[Secondary spondylogenic epidural abscess]. / Vtorichnyi spondilogennyi épidural'nyi abstsess.

The article presents the results of a retrospective analysis of 200 patients with hematogenous osteomyelitis of the spine who were treated in the Tyumen Regional Clinical Hospital #2. Neurological disorders were present in 37 patients (group I); 163 patients (group II) had no neurological disorders; according to CT and MRI, secondary spondylogenic epidural abscess was diagnosed in 24 patients. At admission, the severity of neurological deficit assessed using the Frankel scale was as follows: Grade A - 6 cases, Grade B - 7 cases, Grade C - 17 cases, Grade D - 5 cases, and Grade E - 2 cases (epidural abscess without neurological deficit). At discharge, the severity of neurological deficit was as follows: Grade A - 3 cases, Grade B - 2 cases, Grade C - 13 cases, Grade D - 11 cases, and Grade E - 8 cases. In group I, 35 out of 37 patients underwent surgery; of these, 21 patients had improvements. There were no statistically significant differences in neurological deficit changes between patients with and without epidural abscess. In 12 patients, the neurological status remained unchanged. Two patients died. We present an analysis of the severity of neurological symptoms, depending on the spinal lesion level, and the results of microbiological tests. Changes in neurological symptoms in lesions of various spinal parts are described. Cervical spine lesions and the process caused by S. aureus are shown to significantly increase the risk of neurological disorders. An active surgical approach for complicated forms of spinal osteomyelitis provided partial or complete regression of neurological disorders in 62.2% of cases.

[Treatment of pseudarthrosis of the odontoid process of the axis and complicated transodontoid posterior subluxation of the atlas]. / Lechenie lozhnogo sustava zuba aksisa i oslozhnennogo chrezzubovidnogo podvyvikha atlanta kzadi.

A new method is described for reduction and successful treatment of false articulation of dens axis and neglected complicated transdens subluxation of the atlas to the back by means of skeletal traction applied to the bones of the skull with Ilizarov's apparatus in a 8-year-old boy.