Saratov JOURNAL of Medical and Scientific Research

Shulga A.Е.

Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V. I. Razumovsky Department of Innovation Projectsin Neurosurgery and Vertebrology Research Scientist, Candidate of Medical Science

Circular anchorage of the spine in the correction of scoliotic deformity.

Year: 2018, volume 14 Issue: №3 Pages: 586-591
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Stepukhovich S.V., Zaretskov V.V., Arsenievich V.B., Likhachev S.V., Shul'ga A.E., Zaretskov V.V.
Organization:
Summary:

Aim: to demonstrate clinical case of surgical treatment of scoliotic deformity of the spine in a 17-year-old child. It is shown that the correction of sagittal profile achieved by 2-stage intervention and normalized global balance parameters in combination with circular spine anchorage allows providing earliest and fullest rehabilitation of a child.

AttachmentSize
2018_3-1_586-591.pdf1.64 MB

Biomechanical aspects of circular spondylosynthesis of transitional thoracolumbar spine

Year: 2018, volume 14 Issue: №3 Pages: 560-566
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Likhachev S.V., Zaretskov V.V., Arsenievich V.B., Shul'ga A.E., Shchanitsyn I.N., Skripachenko K.K.
Organization:
Summary:

Aim: to present the potential of biomechanical modeling in individual choice of optimal surgical correction method for transitional thoracolumbar spine injury. Material and Methods. We built solid-base 3-dimensional model of the investigated spine segment in Mimics13 on the basis of CT data of injured thoracolumbar spine. Cage and anchorage models were created in CAE system SolidWorks. Numeric modeling was performed in ANSYS in Workbench medium. We analyzed full movement fields, their maximum values for each model as well as equivalent stress in vertebra and anchorage systems. Results. The analysis of equivalent stress and full movement fields emerging in the models under seven basic types of load revealed the most stable spondylosynthesis model which is circular spine

AttachmentSize
2018_3-1_560-566.doc77.62 KB

Differentiated approach to surgical treatment of patients with rigid posttraumatic deformities of thoracic and lumbar spine

Year: 2017, volume 13 Issue: №3 Pages: 772-779
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shul'ga А.Е., Zaretskov V.V., Bogomolova N.V., Korshunova G.A., Smol'kin A.A.
Organization:
Summary:

The aim: to investigate the outcomes of surgical treatment of patients with rigid posttraumatic deformities in thoracic and lumbar spine on the basis of the comparative analysis of different approaches to the planning of operative intervention management. Material and Methods. A comparative analysis of the results of surgical treatment of 138 patients (main group) with old injuries of thoracic and lumbar spine was carried out with the help of the proposed surgery managing algorithm and 86 patients (comparison group) — without taking the given algorithm into account. The choice of surgery managing in the main group of patients was based on the study of the spinal deformity degree, pain syndrome intensity and life quality indices of patients before and after surgery. Results. In the main group in 122 (88,4%) patients after the surgery spinal deformity correction exceeding 80% was achieved, pain syndrome regressed in accordance with the visual analog scale up to 3 points and less, life quality indices improved up to the level of 0-25%. Conclusion. The application of the proposed algorithm approach enables surgeons to get persistent positive outcomes in the majority of cases.

AttachmentSize
2017_03-2_772-779.pdf1022.65 KB

Towards the causes of secondary post-traumatic deformations of thoracic and lumbar spine

Year: 2015, volume 11 Issue: №4 Pages: 570-575
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shulga А.Е., Zaretskov V.V., Ostrovsky V.V., Arsenievich V.B., Smolkin A.A., Norkin I.A.
Organization:
Summary:

The purpose of the study is to analyze and systematize main causes of secondary spine deformations forming in patients who had operations due to thoracic and lumbar spine damages. Material and Methods. The analysis of poor surgical results of 155 patients previously operated due to various thoracic and lumbar spine damages has been conducted. All patients had complications associated with secondary spinal column deformations at various time after the intervention. Standard investigation included the analysis of patients' complaints, their previous history, somatic, neurological and orthopedic status. Results. The intensity of spinal column deformation was defined due to the character and level of primary trauma structurally characterized predominantly by unstable damages. However as it has been found in this research the main cause of this complicated pathology lied in the number of tactical and technical pitfalls of primary surgical treatment. Conclusion. Surgical operations due to secondary post-traumatic deformations in most cases are laborious and are accompanied by significant surgical trauma therefore systematization and analysis of the main causes of poor results of primary spine surgery may contribute to the preventive treatment of this type of pathology.

