M. A. Mushkin, A. K. Dulaev, A. Mushkin, М. А. Мушкин, Александр Кайсинович Дулаев, А. Ю. Мушкин
A modern concept of assessing tumor lesions of the spine, NOMS, adapted to the conditions of emergency care is presented as a part of a systematic review of the literature. Principles of neurological, oncological, mechanical and system analysis of spine lesions in primary and metastatic spinal tumors, which are the basis for step-by-step tactical decisions, as well as methods for analyzing each component are described.
{"title":"SPINAL TUMORS: A CONCEPT OF INTEGRATED ASSESSMENT IN RELATION TO EMERGENCY CONDITIONS","authors":"M. A. Mushkin, A. K. Dulaev, A. Mushkin, М. А. Мушкин, Александр Кайсинович Дулаев, А. Ю. Мушкин","doi":"10.14531/SS2018.3.92-99","DOIUrl":"https://doi.org/10.14531/SS2018.3.92-99","url":null,"abstract":"A modern concept of assessing tumor lesions of the spine, NOMS, adapted to the conditions of emergency care is presented as a part of a systematic review of the literature. Principles of neurological, oncological, mechanical and system analysis of spine lesions in primary and metastatic spinal tumors, which are the basis for step-by-step tactical decisions, as well as methods for analyzing each component are described.","PeriodicalId":37253,"journal":{"name":"Hirurgia Pozvonochnika","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48683878","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}
M. Mikhaylovskiy, A. Vasyura, V. Novikov, V. Sarnadsky, E. V. Gubina, M. A. Chernyadjeva
Objective.To evaluate the results of surgical correction of idiopathic scoliosis in patients aged 18-50 years, in terms of different age groups.Material and Methods.A total of 393 patients (348 women, 45 men) with idiopathic scoliosis were operated on during 1996-2015. In all cases, posterior correction of the deformity was performed using segmental third-generation instrumentation. The primary curve and structural countercurve were included in the fusion area. Hook fixation was performed in 298 cases, and hybrid (hooks and pedicle screws) in 95. The period of postoperative follow-up was 4.4 years on average. Analysis of immediate and long-term results was performed using X-ray and computer optical topography in three age groups (age at the time of surgery): 18 to 24 years (274 patients), 25 to 34 years (95 patients), 35 years and older (24 patients).Results.No statistically significant differences between age groups were revealed, both in initial parameters (magnitude of the primary curve, countercurve, and the apical vertebra rotation) and in surgical results (magnitude of correction, loss of correction and mobility). When interviewing patients with the SRS-24 questionnaire, the best results were obtained in the group of age 18-24, worse in the group of age 25-34, and even worse in the group of age over 35. Computer topography also revealed the absence of statistically significant difference between age groups.Conclusion.Surgical treatment of adult idiopathic scoliosis provides quite satisfactory results, especially in terms of improving the quality of life, that do not have significant differences when comparing three age groups within the age range exceeding 30 years.
