scholarly journals Evaluation of the role of ventral interventions in the surgery of idiopathic scoliosis in patients with active bone growth

2021 ◽  
Vol 9 (1) ◽  
pp. 17-28
Author(s):  
Marija A. Chernyadjeva ◽  
Aleksandr S. Vasyura ◽  
Vyacheslav V. Novikov

BACKGROUND: Today, the question of the tactics of surgical treatment of patients with idiopathic scoliosis during active bone growth, namely, the need for ventral interventions due to the emergence of modern dorsal instruments, remains open. AIM: This study aims to evaluate the role of ventral interventions in the surgical treatment of patients with progressive idiopathic scoliosis Lenke type 1, 2, 3 during the period of active bone growth. MATERIALS AND METHODS: The long-term results of operational correction 352 patients with thoracic idiopathic scoliosis aged from 10 to 14 years old operated in Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan from 1998 to 2018 using various methods and different instrumentation types. RESULTS: Among patients (352 people) aged 10 to 14 years with idiopathic thoracic scoliosis (Lenke type 1, 2, 3), statistically significant postoperative progression was observed in patients who underwent surgical deformity correction using laminar (hook) fixation. At the same time, additional ventral stage conduction could not prevent deformity progression in the postoperative period. In those groups where hybrid fixation was used combined with the ventral stage and total transpedicular fixation, no significant progression was observed in the postoperative period. CONCLUSION: Modern dorsal systems for transpedicular fixation narrow the indications for using additional mobilizing and stabilizing ventral interventions in the surgical treatment of progressive idiopathic scoliosis in patients with active bone growth. Total transpedicular fixation provides excellent main curve and anti-curvature arch correction in the absence of scoliotic deformity progression in the postoperative long-term follow-up.

2019 ◽  
Vol 16 (1) ◽  
pp. 32-37
Author(s):  
M. A. Chernyadjeva ◽  
A. S. Vasyura ◽  
V. V. Novikov ◽  
D. N. Dolotin

The paper presents a completed case of the surgical treatment of a 10-year-old female patient with progressive grade IV idiopathic scoliosis who underwent surgical correction using total transpedicular fixation. The paper demonstrates long-term results of treatment of idiopathic scoliosis in the actively growing patient without the use of epiphyseodesis and staged surgical interventions.


2019 ◽  
Vol 64 (12) ◽  
pp. 747-752
Author(s):  
Tatyana Valerievna Govorunova ◽  
E. B. Popykhova ◽  
V. Yu. Shirokov ◽  
A. N. Ivanov

An important factor in the pathogenesis of chronic inflammation in periodontitis is endothelial dysfunction (ED). Adhesion molecules are markers of impaired barrier function, adhesive properties and vascular permeability. The study of the concentration of soluble adhesion molecules is very promising in the diagnosis of ED. The purpose of this research was to study changes in the concentration of soluble forms of adhesive molecules of the selectin family and the immunoglobulin superfamily when used as markers of systemic manifestations of ED in the dynamics of the treatment of chronic generalized periodontitis (CP) using surgical and therapeutic schemes. 60 patients with CP (33 women and 27 men) and 20 clinically healthy volunteers (10 men and 10 women) were examined. The state of the endothelium was assessed by the content in the serum of soluble forms of adhesive molecules - sP- and sE-selectins, intercellular adhesive molecules of type 1 (sICAM-1), vascular molecules of cell adhesion of type 1 (VCAM-1) by ELISA. The short-term results of non-surgical treatment of CP are more effective in correction of vascular wall adhesive properties disorders compared with surgical treatment. Conservative treatment of chronic hepatitis C effectively adjusted the blood content of adherent endothelium molecules in women than in men. The long-term results of applying this scheme were characterized by partial preservation of a positive effect on the adhesive properties of the endothelium, however, long-term results were inferior to short-term ones. Surgical treatment of CP in women in the early postoperative period was accompanied by reactive impairment of the adhesive properties of the endothelium. The long-term results of this treatment regimen testified to its greater effectiveness. In women, the effectiveness of treatment of CP in restoring the adhesive properties of the endothelium was higher than in men. The results obtained allow us to conclude that the systemic manifestations of ED in CP were characterized by an increase in the concentration in the blood of soluble forms of adhesion molecules. The dynamics of the concentration of adhesive molecules during the treatment of СР testified to the dependence of the sex of patients on the effectiveness of the influence of therapeutic and surgical treatment regimens on the systemic manifestations of ED.


