Objectives: To compare the outcomes of surgical treatment with lumbar fixation using nitinol rods without fusion and with standard lumbar fixation with titanium rods and interbody fusion. Methods: Treatment results of 70 patients with degenerative lumbar scoliosis aged 40 to 82 were analyzed. In all cases pedicle screws and nitinol rods with a diameter of 5.5 mm were used. Thirty patients underwent fixation at L1-S1 and 40 patients underwent fixation at L1-L5. Spinal fusion was not performed. All patients had radiography, CT and MRI performed. The results were assessed according to the Oswestry scale, SRS 22, SF 36 and VAS. The minimum follow-up period for all patients was 2.5 years. For the control group, consisting of 72 patients, pedicle fixation with titanium rods and interbody fusion in the lumbosacral region were performed. Results: The average level of deformity correction equaled 25° (10° - 38°). The analysis of X-ray and CT-scans revealed a single patient with implant instability, two patients with bone resorption around the screws and one patient with rod fractures. Functional radiography 2.5 years after surgery showed an average mobility of the lumbar spine of 21° (15° - 30°). There were no problems at the adjacent levels. Conclusions: The use of nitinol rods in spinal deformity surgery is promising. This technology is an alternative to rigid fixation. Continued gathering of clinical data and its further evaluation is necessary.

Objective. To assess the effectiveness of the application of adhesion barrier gel Antiadgezin to prevent the development of cicatricial adhesive process and its complications in the spinal canal after decompression surgery for degenerative disease in the lumbar spine.

To analyze results of surgical treatment of patients with congenital kyphosis in the thoracolumbar spine. Material and Methods. A total of 24 patients aged 3 to 57 years with congenital kyphosis were operated on. Vertebral malformation was detected in 13 patients, malsegmentation-in 4, mixed abnormality-in 1, unclassifiable abnormality-in 3, and congenital vertebral displacement-in 3. Congenital kyphotic deformities were treated using five surgical techniques. Neurological complications were observed in one patient. Results. The average postoperative kyphosis angle was 42° (range: 7° to 68°). The average rate of correction was 34 % (range: 6 to 84 %). Conclusion. Differential use of surgical techniques allows achieving good outcomes of treatment, restoring coronal and sagittal balance, and creating conditions for the proper development of the spine.

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.

Objective. To access the efficacy of surgical treatment of scoliosis using anterior approach. Material and Methods. Twenty four patients aged 9-18 years (22 females, 2 males) were operated on. Twelve patients had thoracic deformity, and 12-thoracolumbar and lumbar. Correction was performed through anterior approach using thoracotomy and thoracophrenolumbotomy with single and double rod instrumentation. Results. Mean correction of thoracic deformity was 84 %, mean number of fixed vertebrae was 7. Mean correction of lumbar and thoracolumbar deformity was 74 %, mean number of fixed vertebrae-6. In all cases a good sagittal alignment of the spine was achieved. Conclusion. Anterior correction is indicated for Lenke type I and V scoliotic deformity. Anterior instrumentation is feasible for thoracic deformity below 75°, and for thoracolumbar and lumbar-below 85°.

A case of surgical treatment of C6 fracture-dislocation and C7 fracture in a patient with ankylosing spondylitis is presented. Two-stage surgery with reposition of fracture-dislocation using the halo apparatus and stabilization with segmental instrumentation was performed. Outcome of the surgical treatment included elimination of deformity, achievement of stable fixation, and reduction of neurological signs observed in the patient before surgery.

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To analyze the results of treatment of degenerative spine disease with the use of nitinol rods for lumbosacral fixation as compared with conventional rigid fixation. Material and Methods.The prospective randomized study included 75 patients (34 males, 41 females; mean age 43 years) with degenerative lesion at the L 5 -S 1 level. Surgical treatment was performed with nitinol rods in 35 patients (Group 1), and with standard titanium rods in 40 patients (Group 2). Clinical and radiological results were assessed in 1.5 years after surgery.Results. The VAS leg-and-back, ODI, and SF-36 scores showed improvement in patients of both groups such as a significant reduction in pain intensity and improvement in psychological and physical health. The X-ray examination showed the restoration of the lumbar lordosis in both groups. In Group 1, there was no evidence of screw instability, bone resorption around screws and the adjacent segment disease, and functional radiography demonstrated preservation of mobility (5.0° ± 1.2°). There were seven patients with pseudoarthrosis, and six -with adjacent segment disease in Group 2, surgical intervention was required in four of them. Conclusion.Transpedicular fixation in the lumbosacral spine using nitinol rods is an effective technology allowing for mobility preservation in combination with stable fixation.