Objective. To analyze the course of pregnancy and delivery that occurred before and after surgical correction of idiopathic scoliosis with instrumented fixation of the spine.Material and Methods. The paper presents a retrospective randomized study of 100 patients of reproductive age (18–35 years) with Lenke type 2–6 idiopathic scoliosis. The following aspects of pregnancy were analyzed: the possibility of independent conception, the pain severity according to VAS during each of the three trimesters of pregnancy, and the mode of delivery (naturally or by C-section). A comparative analysis of the data of patients operated on for the spine deformity correction before and after pregnancy and delivery was carried out. Data was collected using a questionnaire survey of patients. Detection and analysis of differences between groups were carried out using the χ 2 criterion.Results. A statistical relationship was found between the presence of instrumentation installed before delivery (during or before pregnancy) and the need for C-section. It was revealed that the lower the caudal end of instrumentation within the L3–S1 region, the higher the C-section occurrence. Predominantly thoracic scoliosis (Lenke types 2–4) is characterized by higher likelihood of independent conception and lower lumbar pain intensity during pregnancy than predominantly lumbar scoliosis (Lenke types 5–6). There are also certain difficulties in conducting spinal anesthesia in patients with installed instrumentation, which negatively affects the possibility of its use.Conclusion. The issue of the course of pregnancy and delivery in idiopathic scoliosis continues to be very significant for both patients and spine surgeons who supervise them. The solution to this issue is impossible without cooperation with obstetrician gynecologists and anesthetists planning and administering anesthetic management during delivery (which is especially important in case of impossibility or significant restriction of spinal anesthesia use in such patients).
Цель исследования: обобщение собственного опыта применения метода трехмерного биомоделирования и изготовления индивидуальных металлоконструкций при оперативном лечении деформаций позвоночника различной локализации и этиологии, оценка его преимуществ, возможностей и эффективности. Пациенты и методы. В период с 2011 по 2018 г. трехмерные модели позвоночника были изготовлены для 52 пациентов с различными деформациями позвоночника: с врожденной многоплоскостной деформацией позвоночника (n=20), с деформацией верхнешейного отдела позвоночника (n=12), со спондилолистезом III-IV степени (n=10), с нейрогенным сколиозом (n=8), с нейрофиброматозом (n=2). Трехмерные модели изготавливали в масштабе 1:1 методом стереолитографии на основании компьютерной модели, выполненной по данным спиральной компьютерной томографии. Во всех случаях трехмерные модели использовали для предоперационного планирования, включая предполагаемую коррекцию деформации, декомпрессию и фиксацию позвоночника. На основании выполненных трехмерных моделей позвоночника в 26 случаях были изготовлены индивидуальные металлоконструкции для коррекции деформации и фиксации соответствующего отдела позвоночника: пластины для передней фиксации верхнешейного отдела позвоночника, шейно-грудного перехода, пластины и кейджи для фиксации пояснично-крестцового отдела позвоночника и имплантаты для выполнения позвоночно-тазовой фиксации. Результаты. Во всех случаях применение биомоделей позвоночника позволило получить существенную дополнительную информацию как при предоперационном планировании, так и во время операции. Отдаленный период наблюдения за пациентами составил 3 года. У всех пациентов операции по декомпрессии невральных структур и коррекции деформаций дали хорошие клинические и рентгенологические результаты. Применение индивидуальных имплантатов позволило достичь стабильной фиксации позвоночника во всех случаях, за исключением 3, в которых пришлось удалить имплантаты из-за инфекционных осложнений (n=1) и проблем с заживлением послеоперационной раны (n=2). Заключение. Полноразмерные объемные модели позвоночника при деформациях различной этиологии позволяют более полно оценить характер деформации, выполнять предоперационное планирование. Трехмерные объемные модели и компьютерное моделирование делают возможным изготовление индивидуальных металлоконструкций для фиксации позвоночника, что особенно актуально при тяжелых деформациях позвоночника. К л ю ч е в ы е с л о в а: аддитивные технологии, стереолитография, деформация позвоночника, 3D-печать, индивидуальные имплантаты К о н ф л и к т и н т е р е с о в: авторы заявляют об отсутствии конфликта интересов И с т о ч н и к ф и н а н с и р о в а н и я: без грантовой поддержки
Aim. We defined the prevalence of back pain in children and adolescents aged 917 years with spinal deformities. Material and methods. The cross-sectional study included 230 students with different spinal deformities aged 917 years. The prevalence of back pain, intensity, location, and situations in which it occurred were assessed via questionnaire. Results. Among 230 respondents, 186 (80.9%) admitted that they had experienced back pain (mainly in the lumbar spine) at various frequencies within the year preceding the study. Mild pain was prevalent (71% of respondents). Girls experienced back pain significantly more frequently than boys. Conclusions. Back pain in children and adolescents requires clinical and instrumental examination, including X-ray. Back pain is a frequent phenomenon in children with different spinal deformities. Тhe incidence of pain in children and adolescents with spinal deformities in our study is statistically higher than that of healthy individuals of the same age group.
Purpose: to study the dynamics of traumatism, to analyze the injury structure as well as the structure of mortality from external causes in adult population of the Russian Federation. Material and methods. Injury mortality and injury morbidity in adults were analyzed on the basis of official statistical data for the period 2013-2017. Results. The decline of indices with preservation of gender differences as well as the differences in both the age groups and between the urban and rural population was noticed. Conclusion. Development of complex preventive regional program is necessary to the decrease of traumatism and its negative sequels.
Results of open controlled study of 60 outpatients aged 45-70 years, with systemic osteoporosis (postmenopausal and idiopathic) and I-II stages of gonarthrosis by Kellgren - Lawrence classification are presented. All patients were divided into 2 groups: study group (n=30) and control group (n=30). Additional treatment for gonarthrosis (Artra drug for 3 months) was prescribed only to patients from the study group. It was shown that study drug decreased significantly (p
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