The present guidelines on diagnostics, differential diagnostics, and methods of treatment of Cushing’s disease have been developed by a group of Russian specialists.
Objective. To analyze the safety and accuracy of pedicle screw placement in the subaxial cervical and upper thoracic spine using patient-specific 3D navigation templates.Material and Methods. The study included 16 patients who underwent transpedicular implantation of screws in the subaxial cervical and upper thoracic vertebrae using patient-specific 3D navigation templates. A total of 88 screws were installed. All patients underwent preoperative CT angiography to assess visualization of the vertebral artery. Customized vertebral models and navigation templates were created using 3D printing technology. Models and templates were sterilized and used during surgery. The results of screw implantation, as well as the safety and accuracy of the placement, were assessed by postoperative CT.Results. The average deviation from the planned trajectory was 1.8 ± 0.9 mm. Deviation was estimated as class 1 (<2 mm) for 57 (64.77 %) screws, class 2 (2–4 mm) for 29 (32.95 %), and class 3 for two (2.27 %). The safety of screw implantation of grade 0 (the screw is completely inside the bone structure) was in 79 (89.77 %) cases, of grade 1 (<50 % of the screw diameter perforates the bone) – in 5 (5.68 %), and of grade 3 – in 2 (2.27 %).Conclusion. Using 3D navigation templates is an affordable and safe method of installing pedicle screws in the cervical and upper thoracic spine. The method can be used as an alternative to intraoperative CT navigation.
Федеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова» Министерства здравоохранения Российской Федерации,
The objective was to analyze and evaluate patients` quality of life before and after resection of brain meningioma.Methods and materials. We performed study of 31 patients with brain meningioma. The diagnosis of the studied patients was based on clinical and laboratory data, data of radiation and instrumental methods of research. The analysis of patients` quality of life was carried out in the preoperative, early and late postoperative periods. The patient` age ranged from 37 to 65 years; the median age was 57 years. We chose a special questionnaire-EORTC QLQ-C30 to assess quality of life of the studied pre- and postoperative periods. The questionnaire has been tested in many international clinical studies.Results. In the early postoperative period, the severity of pain increased in the patients under study, nausea and vomiting, constipation occurred more often. However, patients assessed their General health in both early and late postoperative periods better than before the operation. In the late postoperative period, there was a positive dynamics in all scales of the questionnaire.Conclusion. On examination of various parameters of quality of life before and after surgery in patients with brain meningioma, it was found that surgical intervention led to an improvement in the quality of life of patients.
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