{"title":"SURGICAL CORRECTION OF ADULT IDIOPATHIC SCOLIOSIS IN PATIENTS OF YOUNG AND MIDDLE AGE","authors":"M. Mikhaylovskiy, A. Vasyura, V. Novikov, V. Sarnadsky, E. V. Gubina, M. A. Chernyadjeva","doi":"10.14531/ss2018.3.52-60","DOIUrl":"https://doi.org/10.14531/ss2018.3.52-60","url":null,"abstract":"Objective.To evaluate the results of surgical correction of idiopathic scoliosis in patients aged 18-50 years, in terms of different age groups.Material and Methods.A total of 393 patients (348 women, 45 men) with idiopathic scoliosis were operated on during 1996-2015. In all cases, posterior correction of the deformity was performed using segmental third-generation instrumentation. The primary curve and structural countercurve were included in the fusion area. Hook fixation was performed in 298 cases, and hybrid (hooks and pedicle screws) in 95. The period of postoperative follow-up was 4.4 years on average. Analysis of immediate and long-term results was performed using X-ray and computer optical topography in three age groups (age at the time of surgery): 18 to 24 years (274 patients), 25 to 34 years (95 patients), 35 years and older (24 patients).Results.No statistically significant differences between age groups were revealed, both in initial parameters (magnitude of the primary curve, countercurve, and the apical vertebra rotation) and in surgical results (magnitude of correction, loss of correction and mobility). When interviewing patients with the SRS-24 questionnaire, the best results were obtained in the group of age 18-24, worse in the group of age 25-34, and even worse in the group of age over 35. Computer topography also revealed the absence of statistically significant difference between age groups.Conclusion.Surgical treatment of adult idiopathic scoliosis provides quite satisfactory results, especially in terms of improving the quality of life, that do not have significant differences when comparing three age groups within the age range exceeding 30 years. ","PeriodicalId":37253,"journal":{"name":"Hirurgia Pozvonochnika","volume":"8 Suppl 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66712647","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. Gubin, A. Burtsev, S. Ryabykh, V. Klimov, A. Evsyukov, D. Ivliev
Objective. To analyze feasibility and safety of C1, C2 fixation for craniocervical stabilization in patients of different age groups.Material and Methods. Study design is a retrospective multicenter cohort analysis. Level of evidence – II. The study was based on the diagnosis and treatment data of 43 patients aged 5–74 years who underwent C1, C2 screw fixation.Results. In most cases, atlantoaxial instability was due to traumatic injuries. Screws were implanted in C1 in 81 cases, and in C2 in 80. Postoperative MSCT data were evaluated in 41 patients. The position of the screws in C1 was defined as ideal in 63,0 % of cases, in the remaining cases there were malpositions, with 6 screws having double malpositions. Out of 80 screws inserted in C2, 64 were implanted transpedicularly. In 59.5 % of cases, a good position was revealed; in other cases different malpositions were noted. In none of the cases neurovascular damage or clinical manifestation occurred.Conclusion. Analysis of screw fixation of C1, C2 showed that this technique is feasible in patients of different age groups. Duration of surgery and blood loss did not go beyond the conventional values. Postoperative malpositions are not accompanied by neurological disorders, which allows to consider this fixation quite safe.
{"title":"ANALYSIS OF C1, C2 SCREW FIXATION FOR ATLANTOAXIAL INSTABILITY IN PATIENTS OF DIFFERENT AGE GROUPS","authors":"A. Gubin, A. Burtsev, S. Ryabykh, V. Klimov, A. Evsyukov, D. Ivliev","doi":"10.14531/ss2018.3.6-12","DOIUrl":"https://doi.org/10.14531/ss2018.3.6-12","url":null,"abstract":"Objective. To analyze feasibility and safety of C1, C2 fixation for craniocervical stabilization in patients of different age groups.Material and Methods. Study design is a retrospective multicenter cohort analysis. Level of evidence – II. The study was based on the diagnosis and treatment data of 43 patients aged 5–74 years who underwent C1, C2 screw fixation.Results. In most cases, atlantoaxial instability was due to traumatic injuries. Screws were implanted in C1 in 81 cases, and in C2 in 80. Postoperative MSCT data were evaluated in 41 patients. The position of the screws in C1 was defined as ideal in 63,0 % of cases, in the remaining cases there were malpositions, with 6 screws having double malpositions. Out of 80 screws inserted in C2, 64 were implanted transpedicularly. In 59.5 % of cases, a good position was revealed; in other cases different malpositions were noted. In none of the cases neurovascular damage or clinical manifestation occurred.Conclusion. Analysis of screw fixation of C1, C2 showed that this technique is feasible in patients of different age groups. Duration of surgery and blood loss did not go beyond the conventional values. Postoperative malpositions are not accompanied by neurological disorders, which allows to consider this fixation quite safe.","PeriodicalId":37253,"journal":{"name":"Hirurgia Pozvonochnika","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66712455","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. M. Haydarov, A. N. Tkachenko, I. A. Kirilova, D. Mansurov
Objective. To analyze prognostic factors for the development of surgical site infection following spine surgery and evaluate rating values for each of them. Material and Methods . The data on 325 patients who underwent spinal surgery were analyzed. Data on 177 patients of the retrospective group who underwent spinal surgery without infectious complications were compared with the data of patients who had local complications of infectious genesis within one year after the operation (36 observations). Results. The study resulted in creation of a learning matrix which became the basis for mathematical prediction and algorithm for the prevention of local infectious complications in patients who underwent spinal surgery. Seventeen criteria for predicting the development of surgical site infection were identified. Conclusion. Approbation of the program in a prospective study (112 cases) with a follow-up period of 12 months after surgery demonstrated significant decrease in the incidence of surgical site infection as compared with that in the retrospective study group (from 16.9 to 9.8 %).
