scholarly journals Tactics of surgical treatment of patients with lumbar spondylolysis

2020 ◽  
Vol 22 (2) ◽  
pp. 84-93
Author(s):  
K. A. Nadulich ◽  
V. V. Khominets ◽  
E. B. Nagornyi
Keyword(s):  
Surgical Treatment ◽  
Young Patients ◽  
Pain Syndrome ◽  
Functional Results ◽  
Intervertebral Discs ◽  
Pathological Process ◽  
Iliac Crest Bone Graft ◽  
Lumbar Spondylolysis ◽  
Pars Interarticularis ◽  
Segmental Fixation

The bilateral defect of the pars interarticularis (spondylolysis) is often the cause of low back pain syndrome and can lead to development of spondylolistesis. In some cases inefficiency of conservative treatment of this condition forces orthopedists to use surgical technologies. At the same time, in young patients with intact intervertebral discs, the rigid segmental fixation of the spine should be avoided. Where no neural decompression is needed, selective osteosynthesis of the pars defect is an optimal technique. The authors present the results of surgical treatment of 15 patients with single and two-level lumbar spondylolysis, 4 of which revealed minimal I degree lytic spondylolystesis of the L5 vertebrae. Localization of the pathological process in all patients was noted on both sides. In two patients spondylolysis defects of two vertebrae were detected (in one- adjacent L4 and L5, in the other - L2 and L4 vertebrae with sacralization of L5). The average period from the onset of symptoms ranged from 6 months to 2 years (an average of 14 months). All patients undergone bone autoplasty with iliac crest bone graft, and osteosynthesis of vertebral arches by a combined laminar-transpedicular system of the screw - rod - hook type. All patients had excellent and good anatomic and functional results. The used method of surgical treatment of patients of this category should be considered pathogenetically justified, as it is aimed at repair of spondylolytic defects as the main cause of segmental instability and forward displacement of vertebrae. The possibility to avoid fixation of intact segments of spine allows to categorize this operation as organ-preserving.

scholarly journals Porous TiNi Implants in Surgery of Spine Degenerative Diseases

2017 ◽  
Vol 2 (1) ◽  
pp. 334
Author(s):  
A.E. Simonovich ◽  
N.G. Fomichev
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Pain Syndrome ◽  
Functional Results ◽  
Spiral Ct ◽  
Bone Block ◽  
Results Of Treatment ◽  
Block Formation ◽  
Osteoplastic Material ◽  
Metal Block

Objective. To evaluate the efficacy of using porous TiNi implants for interbody fusion in the treatment of lumbar spine degenerative diseases.Material and Methods. A total of 570 patients with degenerative lumbar spine disease were operated on with porous TiNi implants. Surgical treatment included stabilization and decompression and stabilization operations through posterior and anterior approaches and endoscopic transabdominal operations. Results of surgical treatment were followed-up for the period of 3 to 24 months. The change of pain syndrome was evaluated using a Visual Analogue Scale (VAS) and Oswestry Disability Index. The degree of interbody bone block formation was assessed based on X-ray and spiral CT data.Results. Functional results of treatment were evaluated at 18-24 months after surgery as good and satisfactory in 94.1% of cases, and the formation of interbody bone-metal block was noted in 94.8% of cases.Conclusion. Nikelid Titanium exhibits good osseointegration properties and can be used as osteoplastic material without additions of bone tissue, which simplifies operation, reduces its traumaticity, and provides good and satisfactory treatment results in 94.1% of cases.

scholarly journals Facet syndrome. Minimally invasive surgical treatment. (Clinical case with a literature re-view).

2021 ◽  
Author(s):  
Vitaliy E. Potapov ◽  
Vladimir Alekseevich Sorokovikov ◽  
Sergey Nikolaevich Larionov ◽  
Aleksandr Petrovich Zhivotenko
Keyword(s):  
Surgical Treatment ◽  
Facet Joint ◽  
Pain Syndrome ◽  
Intervertebral Discs ◽  
Facet Joints ◽  
Spinal Motion ◽  
Minimally Invasive Surgical ◽  
High Incidence ◽  
Facet Syndrome ◽  
Minimally Invasive Surgical Treatment

The problem of the pathology of the facet joints of the lumbar spine remains significant and is medical and social due to persistent pain syndrome, high incidence of morbidity and frequent disability outcomes. The complex anatomical and topographic relationships of the facet joints, intervertebral discs and radicular nerves force clinicians to pay attention to the pathology of facet syndrome. A pair of facet joints and an intervertebral disc constitute a functional unit - a "three-component complex" and are interconnected with each other. The article examines the anatomical and morphological features and radiological classifications of degenerative changes in the facet joints, which are currently used in clinical practice. Facet joint pathologies are the most common nosological form of degenerative-dystrophic process (spondyloarthrosis) and a potential source of pain with the formation of instability of the spinal motion segment and the formation of chronic pain syndrome. The features of facet syndrome diagnostics are presented on a clinical example of surgical treatment by means of laser dereception of facet joints.

scholarly journals Surgical treatment of military with multilevel lumbar vertebral spondylolysis