2011 ◽  
Vol 10 (2) ◽  
pp. 73-76
Author(s):  
Ye. B. Kolotov ◽  
R. R. Aminov ◽  
S. V. Yelagin ◽  
V. V. Kelmakov ◽  
Ye. V. Kolotova

To improve the results of surgical treatment the patients with discogenic compressive syndromes. Using the denervation of interbody discs and facet joints in series allow us, first off all, to induce, and then to discontinue the reflex-pain syndrome in 41 patients in preoperational period, and in 39 patients in long-term postoperative period. Good results come to 82,8 и 89,8% (р < 0,05) accordingly.


2021 ◽  
pp. 40-49
Author(s):  
V. A. Gankov ◽  
E. A. Tseimakh ◽  
G. I. Bagdasaryan ◽  
A. R. Andreasyan ◽  
S. A. Maslikova

Relevance. Treatment of achalasia of the cardia (AС) is currently palliative, aimed at reducing the manifestation of clinical symptoms of the disease. Together with instrumental methods of examination of esophageal function, the Eckardt scale and the GIGLI questionnaire are convenient and simple tools for evaluating results in the long-term postoperative period.The aim of the study was to evaluate the long-term results of surgical treatment of patients with 2-4 stages of AС, after laparoscopic Нeller myotomy with anterior hemiesophagofundoplication by Dor to the results of special methods of esophageal examination and patient questionnaires using the Eckardt scale and the GIGLI questionnaire.Materials and methods. The work included the results of examinations of 103 patients who underwent video laparoscopic Нeller myotomy, with anterior hemiesophagofundoplication by Dor. The period of examination in the postoperative period was from 3 to 7 years. The results of X-ray examination of the esophagus and stomach, manometry of the esophageal and esophageal-gastric junction before and after surgery were studied , and patients were also surveyed according to the Eckardt scale and the GIGLI questionnaire.Results. The analysis of the results of instrumental methods of studying the function of the esophagus in the pre – and postoperative periods showed that the given manometry of the esophagus and esophageal-gastric junction, X-ray of the esophagus and stomach significantly improved in the postoperative period in patients with all stages of the disease. The results of patients of 4th stage AC compared with the results of 2nd and 3rd stages patients were worse(p<0,05).The leading symptom of AK-dysphagia in the long-term postoperative period decreased in all the studied patients, the results were better in patients with stage 2, worse in patients with stage 4 of AK (p<0,05).The leading symptom of AK-dysphagia in the long-term postoperative period decreased in all the studied patients, the 2nd stage patients results were better, 4th stage patients results were worse (p<0,05).Conclusions. After video-endoscopic Нeller myotomy with fundoplication by Dor, the indicators of esophageal manometry and esophageal and stomach radiography significantly improve, the results of the Eckardt scale and GIGLI questionnaire survey of patients show a significant decrease in the severity of clinical manifestations of AC in the balls. This method of surgical treatment can be recommended already at the 2nd stage of AC and as an organpreserving operation for 4th stage.


1976 ◽  
Vol 44 (1) ◽  
pp. 72-76 ◽  
Author(s):  
Werner L. Apt ◽  
Juan L. Fierro ◽  
Ciro Calderón ◽  
Carlos Pérez ◽  
Patricio Mujica

✓ The authors present 27 cases of vertebral hydatidosis with clinical and laboratory findings. The most frequent location of the lesion was the lumbar spine. Principal neurological symptoms were paraparesis, sphincter disturbances, paresthesia and paraplegia. The average number of surgical interventions per patient was 2.6; the most common procedure was laminectomy with extirpation of the cyst and surgical toilet. The results of surgical treatment were generally good in the immediate postoperative period, but long-term results were poor.


