Individual Lordotic Cages Implantation and Radiographic Evaluation of Segmental and Lumbar Lordosis Correction for Patients with Adult Degenerative Scoliosis

Denisov, Anton; Пташников, Д. А.; Mikhaylov, D. A.; Михайлов, Д. А.; Masevnin, Sergey; Smekalenkov, Oleg; Zaborovskii, Nikita

doi:10.21823/2311-2905-2020-26-2-71-78

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…Аддитивные технологии нашли свое применение и в изготовлении индивидуальных имплантатов для спондилодеза (рис. 3) [62].…”

Section: декомпрессия и продолжительный спондилодез с коррекцией дефо...unclassified

“…Денисов и соавт. [62] подтвердили, что применение лордозирующих кейджей с углами 20-30° значительно увеличивает сегментарный лордоз и LL. Степень полученной коррекции сегментарного лордоза и LL была идентична прогнозируемым результатам (рис.…”

Section: декомпрессия и продолжительный спондилодез с коррекцией дефо...unclassified

“…Спондилограмма пациента с ADS. Выполнены протяженная транспедикулярная фиксация и передний спондилодез индивидуальными имплантами (из [62]). подтверждение в работе C.A.…”

Section: выбор уровня спондилодезаunclassified

“…Частота возникновения патологии высока, особенно у пожилых пациентов с пояснично-грудным кифозом >20° и гиполордозом поясничного отдела позвоночника. Стресспереломы металлоконструкций случаются при асептическом расшатывании винтов в дистальном и проксимальном уровнях фиксации, часто при нарушении сагиттального баланса, особенно при использовании протяженного спондилодеза [62]. Spine (Phila Pa 1976).…”

Section: осложнения связанные с хирургическим лечениемunclassified

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Degenerative scoliosis of the spine: diagnosis, classification and surgical approach in older patients

Yarikov

Викторович²,

Denisov³

et al. 2021

Journal of Clinical Practice

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Adult scoliosis is a deformity of the spine with an angle of more than 10 (according to Cobb) in people with a fully formed bone system. Due to the aging of the population, the improvement of surgical techniques, the appearance of new implants and the improvement of anesthetic aids, the problem of degenerative scoliosis is increasingly being considered from the point of view of the possibilities of surgery. There are many theories that contribute to the formation of degenerative scoliosis. Conservative therapy of degenerative scoliosis includes non-steroidal anti-inflammatory drugs, corset therapy, epidural and paravertebral injections with glucocorticosteroids, physical therapy, and physical therapy. With complete ineffectiveness of conservative therapy and with a significant decrease in the quality of life of the patient, the question of performing surgical intervention is individually decided. Currently, the question of the role and scope of surgical intervention in individuals with this pathology remains debatable. The choice of surgical intervention depends on a thorough assessment of clinical symptoms, neurological status, data of instrumental methods of examination and mandatory consideration of the parameters of the global vertebral-pelvic balance. Therefore, in this article, special attention is paid to the algorithms of surgical treatment based on the choice of the type of decompression and the length of the fusion. The paper describes the generally accepted criteria for selecting the level of spondylosynthesis. Special attention is paid to the risk factors for surgical treatment. As well as the complications associated with surgical treatment are described.

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Section: декомпрессия и продолжительный спондилодез с коррекцией дефо...unclassified

Section: выбор уровня спондилодезаunclassified

Section: осложнения связанные с хирургическим лечениемunclassified

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Degenerative scoliosis of the spine: diagnosis, classification and surgical approach in older patients

Yarikov

Викторович²,

Denisov³

et al. 2021

Journal of Clinical Practice

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Application of additive 3D printing technologies in neurosurgery, vertebrology and traumatology and orthopedics

