Vol 16, No 2 (2010)

ORIGINAL ARTICLES

HEEL BONE RECONSTRUCTIVE OSTEOSYNTHESIS

Svetashov A.N., Kopysova V.A., Kaploon V.A., Fyodorov A.A.

Abstract

To detect the most appropriate to heel bone injury severity variants of reconstructive osteosynthesis it was analyzed treatment results of 56 patients. In 15 (26.8%) patients classic methods of surgical service were applied, in 41 (73.2%) cases to restore the defect porous implants were used. Osteosynthesis without heel bone plastic restoration accomplishment was ineffective in 60% patients from control group. Reconstructive osteosynthesis method ensures long-term good functional effect of rehabilitation in 96.4% patients from the basic group.
Traumatology and Orthopedics of Russia. 2010;16(2):7-12
pages 7-12 views

MONOLATERAL SPINAL ANAESTHESIA IN CHILDREN

Kozyrev A.S., Ulrikh G.E., Zabolotsky D.V., Kulev A.G., Kachalova E.G., Vissarionov S.V., Murashko V.V.

Abstract

Monolateral spinal anaesthesia as a component of general anaesthesia was compared to the spinal anaesthesia as a component of general anaesthesia for the unilateral low extremity orthopedic surgery in children. Analgesic effect of two methodics was analysed in 120 children (age 1-18 years old, ASA 1-2). Monolateral spinal anesthesia provides the same level of analgesia thus decreasing zone of desympathysation and providing more hemodynamic stability and decreasing loss of heat. Monolateral spinal anesthesia is not complicated with urinary retention in contrast to classic spinal anaesthesia. Monolateral spinal anesthesia is an effective alternative to a classical spinal anesthesia for the unilateral low extremity orthopedic surgery in children.
Traumatology and Orthopedics of Russia. 2010;16(2):13-17
pages 13-17 views

EXPERIENCE EXCHANGE

HIP RESURFACING - FIRST IMPRESSIONS AND NEW OPPORTUNITIES

Kuropatkin G.V.

Abstract

Midi-time follow-up results of hip resurfacing were retrospectively analyzed. 117 operations in 109 patients with average age 36,2 years were performed. From one to four years follow-up results showed good clinical and functional result with proximal hip bone stock preservation. In spite of technical difficulties of resurfacing, complication level was not more, than in standard total hip arthroplasty. This surgical procedure may be recommends for young, active patients.
Traumatology and Orthopedics of Russia. 2010;16(2):18-21
pages 18-21 views

THE FEATURES OF TIBIOFIBULAR INJURY IN PATENTS WITH ANKLE FRACTURES

Fomin N.F., Ovdenko A.G., Nadjafov R.A., Bogdanov A.N.

Abstract

The role of interposition of soft tissues into tibiofibular syndesmosis is analyzed as a cause of unsatisfactory outcomes in the ankle joint pronation fracture treatment. The study is based on clinical (452 patients) and experimental material (36 experiments) including unfixed anatomic objects. The elevator for minimal invasive operative elimination of interposition of stumps of distal tibiofibular syndesmosis anterior and posterior ligaments is developed and tested.
Traumatology and Orthopedics of Russia. 2010;16(2):22-26
pages 22-26 views

THE USE OF THE PROXIMAL FEMORAL NAIL IN THE TREATMENT OF PROXIMAL FEMUR FRACTURES IN THE OLD PATIENTS

Borovkov V.N., Khrupalov A.A., Sorokin G.V.

Abstract

The analysis of results of surgical treatment of 157 patients with proximal femur fractures was presented. In all cases the osteosynthesis using fixator PFN was performed in clinic of traumatology amd orthopedics of Moscow Municipal Hospital N 71 from 2005 till 2009. The authors concluded: proximal femur nail is mini-invasive and mini-traumatic fixator that is essential at treatment of elderly and old patients.
Traumatology and Orthopedics of Russia. 2010;16(2):27-31
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POSTBURN CICATRICAL FOOT DEFORMITIES IN CHILDREN: CLINICAL ASPECTS AND MANAGEMENT

Afonichev K.A., Filippova O.V., Baindurashvili A.G., Buklaev D.S.

