects of using antiseptics with iodine and iodides as antimicrobial agents. In modern conditions, there is an increasing number of scientific works devoted to the study and development of various drugs, distinguished by their diversity and their specific application. Antimicrobial iodine-containing compounds can be applied to a wide range of materials such as textile, plastics, metals, ceramics to make them resistant to microbial and biofilm growth. The article summarized the literature data on the high antimicrobial activity of iodine both in neutral carriers and in synergy with substances already possessing similar properties. Such complex preparations lose their toxicity to a large extent, having prolonged action with the preservation of their properties. The main mechanisms of antimicrobial action of iodine and iodine compounds are determined by their strong oxidizing ability. Attention is drawn to the spectrum of activity of iodine preparations. Along with the antimicrobial effect, they can promote regeneration processes. In general, innovative iodine preparations with antibacterial and fungicidal properties are promising for medical and other purposes.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"21 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138984410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lymphoma is a heterogeneous group of lymphocyte malignancies that may involve lymphatic tissue, bone marrow, or extranodal sites. The lecture provides a brief overview of the current state of the problem of diagnosis and treatment of primary testicular lymphoma. Primary testicular lymphoma (PTL) is a rare lymphoid malignancy. Though it is rare, PTL is the most common type of testicular tumor in men over 60 years of age. The most common histological type is diffuse large B-cell lymphoma. To date, there are no well-documented etiological or risk factors for PTL. In contrast to other common testicular neoplasms, there was no statistically significant association of PTL with cryptorchidism, trauma, chronic orchitis, or infertility. Ultrasound is generally the first-line imaging method used to characterize testicular lesions. PTL manifests itself in the form of a hypoechoic formation, which can take the form of either a single large formation or multiple small formations that occupy most of the testicular parenchyma or completely replace it. Systemic treatment, including orchiectomy, chemotherapy, radiation therapy, and intrathecal prophylaxis, is necessary for all patients with PTL. In addition to achieving complete remission, the goal of PTL treatment is to prevent recurrences in the contralateral testis and central nervous system. The presented information is supplemented by our own observation and images. Personal medical data is published with the written consent of the patient. In our case, the patient’s age was 38 years, which does not fall into the specified age group for primary testicular lymphoma. In our opinion, the publication of this clinical case and analysis of scientific literature on this topic are relevant.
{"title":"Testicular diffuse large B-cell lymphoma. Clinical lecture and case report","authors":"K. B. Lelyavin, A. V. Taranenko, V. G. Bryukhanov","doi":"10.29413/abs.2023-8.5.8","DOIUrl":"https://doi.org/10.29413/abs.2023-8.5.8","url":null,"abstract":"Lymphoma is a heterogeneous group of lymphocyte malignancies that may involve lymphatic tissue, bone marrow, or extranodal sites. The lecture provides a brief overview of the current state of the problem of diagnosis and treatment of primary testicular lymphoma. Primary testicular lymphoma (PTL) is a rare lymphoid malignancy. Though it is rare, PTL is the most common type of testicular tumor in men over 60 years of age. The most common histological type is diffuse large B-cell lymphoma. To date, there are no well-documented etiological or risk factors for PTL. In contrast to other common testicular neoplasms, there was no statistically significant association of PTL with cryptorchidism, trauma, chronic orchitis, or infertility. Ultrasound is generally the first-line imaging method used to characterize testicular lesions. PTL manifests itself in the form of a hypoechoic formation, which can take the form of either a single large formation or multiple small formations that occupy most of the testicular parenchyma or completely replace it. Systemic treatment, including orchiectomy, chemotherapy, radiation therapy, and intrathecal prophylaxis, is necessary for all patients with PTL. In addition to achieving complete remission, the goal of PTL treatment is to prevent recurrences in the contralateral testis and central nervous system. The presented information is supplemented by our own observation and images. Personal medical data is published with the written consent of the patient. In our case, the patient’s age was 38 years, which does not fall into the specified age group for primary testicular lymphoma. In our opinion, the publication of this clinical case and analysis of scientific literature on this topic are relevant.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"27 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138984472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. A. Koryak, A. D. Botvinkin, V. Sorokovikov, O. Chernikova
Background. About 40 % of patients diagnosed with coxarthrosis annually seek medical help and receive social support due to this disease. Increased use of an expensive surgery for treatment of coxarthrosis and projected growth of its prevalence in the population determine the relevance of socio-economic analysis. The aim of the study. To assess the value and structure of economic damage caused by the delivering health and social care to patients with coxarthrosis at the state level of the Russian Federation. Methods. To assess economic damage, we used the average annual number of various categories of patients and disabled people with coxarthrosis in the Irkutsk region for 2008–2017. Three main categories were identified: patients who visited the outpatients’ clinic; patients with total hip replacement; disabled people due to coxarthrosis. For each category, we calculated weighted average damage per 1 conventional patient, taking into account direct and indirect costs and subsequent multiplication by the average annual number of individual categories of patients. Calculations were performed in 2017 prices. Results. The average annual socio-economic damage from coxarthrosis amounted to 1.39 (1.34÷1.43) billion rubles or 0.1 % of the gross regional product. The most of the damage (64.4 %) were indirect costs associated with disability due to coxarthrosis, 22.2 % of the total amount were the costs of hip replacement surgery, 13.4 % were the costs of outpatient visits. Indirect economic losses due to disability in patients of working age were 4.2 times higher than losses due to disability of oldage pensioners. Conclusion. The results of the study confirm the economic feasibility of surgical treatment of coxarthrosis, especially in patients of working age.
{"title":"Assessing socio-economic damage caused by coxarthrosis in the population","authors":"V. A. Koryak, A. D. Botvinkin, V. Sorokovikov, O. Chernikova","doi":"10.29413/abs.2023-8.5.2","DOIUrl":"https://doi.org/10.29413/abs.2023-8.5.2","url":null,"abstract":"Background. About 40 % of patients diagnosed with coxarthrosis annually seek medical help and receive social support due to this disease. Increased use of an expensive surgery for treatment of coxarthrosis and projected growth of its prevalence in the population determine the relevance of socio-economic analysis. The aim of the study. To assess the value and structure of economic damage caused by the delivering health and social care to patients with coxarthrosis at the state level of the Russian Federation. Methods. To assess economic damage, we used the average annual number of various categories of patients and disabled people with coxarthrosis in the Irkutsk region for 2008–2017. Three main categories were identified: patients who visited the outpatients’ clinic; patients with total hip replacement; disabled people due to coxarthrosis. For each category, we calculated weighted average damage per 1 conventional patient, taking into account direct and indirect costs and subsequent multiplication by the average annual number of individual categories of patients. Calculations were performed in 2017 prices. Results. The average annual socio-economic damage from coxarthrosis amounted to 1.39 (1.34÷1.43) billion rubles or 0.1 % of the gross regional product. The most of the damage (64.4 %) were indirect costs associated with disability due to coxarthrosis, 22.2 % of the total amount were the costs of hip replacement surgery, 13.4 % were the costs of outpatient visits. Indirect economic losses due to disability in patients of working age were 4.2 times higher than losses due to disability of oldage pensioners. Conclusion. The results of the study confirm the economic feasibility of surgical treatment of coxarthrosis, especially in patients of working age.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"9 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139012208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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