Objective To study morphological and radiological parameters of facet joints depending on the grade of the intervertebral disk degeneration. Materials and methods To study the facet joints of the lumbar spine in 145 patients with various grades of degeneration according to Pfirrmann and treated using rigid fixation and TLIF technology, MSCT in 2-energy mode and morphological investigation of the intraoperative material were performed. Results In Pfirrmann grade 2, an increase in the volumetric content of chondrocytes, Hounsfield density of the cartilage plate, and the level of Ca in the facet joints was visualized. They indicate that the joint remains functional. In Pfirrmann grade 5, deep pathological changes occurred with violation of the architectonics of the cartilage formations of the facet joints, formation of bone elements and connective tissue growth into the cartilage and bone structures of the joint, which correlated with the results of MSCT. Conclusion The data obtained show that there is a close relationship between morphological and radiological changes in the facet joints. Modulating the data obtained allows us to obtain objective criteria for evaluating the grade of pathological processes in facet joints and use them as a diagnostic component when planning decompression and stabilizing operations in patients with degenerative diseases of the lumbar spine.
Bone regeneration of patients with osteoporosis takes significantly longer than the rehabilitation period of individuals without bone pathology. This is due to the predominance of destructive processes in the setting of osteoblastic reaction weakened by osteoporosis, persistent inflammatory reactions, as well as proliferating connective tissue.Aim. Тo study the nature and dynamics of processes involved in the destruction and regeneration of bone tissue under various conditions, taking forensic medical assessment into account.Material and methods. We studied the autopsy and biopsy material of bone tissue using clinical-instrumental and histological research methods.Results. Using atomic force microscopy, it was found that in individuals with osteoporosis the formation of endosteal callus exhibits features associated with the impaired interlacing of collagen fibres due to the expanded space between them, and, as a result, an impaired connection between osseous structures with a low level of mineralisation.Conclusion. In accordance with paragraph 24 of Order 194n On the Approval of Medical Criteria for Determining the Severity of Harm to Human Health verified systemic osteoporosis that was the setting for the fracture, which in fact is a pathological fracture, should not be considered as damage to health.
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