[Resection of S1 root schwannoma with extravertebral retroperitoneal spread via posterior median and laparoscopic approach]. / Odnomomentnoe udalenie nevrinomy pravogo spinnomozgovogo koreshka S1 s ekstravertebral'nym retroperitoneal'nym rasprostraneniem zadnim sredinnym i laparoskopicheskim dostupom (klinicheskoe nablyudenie).

The authors report simultaneous surgical treatment of the right S1 root schwannoma with extravertebral retroperitoneal spread. Well-equipped operating theatre, professional experience and multidisciplinary approach involving neurosurgeons and abdominal surgeons ensure total minimally invasive simultaneous resection of schwannoma via posterior median and laparoscopic approach.

[Rigid transpedicular fusion surgery in the treatment of degenerative lumbar stenosis]. / Rigidnaya transpedikulyarnaya fiksatsiya v lechenii patsientov s degenerativnym poyasnichnym stenozom.

OBJECTIVE: To compare an effectiveness of different methods of rigid transpedicular fixation and decompression in patients with degenerative lumbar stenosis. MATERIAL AND METHODS: A prospective study included 160 patients with degenerative lumbar spine stenosis. In the first group (n=37), patients underwent laminectomy and transpedicular fixation, in the second group (n=60) - laminectomy, transpedicular fixation and implantation of interbody fusion cage. In the third group (n=30), interlaminar decompression and transpedicular fixation were carried oud, in the fourth group (n=33) - interlaminar decompression, transpedicular fixation and implantation of interbody fusion cage. Surgeries were performed in three clinics in Moscow. Outcomes were assessed using a visual analogue scale (VAS) and Oswestry questionnaire in 1 and 2 years after surgery. Between-group comparison of the outcomes was performed. In patients with unfavorable outcome, we analyzed the cause of unsatisfactory result and risk factors. RESULTS: Satisfactory result was noted in 103 patients (64%) in 2 years after surgery. Outcomes were comparable in all groups. More significant regression of back pain was noted in group II (laminectomy, transpedicular fixation, interbody cage) compared to other groups. Preoperative risk factors of adverse outcome were resting leg pain VAS score > 4 and age over 71 years. Incidence of pseudoarthrosis and back pain was higher among patients without interbody cage. Incidence of adjacent level lesion was higher among patients with interbody cages. CONCLUSION: Decompression type and implantation of interbody cage do not significantly change postoperative outcomes in most patients with degenerative lumbar stenosis undergoing transpedicular fixation. However, interbody cage implantation during transpedicular fixation is advisable in patients with severe back pain (VAS score > 5-6).

[Optical coherence tomography and optical coherence tomography-angiography in the diagnosis of chiasmo-sellar region compression]. / Opticheskaya kogerentnaya tomografiya i opticheskaya kogerentnaya tomografiya-angiografiya v diagnostike kompressii khiazmal'no-sellyarnoi oblasti.

Preservation of visual functions in patients with chiasmo-sellar region compression (CSRC) is possible with early diagnosis and surgical decompression. PURPOSE: To analyze the parameters of optical coherence tomography (OCT) and optical coherence tomography-angiography (OCTA) in patients with CSRC. MATERIAL AND METHODS: The study included 10 patients (20 eyes) with CSRC, 15 healthy volunteers (30 eyes). OCT, OCTA was performed on Cirrus HD-OCT 5000 AngioPlex™ (Carl Zeiss Meditec, U.S.A.) with AngioVue system. RESULTS: Patients with CSRC were revealed to have decreased thickness of ILM-RPE in the nasal sector of outer circle (p<0.001) and average mGCIPL - total and for all six sectors (p<0.001), decreased RNFL in the inferior sector (p=0.017); decreased superficial vessel density (SVD) and perfusion density in the inner and outer circle areas and in all sectors of the ETDRS grid (p<0.001) except temporal; in the peripapillary area, decreased vessel perfusion density (VPD) in the inferior sector (p=0.025), capillary flux index (CFI) in all sectors (p<0.001; p=0.025 in the inferior sector). Informative diagnostic criteria included ILM-RPE in nasal sector of the outer circle (AUC=0.896); mGCIPL in the inferonasal sector (AUC=0.914), average (AUC=0.846), superior (AUC=0.829) and superonasal (AUC=0.846) sectors; average SVD (AUC=0.805) and SVD in the inner circle area (AUC=0.810); CFI in the inferior sector (AUC=0.806) with p<0.001. CONCLUSION: In CSRC, changes can be seen in OCT and OCTA parameters recorded in the macular and peripapillary regions before the changes in the central visual field. Informative diagnostic OCT and OCTA criteria can help diagnose the pathology early, expand the indications for decompression, and preserve the visual funcitons.