Abstract

The cicatrical deformities of the foot and secondary changes in tendons, muscles and in osteoarticular system with respect to the age and scar location were discussed. It was pointed to a high risk of early development of foot deformities, especially in young children up to five years of age. This indicates the need for regular medical check-up. Clinical experience shows that the hypertrophic scars that extend from the lateral surfaces of the foot to the ankle region create preconditions for development of multiplanar foot deformities, especially in the period of intensive growth of the skeleton. Possible complications in the treatment of multiplanar foot deformities in the presence of scar lesions of surrounding tissues associated with an increased risk of trophic disorders and the development of the inflammatory process are considered. Recommendations on stages of surgical treatment are given.
Traumatology and Orthopedics of Russia. 2010;16(2):32-38
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MODERN TECHNOLOGIES IN TRAUMATOLOGY AND ORTHOPEDICS

TREATMENT OF SHIN BONE FRACTURES USING EXTERNAL ROD APPARATUSES

Kupkenov D.E.

Abstract

Treatment results of 30 patients with diaphyseal fractures of shin bones are presented. All patients were treated by transosseus osteosynthesis tehnique with rod apparatus developed by author. Good outcome of treatment was received in 28 (93,3%) patients, satisfactory - in 2 (6,7%) in one - three years after operation. This method of treatment permits to perform a closed accurate reposition of bone fragments, to achieve the stable fixation for the whole period of treatment and to mobilize patients on second day after operation.
Traumatology and Orthopedics of Russia. 2010;16(2):39-44
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JUBILEE

Vladimir I. Savelyev

Abstract

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Traumatology and Orthopedics of Russia. 2010;16(2):45
pages 45 views

Vladimir M. Mashkov

Abstract

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Traumatology and Orthopedics of Russia. 2010;16(2):46
pages 46 views

МАТЕРИАЛЫ НАУЧНО-ПРАКТИЧЕСКИХ КОНФЕРЕНЦИЙ

THE SURGICAL TREATMENT OF CHILDREN WITH COMPLICATED FRACTURES OF THORACIC AND LUMBAR VERTEBRAE

Vissarionov S.V., Bel'anchikov S.M.

Abstract

The analysis of surgical treatment of 31 patients aged 3 to 17 years with complicated fractures of the vertebrae in the thoracic and lumbar localization was carried out. If damage type A3 with neurological manifestations of type Д В, С at one time served a two-stage decompression-stabilization operation. Surgical treatment of fractures of type В and С consisted in remove all types of dislocation of vertebrae, stabilize the physiologically correct position of the injured segment after the decompression and revision spinal canal. Early surgery in acute phase can eliminate the vertebro-medullar conflict, to stabilize the vertebral-motor segment, restore support ability of injured vertebra (or vertebrae), to recreate the normal anatomy of the spinal canal.
Traumatology and Orthopedics of Russia. 2010;16(2):48-50
pages 48-50 views

SURGICAL TREATMENT OF PATIENTS WITH UNFAVORABLE CONSEQUENCES OF VERTEBRAL-SPINAL INJURIES

Dulaev A.K., Usikov V.D., Ptashnikov D.A., Fadeev E.M., Dydykin A.V., Alikov Z.Y., Dulaeva N.M.

Abstract

The article is dedicated to the vital problem of the consequences caused by negligent surgical treatment of those who suffered spinal and vertebral trauma. The authors carried out a cooperative survey of the results of the previous treatments of patients with traumas with and without complications and they came up with the algorythm of surgical methods, based on the data analysis. Vast database of 614 clinical case treatments with post-operative observations of 1 to 10 years long have been used. The work is aimed at raising the standarts of surgical treatments and improvement of neurological & anatomo-functional results.
Traumatology and Orthopedics of Russia. 2010;16(2):51-54
pages 51-54 views

DISTANT DAMAGES IN PATIENTS WITH TRAUMATIC DISEASE OF SPINAL CORD

Dulub O.I., Il'yasevich I.A., Korchevsky S.A., Babkin A.V.

