[Surgical treatment of spine injuries]. / Khirurgicheskoe lechenie povrezhdenii pozvonochnika.

The history of spinal fixation started in the 19th century and had an intensive development in subsequent years. Special progress in surgery for spinal traumatic injuries was noted in the Second World War. Last decades minimally invasive spinal surgical techniques are developed and introduced in everyday practice.

[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.

[Analysis of dynamic implants use in surgical treatment of degenerative lumbar spine stenosis].

AIM: To improve the results of surgical treatment of lumbar spine stenosis. MATERIAL AND METHODS: Surgical treatment of 84 patients was analyzed. There were 2 groups consisting of 48 and 36 patients respectively. Advanced decompression and fusion were performed in group 1, minimally invasive decompression (flavectomy, marginal arch resection, facetectomy) with implantstion of interspinous dynamic implants DIAM -- in group 2. Patients with isthmic spondylolisthesis were excluded. RESULTS AND DISCUSSION: Both methods did not show difference in efficacy of leg pain relief during follow-up (1.7--8.5 years). 16.7% of patients after fusion of more than 2 segments had pain above and below fusion area in long-term postoperative period. Such pain was not observed in group 2. One patient of the 1st group had fixation system destruction that required repeated intervention. Groups have not difference in back pain severity after surgery on 1 segment. Also less intraoperative blood loss and duration of surgery were established in group 2. CONCLUSION: Minimally invasive decompression with implantstion of interspinous dynamic implants is effective and safe alternative to advanced decompression and fusion in lumbar spine stenosis management.

[The miniinvasive technologies in surgical treatment of diseases and traumas of the spine].

The analysis of miniinvasive surgery for degenerative and traumatic diseases of the spine was conducted. Such methods as microsurgical diskectomy, dynamic implants, vertebroplasty, vertebrae stenting were featured. The use of miniinvasive methods allow the sunstantioal decrease of the hospital-stay time and fasten the rehabilitation.