AttachmentSize
2015_04_570-575.pdf456.58 KB

Transpedicular fixation in comminuted fractures of bodies of thoracic and lumbar vertebrae

Year: 2014, volume 10 Issue: №3 Pages: 441-446
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Zaretskov V.V. Arsenievich V.B, Likhachev S.V., Shulga A.E., Titova Ju.l..
Organization:
Summary:

Research Objective: improvement of transpedicular fixation technique in cases with spine injuries accompanied by vertebral body splintering. Material and Methods. Transpedicular spondylosynthesis was performed in 52 patients aged 18-49 years with comminuted fractures of thoracic and lumbar vertebral bodies. Individual peculiarities of the operation depended on the character of the injury ascertained during the preoperative examination. Standard roentgenography and computer tomography were used. Results. Lasting antalgic effect was observed in 94,2% of the operated patients. In cases with type A3 fractures according to F. Magerl the rate of the surgical correction of the pathologic posttraumatic kyphotic deformity averages 87%. Injuries classified as type A2, B2 or C2 were the indication for transpedicular os-teosynthesis by advanced techniques. Conclusion. Transpedicular spondylosynthesis is one of the effective methods of treatment of patients with comminuted fractures of thoracic and lumbar vertebral bodies, and the choice of carrying out of the procedure depends on the injury character. In cases with comminuted fractures of type A2, B2, C2 it is reasonable to perform transpedicular spondylosynthesis with introduction of the transpedicular screws into the injured vertebral body, and the technique of their use depends on the injury character.

AttachmentSize
2014_03_441-446.pdf850.47 KB

Experience of surgical treatment of unstable СII vertebral fractures

Year: 2010, volume 6 Issue: №2 Pages: 432-435
Heading: Traumatology and Orthopedics Article type: Short message
Authors: V.V. Ostrovskiy, V.G. Ninel, A.E. Shulga, A.A. Smoljkin, E.A. Anisimova
Organization: Saratov State Medical University, Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

CII arch fractures are divided into groups according not to anatomical localization, but to the instability degree resulted from the trauma. Effendi et al classification became greatly widespread. |t is based on the same stability criteria, but it is simpler, intelligible and gives the plan of treatment. All the fractures according to this classification are divided into three types: the first one consists in stable fractures in which even in functional images there is no any rough deformation at the level of CII segment; the second one consists in damages with significant angular (more than 11°) or shift (more than 3,5 mm) deformations, that indirectly indicates damage of soft tissue structures, and first of all diskoligamentous complex. The services of the authors of the present classification are also that they were the first who had defined fracture-dislocation of CII arch, attributed it to the third type. Choice of surgical procedure in unstable CII-III vertebral fractures is ventral spondylosyndesis of CII-III carried out by submaxillary approach after the preliminary closed elimination of deformation of upper cervical part of spine. The differentiated approach to the implant choice with an allowance for morphometric data allows to receive adequate decompression of nervous - vascular structures and reliable stabilization of the damaged segment

AttachmentSize
201002_432_435.pdf365.44 KB

Treatment Results of Injuries of Thoracic and Lumbar Backbone Departments at Osteoporosis Patients

Year: 2009, volume 5 Issue: №2 Pages: 245-247
Heading: Traumatology and Orthopedics Article type: Original article
Authors: V.V. Zaretskov, A.Y. Shulga, A.Y. Chomartov, V.B. Arsenievich, D.Y. Sumin, A.I. Norkin
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

Information relates to radiologic (computer tomography) manifestations providing the visualization of thoracic and lumbar backbone department injuries at osteoporotic patients. Contemporary methods of transcutaneous and trans-pedicle vertebroplasty with bone cement allows to obtain a stable positive healing effect against such pathologies.

AttachmentSize
200902_245_247.pdf2.42 MB