Abstract

Were marked 3 groups of patients with distant damages of spine: with develope of it at early time after vertebro-spinal cord trauma, posttraumatic distant myelopathy and posttraumatic syringogydromyelia. Develope of distant damage was in 54 patients and it was by high powerfulls traumatic action, ft connected to a hard prime damage of spinal cord (79.6% had a completely disturbance of spine cord conduction). Periods of improvement conductions changed for the worse. Confirmation of defeation and level of disturbance of spine cord conduction were done by MRI and different methods of electrophysiology. Medical support and surgical operations (decompressive and bypass operations) guarantee the positive neurological results gettin almost patients.
Traumatology and Orthopedics of Russia. 2010;16(2):55-58
pages 55-58 views

MEDICAL CARE TO PATIENTS WITH COMBINED VERTEBRAL-AND-SPINE INJURY AT TRAUMATOLOGY CENTERS OF 1 LEVEL ON FEDERAL HIGHWAYS M5, M7

Islamov S.A., Nikitin V.V., Faizullin A.A.

Abstract

The aim of the work is the optimizing the organization of medical care to victims of accidents on federal roads M5 and M7. The priority direction in improving outcomes of treatment in patients with polytrauma is an organization of all the processes of diagnostics, resuscitation and surgical treatment based on the timeliness and appropriateness. A special feature of motor accidents in Russia is a long period of patients isolation affected due to geographical features, that in combination with low temperatures increases the proportion of irreversible losses. In UGKB № 21 for the last 5 years 1315 patients with polytrauma were treated. A retrospective study of clinical data showed that among them persons with injuries of the locomotor system amounted to 1,196 (91%), abdomen - 79 (6%), chest - 197 (15%), central and peripheral nervous system - ИЗО (86%). The victims with vertebral-spinal injury amounted to 96 (8%). Surgical treatment was performed after normalization of the patient general condition from 2 to 5 phases of medical care, poor results were obtained in 4 (1%) cases. The most effective form of medical care organization for vertebral-spinal cord injury is a two-stage system.
Traumatology and Orthopedics of Russia. 2010;16(2):59-61
pages 59-61 views

ROBOTIC ASSISTANCE IN SPINE SURGERY

Konovalov N.A., Shevelev I.N., Kornienko V.N., Nazarenko A.G., Asyutin D.S., Isaev K.A., Zelenkov P.V.

Abstract

Robotic assistance recently gains increasing popularity in spinal surgery. Robotic assistance provides higher effectiveness and safety especially in complex anatomy environment. 16 patients with degenerative disc disease were operated with robotic assistance device («SpineAssist»; MAZOR Surgical Technologies, Caesarea, Israel). The robot was used for automated intraoperative positioning of the instruments according to preoperatively planned trajectories. Robotic assistance enabled optimal screw placement even in complex anatomical cases (thin pedicles and rotational deformity). No implant-related complications were recorded.
Traumatology and Orthopedics of Russia. 2010;16(2):62-63
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THE STUDY OF RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH VERTEBRAL-SPINAL TRAUMA

Minasov B.S., Sahabutdinova A.R., Khanin M.Y.

Abstract

A study of the efficacy of medical rehabilitation of 170 patients with spinal-cord injury through the application of modern rehabilitation and surgical technologies was conducted. Patients of I (control) group received standard set of conservative treatment and rehabilitation. Patients of II (main) group the rehabilitation was supplemented with therapeutic exercises with the use of loop complex «Hope» and the rate of adaptation to the stress of hypoxia in the late period of injury. Patient of III (control) group surgical treatment and the conventional range of rehabilitation were performed. Patients of IV (main) group the rehabilitation was completed with early activation using espandernogo complex «Hope» and the rate of adaptation to the stress of hypoxia in the late period of injury. It is proved that the developed complex rehabilitation of patients with spinal-cord injury using an early stable functional osteosynthesis with the minimum extent necessary, the use of complex «Hope» can improve the functional results at the expense of early motor activation, preventing the formation of contractures and muscle atrophy. The use of adaptation to the stress of hypoxia in the late period of vertebro-spinal cord injury improves overall health, reduces the severity of autonomic reactions, emotional stress, can cut pain syndromes.
Traumatology and Orthopedics of Russia. 2010;16(2):64-67
pages 64-67 views

SPINAL CORD STIMULATION IN TREATMENT OF THE NEUROPATHIC PAIN SYNDROMES: INITIAL EXPERIENCE

Rzaev D.A., Rudenko V.V., Pudovkin I.L., Tatarintsev A.P., Godanyuk D.S.

