[Modern minimally invasive technologies in spine surgery]. / Sovremennye maloinvazivnye tekhnologii v khirurgii pozvonochnika.

The number of spine surgeries has been annually increasing all over the world. It is associated with high incidence of spinal degenerative diseases, vertebral traumas and different tumors. Minimally invasive surgical techniques are being developed in spine surgery considering extended surgical procedures, long hospital-stay and disability period. These techniques minimize surgical trauma, shorten hospital-stay and disability period.

[Aortic intramural hematoma after transpedicular thoracic spine fusion]. / Intramural'naia gematoma aorty posle transpedikuliarnoi fiksatsii grudnogo otdela pozvonochnika.

A 55-year-old patient M. with compression fractures of Th7-Th8 underwent Th7-Th8 decompressive laminectomy, Th6-Th9 transpedicular spine fusion procedure on January 31, 2017. After that, multiple myeloma was diagnosed at the National Research Center for Hematology. Computed tomography revealed misplacement of a left Th6 screw, its anterior cortical perforation and penetration into the aorta. Signs of intramural hematoma were noticed in this area. The patient was referred to the Petrovsky National Research Center of Surgery. Two-stage surgical approach was preferred. Endovascular repair of the thoracic aorta (TEVAR) was followed by revision of transpedicular fusion system and reinstallation of the screw. Operation was performed on July 14, 2017. Postoperative period was uneventful.

[Surgical treatment of pain syndrome in lumbar spine in patients with obesity]. / Khirurgicheskoe lechenie bolevogo sindroma v poiasnichnom otdele pozvonochnika u bol'nykh s ozhireniem.

AIM: To analyze the reduction of pain severity, time of surgery, intraoperative blood loss, incidence of unintentional lesion of dura mater, infectious complications and hospital-stay after lumbar microdiscectomy. MATERIAL AND METHODS: The study included 104 patients aged 24-58 years (37 men and 67 women, mean age 45 years) who underwent lumbar microdiscectomy within January 2015 - June 2016. The main and control groups consisted of 48 and 56 patients with and without obesity respectively. In all cases lumbar microdiscectomy was made. Pain syndrome was assessed by visual analogue scale and Oswestry questionnaire. RESULTS: In 6 weeks, 6 and 12 months after surgery significant improvement of both lumbar and leg pain was observed. Significantly reduced pain was stable and similar in both groups within follow-up although there was a tendency to increased pain in long-term period in group 1. Blood loss and infections were slightly higher in obese group while surgery time and hospital-stay were significantly higher in these patients. CONCLUSION: Features of patients with excessive body weight should be considered prior to elective surgery. Probably, implants are advisable to stabilize spinal motion segment and improve the outcomes among patients with excessive body weight.