Saratov JOURNAL of Medical and Scientific Research

spine

Dorsal correction of rigid posttraumatic deformities of thoracic spine in spinal cord injury

Year: 2018, volume 14 Issue: №3 Pages: 611-617
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shul'ga А.Е., Zaretskov V.V., Likhachev S.V., Smolkin A.A.
Organization:
Summary:

Aim: the analysis of the outcomes of dorsal remedial operation in patients with rigid posttraumatic deformities in thoracic spine accompanied by spinal cord injury. Material and Methods. We analyzed surgical outcomes of transpe-dicular anchorage of 28 patients aged 34.5±19.5 with rigid posttraumatic deformities of thoracic spine: 12 patients with acute injury (1st group), 16 patients with long-term deformities (2nd group). The results were estimated by the severity of neurological deficit, pain intensity,the grade of deformity correction as well as by the LQ indexes. All interventions were performed from lateral medial approach with transpedicular anchorage. Results. There were no changes of neurological deficit in both patient groups, however we managed to obtain sufficient spine deformity correction. Pain intensity in patients of 1st group was 6 (5.3-7.8), function — 46.5 (42.5-49.8); 12 months postsurgically pain intensity corresponded to the score of 0 (0.0-0.1); function — 82 (79.0-86.0). The intensity of pain syndrome was significantly reduced in 2nd group patients (VAS reduced from 6 (4.0-7.0) to 1 (0.0-2.0), which in turn allowed for earliest rehabilitation of patients in sedentary position, thus increasing their mobility and functional independence (FIM increased from 70 (65.0-76.0) to 92 (89.0-95.0). Conclusion. Single-step dorsal surgical interventions in patients with rigid deformities of thoracic spine allow restoring normal spinal column axis, performing reconstruction of spinal cord column and safely stabilize injured locomotor segments both in acute and in late periods of spinal cord injury.

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The epidemiology of spine and spinal cord injuries

Year: 2018, volume 14 Issue: №3 Pages: 592-595
Heading: Traumatology and Orthopedics Article type: Review
Authors: Tolkachev V.S., Bazhanov S.P., Ulyanov V.Yu., Fedonnikov A.S., Ninel V.G., Salikhu Kh., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The article contains domestic and foreign data reflecting epidemiological peculiarities of traumatic injuries of spine and spinal cord, their character and incidence among various population groups with respect to gender and age parameters. The study outlines spine and spinal cord injury structure with regard to modern classification schemes, introduces injury incidence data, specifies indexes of lethality in spine and spinal cord injuries.

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The tactics of surgical treatment in metastatic lesions of upper cervical spine.

Year: 2018, volume 14 Issue: №3 Pages: 498-501
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Bazhanov S.P., Gulyaev D.A., Ulyanov V.Yu., Ostrovskiy V.V., Tolkachev V.S.
Organization: The Almazov National Medical Research Centre, Head of Second Cerebral and Spinal Cord Tumors Department, Doctor of Medical Sciences
Summary:

We demonstrated a successful case of surgical treatment of the patient with metastatic lesion of upper cervical spine with respect to multidisciplinary approach. We performed simultaneous two-stage surgical intervention, the first stage being occipitospondylodesis by multi-segment construction; and second —tumor resection from expanded combined access. It has been stated that the proposed surgical tactics allows performing curative resection in one surgical session without neurological deficit buildup in the postoperative period.

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On the issue of surgical reconstruction in complicated aggressive hemangiomas of sacrolumbar transitional spine

Year: 2018, volume 14 Issue: №3 Pages: 487-492
Heading: Traumatology and Orthopedics Article type: Author's opinion
Authors: Arsenievich V.B., Zaretskov V.V., Likhachev S.V., Stepukhovich S.V., Mizyurov S.A., Sadchikov D.D.
Organization: Saratov State Medical University
Summary:

We presented surgical results of complicated aggressive hemangioma treatment in transitional sacrolumbar spine. It has been stated that individual peculiarities of decompressive stabilizing surgery depend on the volume of vertebral lesions and their results improve in the combination with presurgical X-ray therapy.

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Decompressive stabilizing operations in the treatment of complicated aggressive hemangiomas of transitional spine.