Abstract

In the article initial experience of spinal cord stimulation for chronic pain syndromes is described. The trial was done for 62 patients, in 52 cases trial was successful and subcutaneous pulse generator were implanated. Maximal follow-up is 26 months. The level of pain evaluates at VAS. Permanent pain-relieve results were achieved in 46 patients (74,2%). These results correspond to literature data.
Traumatology and Orthopedics of Russia. 2010;16(2):68-71
pages 68-71 views

CAPABILITIES OF ELECTRONEUROSTIMULATION IN PATIENTS WITH VERTEBRAL-SPINAL INJURIES

Toma A.I., Ninel V.G., Norkin I.A., Toma G.V., Smol'kin A.A.

Abstract

The possibilities of epidural electrical stimulation in the complex treatment of patients with spinal injury in the acute and late periods of traumatic disease of the spinal cord. The authors presented the analysis of treatment results of 356 patients with a spinal-cord injury at age 16 to 71 years, including 293 patients in the acute and early periods of trauma, and 63 - in the late period. Injuries of the cervical spine were observed in 145 (40,7%) men, thoracic - in 59 (16,6%), thoracolumbar - in 89 (25,0%), lumbar - in 63 (17,7%). As the result of the conducted electropulse influence on the spinal cord in the acute period of the trauma we succeeded in achieving positive outcomes in 80,9% of patients, and that is 11,7% better, than in the comparison group. That allowed us to restore lost functions of the spinal cord more completely in more than the half of the patients with consequences of vertebral cerebro-spinal trauma.
Traumatology and Orthopedics of Russia. 2010;16(2):72-75
pages 72-75 views

TACTIC OF SURGICAL TREATMENT OF PATIENTS WITH THE OLD VERTEBRAL AND SPINAL CORD INJURIES

Usikov V.D., Fadeev E.M., Ptashnikov D.A., Magomedov S.S., Dokish M.Y.

Abstract

The 329 patients with the old vertebral and spinal cord injuries have been treated surgically in 6 month - 18 years after injury. Tactics of surgical treatment of patients was based on fracture type, degree of neurological deficit and rigidity of deformation. The combination of neurosurgical and orthopedical principles of surgery lets us to achieve an improvement in live quality in 92,7% of cases.
Traumatology and Orthopedics of Russia. 2010;16(2):76-78
pages 76-78 views

INSTABILITY AT CHRONIC DAMAGES OF A BACKBONE AND SPINAL CORD

Shchedrenok V.V., Orlov S.V., Moguchaya O.V.

Abstract

By means of mathematical modeling studying influence of angular deformation of a body on development of a spinal stenosis was performed. It is proved, that the increase in a corner of deformation promotes development of narrowing of the channel. The given law on an example of treatment of 10 patients with chronic damages of a backbone and a spinal cord is studied. At all patients the progression of deformation that has demanded surgical treatment was observed. The lead treatment has reduced a painful syndrome, has improved social adaptation, but has not affected a level of neurologic deficiency.
Traumatology and Orthopedics of Russia. 2010;16(2):79-81
pages 79-81 views

TACTIC IN SURGICAL TREATMENT OF THORACIC IDIOPATHIC SCOLIOSIS IN CHILDREN

Vissarionov S.V., Drozdetsky A.P.

Abstract

The results of surgical treatment of 263 patients with thoracic scoliosis from 13 to 18 years old with deformity 50-152° (Cobb) are presented. It was used three tactical variants with dorsal instrumentation Cotrel-Dubousset (CDI). Operation correction in idiopathic thoracic scoliosis varies within in limits from 46,2 to 95%. Lost of correction in 10 years follow up period was 5,10-10,15%. Authors concluded that tactic of surgical treatment of idiopathic thoracic scoliosis should be individual and depends on patient's age, growth potential, and degree of deformation and mobility of the curve.
Traumatology and Orthopedics of Russia. 2010;16(2):82-85
pages 82-85 views

EXPERIMENTAL EVALUATION OF CORRECTION FEATURES OF POSTTRAUMATIC KYPHOSIS OF THORACIC AND LUMBAR SPINE

Nadulich K.A., Shapovalov V.M., Teremshonok A.V., Vasilevich S.V.