2020 ◽  
Vol 6 (2) ◽  
pp. 63-73
Author(s):  
V. V. Khominets ◽  
K. A. Nadulich ◽  
E. B. Nagorny ◽  
A. V. Teremshonok ◽  
A. L. Kudyashev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Young Patients ◽  
Lumbar Vertebra ◽  
Functional Results ◽  
Good Treatment ◽  
Fixation Technique ◽  
Treatment Results ◽  
Organ Sparing

Purpose. To demonstrate the effectiveness of an isolated fixation technique of multilevel spondylosis disorders in young patients.Materials and methods. Two military men were operated for multilevel spondylosis of lumbar vertebra (LII, LIV and LIV, LV).Results and discussion. Patients underwent bone autoplasty and osteosynthesis of vertebral arches using hybrid lamina transpedicular system in a screw-rod-hook form. Good anatomic and functional results were got.Conclusion. Avoidance of fixation of intact functional spinal units allows to achieve good treatment results and classify this operation as organ sparing surgery.

scholarly journals Cervical intervertebral disc denervation during rotator cuff tendon plasty

2021 ◽  
Vol 18 (1) ◽  
pp. 39-46
Author(s):  
A. V. Peleganchuk ◽  
O. N. Leonova ◽  
A. A. Alekperov
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Rotator Cuff ◽  
Intervertebral Disc ◽  
Rotator Cuff Tear ◽  
Functional Activity ◽  
Shoulder Joint ◽  
Pain Syndrome ◽  
Intervertebral Discs ◽  
Cuff Tear

Objective. To analyze the effect of denervation of intervertebral discs in the cervical spine on the results of surgical treatment of patients with injuries to rotator cuff tendons of the shoulder joint.Material and Methods. Study design: descriptive hypothesis-generating study. The study included patients requiring surgical treatment of rotator cuff tear.  Two groups were identified: Group A included 28 patients who underwent plastic repair of rotator cuff tear with additional denervation of intervertebral discs, and Group B – 30 patients who underwent only plastic surgery for rotator cuff tear. The intensity of pain according to the VAS, functional activity due to neck pain (NDI), functionality of the shoulder joint (UCLA), and the degree of intervertebral disc degeneration according to MRI were assessed, and the effectiveness of treatment was determined. Statistical calculations were performed using the RStudio program.Results. In the group of patients with denervation of intervertebral discs, a more pronounced decrease in the intensity of pain syndrome at 3, 6, and 12 months (p < 0.001; p < 0.001; and p = 0.002), a more proportion of effectively treated patients at 3 months (p = 0.003), and significant increase in functional activity according to NDI at 3, 6 and 12 months of follow-up period (p < 0.001; p = 0.010; and p = 0.045) were observed.Conclusions. There is an underestimation of the role of degenerative cervical spine pathology in the occurrence of shoulder joint pain. In the case of rotation cuff plasty the additional denervation reduces the intensity of pain syndrome in the shoulder joint in the postoperative period.

Clinical and functional results of surgical treatment of cataract and presbyopia by using diffraction-refraction IOL AcrySof ReSTOR

2010 ◽  
Vol 26 (4) ◽  
pp. 26-29
Author(s):  
V. Kolomiets ◽  
◽  
S. Dmitriev ◽  
T. Dushenchuk ◽  
Yu. Lazar ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Functional Results

scholarly journals Results of surgical treatment of developmental dysplasia of hip considering child’s age

2011 ◽  
Vol 139 (1-2) ◽  
pp. 58-63 ◽  
Author(s):  
Sonja Milasinovic
Keyword(s):  
Surgical Treatment ◽  
Human Life ◽  
Functional Results ◽  
Developmental Dysplasia ◽  
Preoperative Treatment ◽  
Locomotor System ◽  
Developmental Dysplasia Of Hip ◽  
Innominate Osteotomy ◽  
Medical Documents ◽  
Late Discovery

Introduction. Developmental dysplasia of the hip (DDH) represents one of common diseases of the locomotor system. Late discovery and inadequate healing of this defect leads to serious disability in the best years of human life. Objective. The aim of this study was to analyze the quality of functional and anatomic restitution of the diseased hip, depending on the age of the patient at the time of surgery. Methods. Our retrospective study was developed on 78 children surgically treated for DDH. The examiners were distributed in three groups according to age in which they had been operated. The data were produced on the basis of full-scale medical documents for each patient. Results. We analyzed and compared anatomic and functional results of surgeries treating DDH in the group of examiners. On examination, we got data that the most prevalent were distorted gait, inequality of the legs and positive Trendelendburg?s sign in the group of children who had been operated in the oldest age. The patients who were surgically treated in older age had worse postoperative results in aspect value angle of flexion and abduction in treated hip, higher frequency in manifesting pain and asymmetric gait. Better corrective results on aspect of dimension of the colodiaphyseal and Hilgenrainer?s angle will be obtained if DDH treatment is conducted in younger age of patients. In 94.95%, the patients were treated with Salter innominate osteotomy of pelvis with osteotomy of the femur involving its shortening and reverse rotation. Preoperative treatment with Pavliks harness was provided in 44.02% children, with abduction of Hilgenrainer?s apparatus in 2.6%, with abductions ?Niva? slips in 2.6% and preoperative extension in 28.2%. Conclusion. The surgical treatment of DDH in the observed patients done at the earlier age of growth resulted in the evidently better anatomical and functional results at postoperative observation.

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