Yarikov

Викторович²,

Gorbatov

et al. 2021

Journal of Clinical Practice

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Additive technologies are now widely used in various fields of clinical medicine. In particular, 3D printing is widely used in neurosurgery, vertebrology and traumatology-orthopedics. The article describes in detail the basic principles of medical 3D printing. The modern classification of 3D printers is presented based on the following principles of printing: FDM, SLA, SLS and others. The main advantages and disadvantages of the above-mentioned 3D printers and the areas of clinical medicine in which they are used are described. Further in the review, the authors discuss the experience with 3D printing applications, based on the data of the modern scientific literature. A special attention is paid to the use of 3D printing in the manufacture of individual implants for cranioplasty. 3D printing technologies in reconstructive neurosurgery make it possible to create high-precision implants, reduce the time of surgical intervention and improve the aesthetic effect of the operation. The article also presents the data of the modern literature on the use of 3D printing in vertebrology, where a special role is given to the use of guides for the installation of transpedicular screws and the use of individual lordosing cages. The use of individual guides, especially for severe spinal deformities, reduces the risk of metal structure malposition and the duration of surgical intervention. This technique is also widely used in traumatology and orthopedics, where individual implants made of titanium, a bone-substituting material, are created using 3D printing, thanks to which it is possible to replace bone defects of any shape, complexity and size and create hybrid exoprostheses. The role of 3D modeling and 3D printing in the training of medical personnel at the present stage is described. In conclusion, the authors present their experience of using 3D modeling and 3D printing in reconstructive neurosurgery and vertebrology.

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Histological and Morphometric Changes in the Femoral Nerve During Lateral Interbody Fusion of the Lumbar Spine: Experimental Study

Варсегова

Дюрягина²,

Antonov³

et al. 2021

Traumatology and Orthopedics of Russia

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Neuropathies of the lumbar plexus trunks, in particular those of the femoral nerve, are the most common complications of lateral interbody spondylodesis of the lumbar spine. Modeling of this surgical intervention in normal animals experimentally makes it possible to assess the degree of its trauma to the nervous structures, and to understand what is the reason for the persistence or aggravation of neurological symptoms iatrogenic injuries or the existing pathology progression. Purpose of the Study. To study histological and morphometric changes in the femoral nerve in the long-term periods after modeling of the lateral interbody spondylodesis of the canine lumbar spine. Design of the Study. An experimental prospective continuous uncontrolled study. Material and Methods. Discectomy via lateral approach was performed in 18 mongrel dogs (aged 2-3 years, mass 13.2-17.6 kg) at the level of L4-5 и L5-6, interbody titanium implants were mounted, the lumbar spine was stabilized with a wire device for external fixation within 30 days. Clinical-and-neurological evaluation was performed, as well as histological investigation of the femoral nerves from the side of surgical approach. Results. In the early postoperative period a temporary decrease in the femoral nerve function was observed, which was manifested by the disorder of the support function and muscle weakness of the pelvic limbs, decrease in the knee reflex, the foot support shift to the metatarsal pad. Later, until the end of the study (18 months), the general condition of all animals was satisfactory, there were no disorders of the limb support function and motor reflexes. After six months, in the femoral nerve there was 4-fold decrease in the proportion of large fast-conducting myelin fibers D 10 m and 3-fold increase in that of the small ones. The mean axon diameter and myelin thickness were 62% and 53% of the norm. After 12-18 months, the dimensional characteristics of myelin fibers were restored. During the entire experiment, 4-6% of myelin fibers were reactively-and-destructively altered. Conclusions. The modeling of the lateral interbody spondylodesis of the lumbar spine in normal animals experimentally demonstrated the absence of neurological symptoms after 6-18 months, which indicated low invasiveness of the surgical intervention. Nevertheless, the subclinical reactive-and-destructive changes in the myelin fibers of the femoral nerve revealed 6 months after the surgery indicated the need for preventive anti-neurotic therapy.

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Individual Lordotic Cages Implantation and Radiographic Evaluation of Segmental and Lumbar Lordosis Correction for Patients with Adult Degenerative Scoliosis

Cited by 4 publications

References 25 publications

Degenerative scoliosis of the spine: diagnosis, classification and surgical approach in older patients

Degenerative scoliosis of the spine: diagnosis, classification and surgical approach in older patients

Application of additive 3D printing technologies in neurosurgery, vertebrology and traumatology and orthopedics

Histological and Morphometric Changes in the Femoral Nerve During Lateral Interbody Fusion of the Lumbar Spine: Experimental Study

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