Abstract

Experimental biomechanical study was performed in 60 spine specimens. Anterior wedge osteotomy and fixation of a specimen in a kyphotic position modeled kyphotic deformity. Deformity correction with various instrumentation systems was firstly performed by maximal extension of segments adjacent to kyphosis-producing block, and carried on after crossing of intervertebral anatomical structures. The study resulted in defining rational approach to surgical correction of posttraumatic deformities in the thoracic and lumbar spine. Minor kyphotic deformities are effectively corrected by instrumentation without mobilization of the spine. Large unfixed kyphosis sometimes requires anterior mobilization. Cases with rigid posttraumatic kyphotic deformity should be operated on with combined mobilization of the spine.
Traumatology and Orthopedics of Russia. 2010;16(2):86-88
pages 86-88 views

RESULTS OF COMBINED FIXATION OF SCOLIOTIC SPINAL DEFORMITY IN ADULTS

Usikov V.D., Ptashnikov D.A., Smekalenkov O.A., Mikhailov D.A.

Abstract

The results of surgical treatment of adult patients with scoliosis in the form of different fixation of L5-S1 segment. The best results were obtained in patients who underwent combined spinal fixation (transpedicular system and the system interspinous dynamic stabilization). In this group good indicators of quality of life of patients in the form of lack of pain and preservation of the normal volume movements in the lumbar spine were received.

Traumatology and Orthopedics of Russia. 2010;16(2):89-92
pages 89-92 views

EVALUATION OF EFFECTIVENESS OF PERCUTANEOUS VERTEBROPLASTY IN COMPLEX TREATMENT OF OSTEOPOROSIS WITH PATHOLOGICAL VERTEBRAL FRACTURES

Astapenkov D.S.

Abstract

The effectiveness of vertebroplasty in treatment of 84 patients with osteoporosis and pathological fractures of the vertebrae was evaluated. 68 patients of the first group were underwent a comprehensive conservative treatment, percutaneous vertebroplasty was performed additionally in 16 patients in second group. The study found that in the second group treatment results were slightly better: the investigated parameters showed a significant dynamics, ie, vertebroplasty improved the results of treatment of osteoporotic patients with pathological fractures of the vertebrae.
Traumatology and Orthopedics of Russia. 2010;16(2):93-96
pages 93-96 views

EXPERIMENTAL STUDY OF STABILITY AT CEMENT AND CEMENTLESS IMPLANTATION OF TRANSPEDICULAR SCREWS INTO VERTEBRAE WITH LOW MINERAL DENSITY OF BONE

Afaunov A.A., Usikov V.D., Ptashnikov D.A., Takhmazyan K.K., Dokish M.Y.

Abstract

The stability of cemented and noncemented transpedicular screw implantations in vertebra with low mineral bone density was studied in experiment. We analyzed the destabilization of screw under distraction load, attached along longitudal axis of the screw on universal servo-hydraulic test machine «Walter+bay ag» LFV-10-T50. The factors of bone-cement-metallic block rigidity of cemented screw was in 2,10-2,38 times more then in situation with traditional transpedicular screw.
Traumatology and Orthopedics of Russia. 2010;16(2):97-101
pages 97-101 views

SURGICAL TREATMENT FOR OSTEOPOROTIC SPINAL FRACTURES IN THE THORACO-LUMBAR SPINE AND AN ESTIMATION OF EFFICACY IN THE FOLLOW-UP

Vetrile S.T., Kuleshov A.A., Shvets V.V., Darchia L.U.

Abstract

85 patients with osteoporotic vertebral fractures of lower thoracic and lumbar spine were operated. Surgical options including posterior reconstruction, anterior reconstruction and combined anterior and posterior surgery, vertebroplasty. In the postoperative period the great attention was given to rehabilitation and correction lowered BMD depending on osteoporosis type. The long-term outcomes were followed in 69%. Good results were achieved in 76% of cases, satisfactory - in 20%, unsatisfactory results - in 4%. The differential approach to surgical treatment osteoporotic spinal fractures in the thoraco-lumbar spine allows to restore in short terms stability of spine and return activity to patients.
Traumatology and Orthopedics of Russia. 2010;16(2):102-105
pages 102-105 views

VERTEBRAL AND PERIPHERAL FRACTURES: DIAGNOSTIC TOOLS AND MEDICO-SOCIAL SIGNIFICANCE

Zotkin E.G., Khurtsilava O.G., Zubkova I.I., Safonova Y.A.

