Patients with vertebrobasilar insufficiency, which are frequent in neurological and neurosurgical practice, require a complex examination to reveal its ethiology and to perform a differential diagnostics. The study objective was to develop a diagnostic algorithm for detection of clinically significant forms of Kimmerle anomaly, and to introduce a new technique for surgical treatment under intraoperative monitoring of the vertebral artery decompression. When a patient with the Kimmerle anomaly shows a vertebrobasilar insufficiency, a comprehensive surgical policy includes a complex clinicalphysiological assessment of the vertebrobasilar basin (from vertebral arteries entrances up to the basilar artery and its branches). If any other pathology is excluded, the Kimmerle rings (foramen arcuale) are removed and hemodynamics in the vertebrobasilar basin is estimated by clinical and graphical Doppler methods.
Development history and construction features of the first Russian functional lumbar disc endoprosthesis, its application technique, as well as indications and contraindications for surgical disc replacement are presented. The early and long-term results of Russian devices application are compared with those of foreign analogs. The result evaluation was performed by objective methods of study: clinical biomechanics, neurophysiology, and functional spine radiology. The follow-up period ranged from 1 to 10 years.