{"title":"PREDICTION OF SURGICAL SITE INFECTION IN SPINE SURGERY","authors":"V. M. Haydarov, A. N. Tkachenko, I. A. Kirilova, D. Mansurov","doi":"10.14531/SS2018.2.84-90","DOIUrl":"https://doi.org/10.14531/SS2018.2.84-90","url":null,"abstract":"Objective. To analyze prognostic factors for the development of surgical site infection following spine surgery and evaluate rating values for each of them. Material and Methods . The data on 325 patients who underwent spinal surgery were analyzed. Data on 177 patients of the retrospective group who underwent spinal surgery without infectious complications were compared with the data of patients who had local complications of infectious genesis within one year after the operation (36 observations). Results. The study resulted in creation of a learning matrix which became the basis for mathematical prediction and algorithm for the prevention of local infectious complications in patients who underwent spinal surgery. Seventeen criteria for predicting the development of surgical site infection were identified. Conclusion. Approbation of the program in a prospective study (112 cases) with a follow-up period of 12 months after surgery demonstrated significant decrease in the incidence of surgical site infection as compared with that in the retrospective study group (from 16.9 to 9.8 %).","PeriodicalId":37253,"journal":{"name":"Hirurgia Pozvonochnika","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47453305","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}
D. M. Zavyalov, V. Orlov, M. N. Kravtsov, K. Babichev
Objective. To analyze the effectiveness of methods for the prevention of cicatricial adhesive epiduritis (CAE) after lumbar microdiscectomy. Material and Methods. The results of treatment of 108 patients with herniated intervertebral discs at the lumbosacral level were analyzed. Cicatricial adhesive epiduritis was prevented using 4 % sodium carboxymethylcellulose gel in Group I (n = 36), by placing autograft from the internal leaf of the lumbar fascia into the space between the vertebral arches in Group II (n = 32), and prevention of CAE was not carried out in Group III (n = 40). Results. Complete examination of patients after microsurgical removal of the herniated lumbar intervertebral disc revealed cicatricial adhesive changes in the epidural space in all studied groups, though the degree of their expression was different: in Groups I and II, cicatricial adhesive epiduritis was insignificant without clinical manifestations, in Group III, clinical manifestations were observed. Conclusion. The proposed methods for prevention of cicatricial adhesive epiduritis after microsurgical treatment of herniated lumbar intervertebral disc protect the epidural space and perform a barrier function.