Abstract

Medico-social significance of osteoporosis is determined by the high frequency of low-traumatic fractures of bone. According to the European Vertebral Osteoporosis Study the prevalence of vertebral fractures was 11,5% in women of 50-54 years of age and reached 34.8% in women of 75-79. The only prospective population-based study conducted in Russia have showed that the incidence of new vertebral fractures was 5,9% in men and 9,9% in women over 50. Stratified epidemiologic study conducted in St. Petersburg, have showed that in men the peak of clinical fractures, developed with minimal trauma, was at the age of 20-24 and 65-69. In women the peak of fractures was determined at the ages 50-54 years. It has been suggested that early administration of antiosteoporotic drugs can effectively prevent vertebral and peripheral fractures.
Traumatology and Orthopedics of Russia. 2010;16(2):106-109
pages 106-109 views

THE TREATMENT OF OSTEOPOROTIC VERTEBRAL FRACTURES USING KYPHOPLASTY

Kavalersky G.M., Slinyakov L.Y., Makirov S.K., Chensky A.D., Chernyaev A.V., Bobrov D.S.

Abstract

In article results of treatment of 20 patients more senior 60 years with osteoporotic fractures of thoracolumbar spine. To all patients has been executed percutaneous kyphoplasty. In process kyphoplasty restoration of ventral departments of the broken vertebra on 15+6.2 % is reached. Correction of a local kyphosis angle is reached in limits 5-10e (7,3+2,5e). Recourse of a painful syndrome with 7,1+1,9 to 2,1+1,7 on a visual analogue scale is noted. In the remote period it is noted increases in a painful syndrome, increase of a local kyphosis angle and deformations of a body of a vertebra. Thus, percutaneous kyphoplasty, being a minimally invasive astabilisation technique, allows to restore strengthening characteristics of bodies of vertebras, to increase height ventral departments of bodies, correction of the biomechanical infringements resulting fracture thereby is reached.
Traumatology and Orthopedics of Russia. 2010;16(2):110-112
pages 110-112 views

THE PROPHYLAXIS OF VERTEBRAL COMPRESSION REFRACTURES USING ZOLEDRONIC ACID

Kochish A.Y., Ivanov S.N., Khrulev V.N.

Abstract

29 women with postmenopausal osteoporosis, complicated by compression vertebral fractures were treated by infusion of zoledronic acid, 5 mg. The results were assessed using dual-energy X-ray absorptiometry. By 12 months BMD increased both in lumbar spine (mean 5,2% (σ=0,17) and in femoral neck (mean 3,9% (σ=0,20)); by 24 month the mean increase were 6,3% и 4,0% (σ=0,33) respectively. No new compression vertebral fractures were found.
Traumatology and Orthopedics of Russia. 2010;16(2):113-115
pages 113-115 views

SURGICAL TREATMENT OF VERTEBRAL FRACTURES ASSOCIATED WITH LOW MINERAL BONE DENSITY

Rerikh V.V., Sadovoy M.A., Rakhmatillaev S.N., Borzykh K.Q.

Abstract

Surgical treatment of 177 patients with monolocal fractures of thoracic and lumbar vertebral bodies was performed using transpedicular fixation (n=17), transpedicular fixation and osteoplasty (n=101), vertebroplasty (n=48) or kyphoplasty (n=ll). Restoration of support ability of the fractured osteoporotic vertebrae within ventral column by means of plasty particularly in combination with internal fixation allows achievement of better clinical outcomes, improvement of the quality of life in patients in the early and late periods after surgery.
Traumatology and Orthopedics of Russia. 2010;16(2):116-119
pages 116-119 views

VERTEBRAL OSTEOPOROTIC COMPLICATIONS

Chumak N.A., Dulub O.I., Babkin A.V.

