Российский научный центр «Восстановительная травматология и ортопедия» им. акад. Г. А. илизарова МЗ РФ (директор-д-р мед. наук А. В. Губин), г. Курган ЦеЛь. Систематизация наблюдаемых в процессе интраоперационного нейромониторинга электрофизиологических феноменов, с последующей разработкой оценочной (балльной) шкалы результатов нейрофизиологического тестирования пирамидного тракта, удобной для восприятия хирурга. МАтеРиАЛ и МетОды. 288 больным 1-27 лет под интраоперационным нейрофизиологическим контролем произведена инструментальная коррекция деформации грудного/грудопоясничного отдела позвоночника. РеЗуЛьтАты. Произведена оценка в баллах изменений моторных вызванных потенциалов, наблюдаемых в процессе оперативного вмешательства. Показано, что частота встречаемости изменений их параметров, указывающих на опасность возникновения ятрогенных повреждений, зависит от возраста пациента и не превышает 10 % от всего массива наблюдений. ЗАКЛючеНие. интраоперационный нейрофизиологический контроль позволяет хирургу и анестезиологу своевременно скорректировать свои действия, что минимизирует опасность возникновения ятрогенных неврологических расстройств.
We report a case of surgically proven, focal left parietal tuberculous leptomeningitis. Occlusion of superficial cerebral veins in the affected area led to dilatation of medullary veins to drain the left parietal lobe. Deep medullary veins were clearly demonstrated on MRI and angiography.
Design Presentation of clinical cases and literature analysis. Material and methods Clinical observation of patients with congenital cervical spine and shoulder girdle anomalies operated on with neuromonitoring was performed. Operative treatment of Sprengel's deformity was produced with the use of neuroimaging. Results Surgical treatment resulted in good clinical outcomes without neurological adverse events and good aesthetic and radiological appearance at the descended scapula. Discussion Consideration for intraoperative neuromonitoring should be given to prevent neurological complications at lowering the elevated scapula. Conclusion Review of outcomes showed efficacious application of the most valid methods used to descend the scapula with neuromonitoring. This was supported by clinical and radiological findings of the extent of cranial transposition after appropriate correction and absence of neurological adverse events early postsurgery and at a longterm follow-up. No recurrence of scapular dislocation was observed at a long-term follow-up.
A case of posttraumatic compressive subarachnoid cyst of the thoracic spine studied by MR myelography, and myelo-CT is reported. This cyst was surgically confirmed and treated by shunting.
The paper presents recommendations on the assessment and treatment of vertebral pathology in patients with various types of mucopolysaccharidosis. The recommendations are based on literature data and the authors’ own experience. The purpose of the publication is an invitation to the discussion in the format of an expert consensus.
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