{"title":"COMPARATIVE ANALYSIS OF METHODS TO PREVENT CICATRICIAL ADHESIVE EPIDURITIS AFTER MICRODISCECTOMY IN THE LUMBOSACRAL SPINE","authors":"D. M. Zavyalov, V. Orlov, M. N. Kravtsov, K. Babichev","doi":"10.14531/ss2018.2.56-65","DOIUrl":"https://doi.org/10.14531/ss2018.2.56-65","url":null,"abstract":"Objective. To analyze the effectiveness of methods for the prevention of cicatricial adhesive epiduritis (CAE) after lumbar microdiscectomy. Material and Methods. The results of treatment of 108 patients with herniated intervertebral discs at the lumbosacral level were analyzed. Cicatricial adhesive epiduritis was prevented using 4 % sodium carboxymethylcellulose gel in Group I (n = 36), by placing autograft from the internal leaf of the lumbar fascia into the space between the vertebral arches in Group II (n = 32), and prevention of CAE was not carried out in Group III (n = 40). Results. Complete examination of patients after microsurgical removal of the herniated lumbar intervertebral disc revealed cicatricial adhesive changes in the epidural space in all studied groups, though the degree of their expression was different: in Groups I and II, cicatricial adhesive epiduritis was insignificant without clinical manifestations, in Group III, clinical manifestations were observed. Conclusion. The proposed methods for prevention of cicatricial adhesive epiduritis after microsurgical treatment of herniated lumbar intervertebral disc protect the epidural space and perform a barrier function.","PeriodicalId":37253,"journal":{"name":"Hirurgia Pozvonochnika","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47189060","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. Vasyura, M. Mikhaylovskiy, V. Novikov, E. V. Chesheva
Clinical observations of 13- and 15-year-old patients with severe (118° and 133°) idiopathic scoliosis, subjected to operative correction with the use of segmental instrumentation are presented. Intraoperative monitoring of the spinal cord function was performed by recording motor potentials of the brain and skin thermometry from the lower limbs (authors’ technique). During the operation, there was a gradual decrease in potentials in one case and sharp in another, with no changes in cutaneous temperature. Based on the data of skin thermometry, surgeons decided not to remove the implant and to bring the operation to completion in both cases. In the postoperative period, neurological complications were not revealed. The conclusion is made about the advisability of including the skin thermometry in a complex of intraoperative monitoring of spinal cord function in patients with spine deformities.
{"title":"INTRAOPERATIVE DIAGNOSIS OF NEUROLOGICAL COMPLICATIONS IN SURGERY OF SEVERE SCOLIOSIS: REPORT OF CLINICAL CASES","authors":"A. Vasyura, M. Mikhaylovskiy, V. Novikov, E. V. Chesheva","doi":"10.14531/SS2018.2.7-11","DOIUrl":"https://doi.org/10.14531/SS2018.2.7-11","url":null,"abstract":"Clinical observations of 13- and 15-year-old patients with severe (118° and 133°) idiopathic scoliosis, subjected to operative correction with the use of segmental instrumentation are presented. Intraoperative monitoring of the spinal cord function was performed by recording motor potentials of the brain and skin thermometry from the lower limbs (authors’ technique). During the operation, there was a gradual decrease in potentials in one case and sharp in another, with no changes in cutaneous temperature. Based on the data of skin thermometry, surgeons decided not to remove the implant and to bring the operation to completion in both cases. In the postoperative period, neurological complications were not revealed. The conclusion is made about the advisability of including the skin thermometry in a complex of intraoperative monitoring of spinal cord function in patients with spine deformities.","PeriodicalId":37253,"journal":{"name":"Hirurgia Pozvonochnika","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66711760","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}
Objective. To analyze the types and frequency of adverse drug reactions to local intrawound application of vancomycin powder in patients after posterior decompression and stabilization in the lumbosacral spine. Material and Methods . Clinical series published in 2011–2017 were analyzed. At the first stage, Medline and PubMed databases were searched for English-language literature sources using the keywords «intrawound vancomycin», «surgical site infection», and «posterior lumbar fusion», and e-Library for Russian-language sources using «local application of vancomycin powder», «infection in the surgical site», and «posterior decompression and stabilization». At the second stage, abstracts of articles were examined, and publications that did not meet the research criteria were excluded. At the third stage, the full texts of the selected articles were reviewed for compliance with inclusion criteria, as well as references for relevant studies. Results. Nineteen clinical studies (16 retrospective and 3 prospective) with a total of 13,077 patients were selected for a systematic review. In 55.3 % (7,236) of posterior lumbosacral surgery cases, vancomycin powder was applied locally to prevent surgical site infection. Among the entire cohort of patients, unwanted drug reactions were detected in 2.19 % of patients. Conclusions. Local application of vancomycin powder is associated with a low incidence of unwanted drug reactions.