Abstract

Modern concepts of pathogenesis, current approaches of diagnosis and treatment of common complications of vertebral osteoporosis are considered on the basis of clinical cases.
Traumatology and Orthopedics of Russia. 2010;16(2):120-122
pages 120-122 views

VENTRAL SPONDYLODESIS BYTITAN IMPLANTS AT SPINE TUMORS

Babkin A.V.

Abstract

At RSPC of traumatology and orthopaedic surgery and Institute of powders metallurgic porous implants are working out which allow complitely replace alio- and autotranplants and improve the surgical technology of interbody spondylodesis. Porous implants, made from mechanic durabilities, are bioinert or biocompatible materials, provide durabilities prime spondylodesis. It doesn't need an additional fixation, realize a possibility to grow a bone matter in powder structure of implants.
Traumatology and Orthopedics of Russia. 2010;16(2):123-125
pages 123-125 views

SPINAL TUMORS AND ITS TREATMENT PERSPECTIVES IN OUR DAYS

Valiev A.K., Musaev E.R., Sushentsov E.A., Borzov K.A., Aliev M.D.

Abstract

The treatment of the patients with metastatic spinal lesions is one of the most difficult problems in modern vertebrology and oncology. The experience of Russian Cancer Research Center based on the clinical analysis on 214 patients with metastatic spine disease showed the results of median survival rate overall 6 months. The mean survival rate in cases of renal cancer metastases consisted 11,2 months, breast cancer - 16,2 months, lung cancer mts - 2,1 months, prostate cancer - 17,7 months, unknown primary origin - 7,8 months. We compared our results with expected survival, scored by Tokuhashi scale. The real survival rate and expected matched only in patients with renal and lung cancer mts.
Traumatology and Orthopedics of Russia. 2010;16(2):126-128
pages 126-128 views

THORACOSCOPIC SURGERY FOR SPINE AND PARASPINAL NEUROGENIC TUMORS

Gushcha A.O., Arestov S.O.

Abstract

There is our experience of thoracoscopic surgery treatment of primary and metastatic spine tumors and paraspinal neurogenic tumors including "dumbbell". Thoracoscopic approach impressively decreases of complication rate in comparison with open surgery and considerably increase quality of life. Activization time for the patient with thoracoscopic surgery was 5,36+3,34 (for neurogenic paravertebral tumors 3,40+2,31). Comparison endoscopic and microsurgical methods demonstrate advantages of endoscopic technologies. Further development of neuroendoscopy in spinal surgery makes possible to increase effectiveness of treatment of various spine pathology. We conclude that neuroendoscopy is new and effective method of treatment not only degenerative diseases but is really effective technology of tumor resection both extra and intramedullar.
Traumatology and Orthopedics of Russia. 2010;16(2):129-131
pages 129-131 views

ALGORITHM OF THE SURGICAL TREATMENT FOR SPINAL TUMORS

Ptashnikov D.A., Usikov V.D., Korytova L.I., Magomedov S.S., Karagodin D.F., Rominskiy S.R., Dulaev A.K., Alikov Z.Y., Dulaeva N.M.

Abstract

The 571 patients with the tumors of cervical, thoracical and lumbar spine (159 patients with benging tumors, 35 - with primary malignant tumors and 377 - with metastatic lesion of the spine) have been treated surgically in 1997-2009. Tactics of surgical treatment of patients with a tumoral lesion of a column was based on an individual approach to each case of disease and depend on histological type of a tumor, localization, a degree of diffusion of process, presence of complications, age, a somatic state of the patient and sensitivity of a tumor to conservative methods of treatment.
Traumatology and Orthopedics of Russia. 2010;16(2):132-135
pages 132-135 views

COMPARATIVE ANALYSIS OF THE TREATMENT OF THE EOSINOPHILIC GRANULOMA WITH VERTEBRAL INVOLVEMENT USING ORTHOPEDIC CORSET AND SURGICAL OPERATION

Snetkov A.I., Kolesov S.V., Frantov A.P., Batrakov S.Y., Kudryakov S.A., Efendiev R.M., Sazhnev M.L.

