Objectives. To estimate macroscopically the strength, rigidity and limit of elasticity in the “spinal segments – transpedicular fixator” system. versus similar characteristics of the intact spine under dislocating rotational loads. Material and Methods. Еxperiments with anatomic specimens of Th12–L2 segments were performed. Unstable damages of L1 and transpedicular fixation with 4 screw transpedicular spinal system were imitated. All specimens were exposed to the testing rotational load in universal test machine Zwick 1464. Results. It is established that under rotational load general strength of the injured Th12–L1–L2 spinal segments fused with transpedicular fixator is 20 % lower than that in a corresponding intact spine segment. Rigidity parameters of fused segments are 17.5 % lower than those of intact segments. Destabilization of «spinal segments – transpedicular fixator» system under rotational loads is caused by the compression of a bone substance in Th12 and L2 bodies with screws and a turn of screws around longitudinal rods due to a rod slip in anchoring elements. Conclusion. The performed study may serve a basis for following data analysis from a viewpoint of metal resistance and for development of optimal rehabilitation loads to the injured spine during postoperative period.
The current problems of treatment of degenerative dystrophic spine disease are discussed. The authors have fulfilled a research in microinvasive surgery by mechanical decompressor. 55 persons, 25 of which are men and 30 are women with degenerative dystrophic spine diseases complicated by intervertebral disk hernia were observed. The results were estimated in 5 days and 3, 6, 12 months after the operation. Good results of the treatment in all the patients were received, pain syndrome was disappeared. The microdiscectomy using mechanical decompressor appeared to be useful in treatment of osteochondrosis of spine.
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.
A clinical case of single-step posterior-only approach in surgical treatment of a patient with severe kyphotic deformity. Surgery resulted in reduction of neurological deficit and pain, and restoration of proper trunk balance.
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.
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.
The analysis of the results of transpedicular screw fixation in the treatment of patients with osteoporotic vertebral compression fractures was done. In the first group (N=27) the polysegmental transpedicular screw fixation was applied. In the second group (N=20) we used short-level stabilization with additional augmentation of transpedicular screws by bone cement. The spinal stability, restoration of function, correction of spine's deformation and pain relief was same in both groups. But in the second group the results was achieved with less traumatization and time of rehabilitation of the patients.
Objective. To validate the approach to treatment of patients with primary tumors of the spine. Material and Methods. The experience of surgical treatment of 47 patients with benign tumors of the spine was analyzed. The treatment approach was defined with the account of tumor type and localization, and of patient’s somatic status. The diseased area was examined with the help of X-ray, CT scanning, and MRI, and a punch biopsy in some patients. Results. The tumor recurrence was registered in 6 (14.6 %) patients. This shows that in some cases the exact margins of the tumor were not defined despite the comprehensive diagnostic possibilities. Functional results of the treatment implied the restoration of the spine support ability and the pain regress in all observations. Bone plasty was the method of choice for interbody defect replacement. Conclusion. The radical surgery (corpectomy and spondylectomy) considerably reduces the risk of tumor recurrence. Lumbosacral location of the tumor with paravertebral extension presents serious technical problems in its total removal. Autogenic cortical cancellous bone proved to be a good plastic material for defect replacement after vertebra resection and fusion.
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