{"title":"ADVERSE DRUG REACTIONS TO LOCAL INTRAWOUND VANCOMYCIN APPLICATION AFTER POSTERIOR LUMBOSACRAL FUSION","authors":"V. Byvaltsev, I. Stepanov, V. Borisov","doi":"10.14531/SS2018.2.76-83","DOIUrl":"https://doi.org/10.14531/SS2018.2.76-83","url":null,"abstract":"Objective. To analyze the types and frequency of adverse drug reactions to local intrawound application of vancomycin powder in patients after posterior decompression and stabilization in the lumbosacral spine. Material and Methods . Clinical series published in 2011–2017 were analyzed. At the first stage, Medline and PubMed databases were searched for English-language literature sources using the keywords «intrawound vancomycin», «surgical site infection», and «posterior lumbar fusion», and e-Library for Russian-language sources using «local application of vancomycin powder», «infection in the surgical site», and «posterior decompression and stabilization». At the second stage, abstracts of articles were examined, and publications that did not meet the research criteria were excluded. At the third stage, the full texts of the selected articles were reviewed for compliance with inclusion criteria, as well as references for relevant studies. Results. Nineteen clinical studies (16 retrospective and 3 prospective) with a total of 13,077 patients were selected for a systematic review. In 55.3 % (7,236) of posterior lumbosacral surgery cases, vancomycin powder was applied locally to prevent surgical site infection. Among the entire cohort of patients, unwanted drug reactions were detected in 2.19 % of patients. Conclusions. Local application of vancomycin powder is associated with a low incidence of unwanted drug reactions.","PeriodicalId":37253,"journal":{"name":"Hirurgia Pozvonochnika","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66711835","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}
D. Malamashin, M. M. Schelkunov, M. A. Krasnikov, A. Mushkin
The paper presents a case of rapidly developing severe cervical kyphosis in a 5-year-old child which was the first clinical manifestation of type I neurofibromatosis (NF1). Surgical correction was carried out in two stages with preliminary hardware halo-traction and subsequent reconstruction of the spine using titanium mesh cage with bone autograft and posterior instrumentation. The deformity was corrected from the magnitude of 79° to the restoration of physiological lordosis. Long-term results were followed-up for 2.5 years with full maintenance of the achieved deformity correction. A 15-year literature review on the cervical spine lesions in NF1 is presented.
{"title":"SURGICAL CORRECTION OF SUBAXIAL KYPHOSIS IN A CHILD WITH TYPE I NEUROFIBROMATOSIS: RARE CLINICAL CASE AND LITERATURE REVIEW","authors":"D. Malamashin, M. M. Schelkunov, M. A. Krasnikov, A. Mushkin","doi":"10.14531/ss2018.2.12-17","DOIUrl":"https://doi.org/10.14531/ss2018.2.12-17","url":null,"abstract":"The paper presents a case of rapidly developing severe cervical kyphosis in a 5-year-old child which was the first clinical manifestation of type I neurofibromatosis (NF1). Surgical correction was carried out in two stages with preliminary hardware halo-traction and subsequent reconstruction of the spine using titanium mesh cage with bone autograft and posterior instrumentation. The deformity was corrected from the magnitude of 79° to the restoration of physiological lordosis. Long-term results were followed-up for 2.5 years with full maintenance of the achieved deformity correction. A 15-year literature review on the cervical spine lesions in NF1 is presented.","PeriodicalId":37253,"journal":{"name":"Hirurgia Pozvonochnika","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66711268","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}
The paper presents results of the author’s multi-year research in the field of cellular technologies. The differentiation stages of the chondro-osseous graft are described based on the findings of morphological, ultrastructural, and molecular genetic studies. The stages of cell transformation, dynamics of synthetic processes and matrix formation are identified. Hypotheses of the histogenesis of initial stages of different types of bone tissue, and the formation of microcirculatory and vascular beds in the process of osteogenesis are suggested. Experimental testing of regenerative potentialities of the bone graft in animals has shown that it is a primitive bone tissue with a high potency to proliferation, formation and differentiation into definitive bone tissue within a transplant zone.