Abstract

The results of treatment of 72 patients with pathological fracture of vertebra bodies against eosinophilic granuloma a spine are analysed. Orthopedic corset technologies are used in treatment of 42 patients, surgical treatment was applied. Orthopedic corset may be used in patients with eosinophilic granuloma of backbone. This method of treatment was used in a case of the absence of spine secondary deformations and neurologic semiology. Orthopedic corset treatment is associated with long immobilization on the average within 1,5-2 years and never leads to a complete recovery of the damaged spine. Surgical treatment consists in use only at loss of height of a body to 30-40%, when destruction of spine more severe it is necessary to use operative treatment in two stages. Absolute indications to surgical treatment are the neurologic deficit and secondary deformations of a spine. Surgical treatment allows to reduce terms of treatment till 3-4 months and quickly to return the patient to an active life.
Traumatology and Orthopedics of Russia. 2010;16(2):136-139
pages 136-139 views

CORPOR- AND SPONDYLECTOMYIN SYSTEM OF SURGICAL TREATMENT OF VERTEBRAL TUMORS

Usikov V.D., Ptashnikov D.A., Magomedov S.S.

Abstract

The authors have reported the 10-years experience of treatment of 571 patient with spinal tumors. Radical resection (en bloc) of tumors was done in 114 cases (65 - corpectomy, 55 - spondylectomy). The rate of tumors recurrence was - 9%, it depended from type of tumors and it's size.
Traumatology and Orthopedics of Russia. 2010;16(2):140-142
pages 140-142 views

SURGICAL TREATMENT OF TUMORS OF THE UPPER-THORACIC SPINE

Heylo A.L., Aganesov A.G.

Abstract

The experience of surgical treatment of 19 patients with tumors of the upper-thoracic spine is analyzed. All the patients had undergone decompressive-stabilizing surgical procedures. Surgical approach, form of decompression and fixation were determined depending on the signs of compression of the spinal cord and neural structures, etiology and degree of the vertebral body destruction. Good and satisfactory short- and long-term results were achieved in all the patients. The case of surgical treatment of female patient with giant neurofibromas of Th2 vertebrae is also reported.
Traumatology and Orthopedics of Russia. 2010;16(2):143-145
pages 143-145 views

THE EXPERIENCE OF DECOMPRESSION-AND-STABILIZING SURGERIES IN PATIENTS WITH MULTIPLE MALIGNANT TUMORS OF THORACIC AND LUMBAR SPINE

Shapovalov V.M., Nadulich K.A., Teremshonok A.V., Nagorny E.B.

Abstract

The authors have analyzed the surgical treatment of 34 patients with multiple malignant, mainly metastases tumors of thorax and lumbar spine, using spinal implants. The results of the estimation of life quality, neurological status and survival after the surgery have shown the effectiveness of decompress and stabilization technologies at any variants of malignant tumor spine injuries, especially involving specific therapy. 27 patients were observed during the period from 10 months to 5 years.
Traumatology and Orthopedics of Russia. 2010;16(2):146-148
pages 146-148 views

TRANSORAL REMOVAL OF SKULL BASE AND C1-C2 VERTEBRAL BODY TUMOURS AND NONTUMOROUS PATHOLOGY IN THE CRANIOCERVICAL JUNCTION ACCOMPANIED BY CRANIOVERTEBRAL INSTABILITY

Shkarubo A.N., Guscha A.O.

Abstract

27 patients aged 2,5-61 years with skull base and C1-C2 vertebral body tumours and nontumorous pathology in the craniocervical junction underwent surgery. All patients revealed craniovertebral instability. To perform OSD we used autobone and metallic wire in 1 case, "Ventrofix" - 2; "CCD" - 9, "Vertex" - 15. In 26 cases OSD was followed by transoral tumor removal; in 1 - removal of the skull base chordoma spreading into C1-C2 segments was followed by OSD. In our practice we used original patent instruments, devices and surgical techniques. After the tumor has been removed, the skull defect hermetic closure and plasty were performed using the original patent technique for preventing postoperative CSF leakage as well as different glue compositions. This technique proved to shorten hospitalization period and reduce treatment costs as well as launch an early rehabilitation programme - on the 3d-4th day after operation. Use of new technologies in surgical treatment of skull base tumors invading upper cervical spinal segments accompanied by craniovertebral instability allowed to improve surgical outcome and start up early rehabilitation.
Traumatology and Orthopedics of Russia. 2010;16(2):149-152
pages 149-152 views

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