Year: 2017, volume 13 Issue: №3 Pages: 746-751
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Likhachev S.V., Arsenievich V.B., Salina E.A., Stepukhovich S.V., Norkin A.l., Mizyurov S.A., Zaretskov V.V.
Organization: Saratov State Medical University
Summary:

The aim: to study the efficiency of surgical treatment of complicated aggressive hemangiomas in transitional spine. Material and Methods. Decompressive stabilizing operations were made to 26 patients aged 35-52 years with hemangiomas of vertebral bodies. Individual surgical features varied due to the character and level of the injury. Results. In the experimental patients' group in admission there was neurological deficit of compressional origin associated with the critical values of luminal narrowing due to the epidural component of the neoformation. Stable antalgic effect and decrease in neurological deficit were seen postsurgically. Conclusion. While choosing the surgical option of decompressive stabilizing treatment a surgeon should take into account roentgenomorphometric features of the injured vertebrae. Adequately planned intervention fulfilled with the account of the injury character allows obtaining favorable outcomes as well as LQ improvement, neurological deficit decrease and the elimination of pain syndrome.

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Comparative retro- and prospective analysis of treatment outcomes in patients with SCI and cervical spine injuries in acute and early periods of traumatic disease

Year: 2017, volume 13 Issue: №3 Pages: 710-715
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Bazhanov S.P., Ulyanov V.Yu., Chibrikova Yu.A., Biryukova A.V., Norkin I.A., Gulyaev D.A., Salihu H.
Organization: Almazov National Medical Research Centre, Saratov State Medical University
Summary:

The aim: to conduct comparative retro- and prospective study of treatment outcomes in patients with cervical spine and SC injuries on the basis of assessment scale analysis. Material and Methods. 217 patients with closed cervical spine and SC injuries commeasurable by age, degree of neurological deficit, acute physiological and chronic state disorders were enrolled into the study. 177 patients comprised the main group (prospective study) and 40 — comparison group (retrospective study). To compare treatment outcomes we used Karnofsky score (Karnofsky, 1949), a quantitative assessment score for general patient status scales, APACHE II, Acute Physiology and Chronic State Evaluations (Knaus — Draper, 1985) and SCIM II, Spinal Cord Independence Measure Scale. Results. Comparative analysis based on the quantitative values of assessment scales, indicates an improvement of short-term treatment outcomes in patients with SC and cervical spine injuries in the main group. Conclusion. Complex approach to differentiated surgical treatment management and unique neuroprotection methods significantly improves short-term treatment outcomes having positive effect on general patient status, severity of acute physiological and chronic state disorders and patients' independence in the post-surgical period.

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Electroneuromyographic estimation of the functional condition of the lumbar spine department

Year: 2017, volume 13 Issue: №1 Pages: 157-160
Heading: Neurology Article type: Original article
Authors: Nazarenko N.V., Remnyov A.G., Golyakhovsky A.V.
Organization: Sanatorium "Barnaulsky", Altai Regional Diagnostic Center
Summary:

Purpose: to establish the nature of the change in the F-wave parameter in patients with degenerative spondylolis-thesis of the lumbar spine, radicular syndrome. Material and methods. 20 patients with a clinical diagnosis of degenerative spondylolisthesis, 20 patients with radicular syndrome due to herniation of intervertebral disc, 20 patients of the control group were examined. Results. Decreased F-wave latency in the group of patients with degenerative spondylolisthesis, no change in F-wave latency in the group of patients with radicular syndrome. Conclusion. A screening assessment of the functional state of the lumbar spine is possible by electroneuromyography

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Correction of immune disorders in patients with malignant tumors at level of craniovertebral junction and upper cervical spine

Year: 2013, volume 9 Issue: №2 Pages: 295-301
Heading: Oncology Article type: Original article
Authors: Bazhanov S.P., Uljanov V.Yu., Norkin I.A., Gulyaev D.A.
Organization: Russian Scientific Research Institute of Neurosurgery n.a. Professor A. L. Polenov
Summary:

Objective: To study the cellular and humoral immunity in patients with malignant tumors of the upper cervical spine. Material and methods: The study included 22 patients with malignant tumors of the craniovertebral junction and upper cervical spine. To assess the function of the immune system the methods of population and subpopulation immuno-phenotyping of peripheral blood lymphocytes have been applied. Cytokine parameters and functional status (cytotoxic) activity of NK-cells have been studied using immunofermental methods. The indices have been presented in absolute and relative terms. All the patients have been subjected to the adjuvant therapy. Results: Correction of cellular immunity has led to significant increase in CD3 + (T-lymphocytes) and CD3 + CD8 + (T-killers). Cytokine levels in the groups studied in the dynamics have not been significantly altered. The changes of cytotoxic (functional) activity of NK-cells in the first group after the combined treatment have been considered to be higher than before the treatment. Cytotoxic index of (functional) activity of NK-cells in the second group under the study after the combined treatment has been determined to be lower than before the treatment. Conclusion: It has been found out that the application of complex treatment accompanied by immunotropic therapy may positively influence the immune status.

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