{"title":"NEW PLASTIC MATERIAL FOR THE TREATMENT OF VERTEBRAL PATHOLOGY AND NOT ONLY...","authors":"A. Zaidman","doi":"10.14531/SS2018.2.91-97","DOIUrl":"https://doi.org/10.14531/SS2018.2.91-97","url":null,"abstract":"The paper presents results of the author’s multi-year research in the field of cellular technologies. The differentiation stages of the chondro-osseous graft are described based on the findings of morphological, ultrastructural, and molecular genetic studies. The stages of cell transformation, dynamics of synthetic processes and matrix formation are identified. Hypotheses of the histogenesis of initial stages of different types of bone tissue, and the formation of microcirculatory and vascular beds in the process of osteogenesis are suggested. Experimental testing of regenerative potentialities of the bone graft in animals has shown that it is a primitive bone tissue with a high potency to proliferation, formation and differentiation into definitive bone tissue within a transplant zone.","PeriodicalId":37253,"journal":{"name":"Hirurgia Pozvonochnika","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66711472","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}
Objective. To specify the extent of preoperative examination of patients with lumbar degenerative diseases and to study the effect of examination results on the tactics of surgical treatment. Material and Methods. The study included retrospective analysis of 1340 patients with lumbar degenerative diseases treated in the Neurosurgical Department No. 2 of Novosibirsk RITO n.a. Ya.L. Tsivyan during 2017. Results. The average height of the intervertebral disc as evaluated with MRI was 7.4 ± 1.8 mm, and that evaluated with MSCT – 4.9 ± 1.5 mm, with a statistically significant difference between them (p < 0.05). Immediate preoperative examination of patients with lumbar disc herniation showed reduction or lysis of the hernia fragment in some of them. Reduction of the leg pain and hernia size (by more than 50 %) and lysis of the herniated disc fragment evidenced by MRI were observed in 21 (3.2 %) patients. Comparison of the preplanned and actually performed extent of decompression and stabilization interventions showed that tactics and/ or extent of surgical treatment changed in 37.6 % of cases. Conclusion. The complex of instrumental radiological and neuroimaging studies, as well as methods of provocative procedure in the lumbar spine performed immediately before the planned surgical treatment allow choosing the proper treatment tactics, specifying or correcting the volume of surgical treatment, and to prognosing its outcome in lumbar degenerative diseases.
{"title":"ON THE EXTENT OF PREOPERATIVE RADIOLOGICAL AND CT EXAMINATION OF PATIENTS WITH DEGENERATIVE DISEASES OF THE LUMBAR SPINE","authors":"A. Krutko, A. Sanginov","doi":"10.14531/ss2018.2.66-75","DOIUrl":"https://doi.org/10.14531/ss2018.2.66-75","url":null,"abstract":"Objective. To specify the extent of preoperative examination of patients with lumbar degenerative diseases and to study the effect of examination results on the tactics of surgical treatment. Material and Methods. The study included retrospective analysis of 1340 patients with lumbar degenerative diseases treated in the Neurosurgical Department No. 2 of Novosibirsk RITO n.a. Ya.L. Tsivyan during 2017. Results. The average height of the intervertebral disc as evaluated with MRI was 7.4 ± 1.8 mm, and that evaluated with MSCT – 4.9 ± 1.5 mm, with a statistically significant difference between them (p < 0.05). Immediate preoperative examination of patients with lumbar disc herniation showed reduction or lysis of the hernia fragment in some of them. Reduction of the leg pain and hernia size (by more than 50 %) and lysis of the herniated disc fragment evidenced by MRI were observed in 21 (3.2 %) patients. Comparison of the preplanned and actually performed extent of decompression and stabilization interventions showed that tactics and/ or extent of surgical treatment changed in 37.6 % of cases. Conclusion. The complex of instrumental radiological and neuroimaging studies, as well as methods of provocative procedure in the lumbar spine performed immediately before the planned surgical treatment allow choosing the proper treatment tactics, specifying or correcting the volume of surgical treatment, and to prognosing its outcome in lumbar degenerative diseases.","PeriodicalId":37253,"journal":{"name":"Hirurgia Pozvonochnika","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48921177","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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