Author(s):  
S. I. Mokhnatyi ◽  
O. M. Dovgan

The article presents a single-center experience of surgical treatment of patients with severe mitral regurgitation(MR) caused by mitral valve prolapse (MVP). The study is based on long-term results of reconstructive interventions on the mitral valve (MV) of the UCCC of the Ministry of Health of Ukraine. The purpose of this work is to determine the factors that influence the long-term results of surgical treatment of MR in prolapse of the mitral valve leaflets. Material and methods.From January 1, 2011, to January 1, 2018, 146 patients with severe MR were operated on the basis of the UCCC, which was conditioned by the prolapse of mitral valve leaflets. Results.Long-term results were analyzed in 95.2% of patients. The average postoperative follow-up period was 39.7 ± 19.8 months. The overall mortality rate was 1.4%. Freedom from moderate and severe MR in the remote postoperative period decreased to 94.2%, compared to the early postoperative period. Residual MR was absent in 17 (12.4%) patients. In 76 (55.5%) patients trivial MR was detected, in 36 (26.3%) there was a mild MR, in 3 (2.2%) a moderate MR. In 5 (3.6%) patients, a severe MR was detected during the observation. Using statistical methods, it was found that the anatomical variant of MVP influences the prognosis of treatment results in the long postoperative period with worse results in the group with isolated prolapse of the anterior leaflet. Also, the dependence of the results on the applied surgical techniques with better results in annuloplication using the annuloplasty rings and in the application of resection of the posterior mitral leaflet. On the basis of statistics, a prognostic model for the evaluation of MV repair results in the distant period was developed. The height of coaptation of mitral leaflets was determined as one of the indicators for predicting the results of surgical treatment of MR with MVP. Conclusions: 1. In most cases, a successful mitral valve repair is possible with the MVP. 2. A good immediate result does not mean keeping it in the long term. 3. The long-term results of MV reconstruction depend on the anatomical variant of the MVP, with worse results in patients with isolated prolapse of the anterior mitral leaflet. 4. The result of MV repair depends on the surgical techniques used, with better results when using the annuloplasty rings and resection of the posterior mitral leaflet. 5. The height of the coaptation of the MV leaflets is an indicator that allows predicting the outcome of surgical treatment in the long postoperative period.


2015 ◽  
Vol 174 (5) ◽  
pp. 32-34
Author(s):  
I. N. Zubarovskiy ◽  
M. V. Mikhailova ◽  
S. K. Osipenko

The article analyzed an experience of treatment of 51 patients with follicular tumors. It was proved, that there weren’t any complications and recurrences in case of typically performed operation and adequate replacement therapy in postoperative period. It was noted a good quality of life from 2 to 5 years.


Author(s):  
Sh.Kh. Gizatullin ◽  
◽  
D.I. Zhukov ◽  
V.Yu. Kurnosenko ◽  
E.A. Kim ◽  
...  

Transpedicular fixation (TPF) as a method of posterior fusion is currently the most common, reliable and economically justified option of spinal fusion in various diseases and injuries of the lumbar spine, having more than half a century of history. As a result of the search for less invasive and more effective methods of fixation of the spinal segments to improve the results of surgical treatment, shorten the hospitalization, and reduce the number of perioperative complications, an approach involving fusion with rigid implant from the anterior (ALIF) was developed. Objective. To analyze the immediate and long-term results of treatment of single-level herniated discs by total removal of the intervertebral disc using anterior access with a rigid spondylodesis (ALIF) and the method of posterior discectomy, spondylodesis and transpedicular fixation (TPF). Materials and methods. A prospective cohort study was conducted. The study included patients after total intervertebral disc removal by the ALIF method and patients after discectomy and TPF. The achieved result was evaluated using radiological tests, as well as using standardized questionnaires and surveys. Results. After the surgery, patients in both groups showed a significant reduction in pain on the NRS scale. Patients from the first group had 4 to 0 for back and 8 to 0 for leg, patients from the second group had 6 to 4 for back and 8 to 0 for leg. The quality-of-life assessment by ODI scale also showed a positive trend from 36 to 4 in the first group and from 22 to 12 in the second group. Clinically, the result of surgical treatment was rated as excellent 5 in the ALIF group and as good in the TPF group 4 on the modified subjective assessment scale Macnab. Conclusion. The ALIF method as a decompression-stabilizing surgical aid is less traumatic. The less invasive nature of the technique was confirmed by significantly shorter surgical intervention time, smaller volume of intraoperative blood loss, and a shorter period of hospitalization. In the long-term period, statistically significant differences were obtained indicating that the ALIF method is more effective than TPF.


2005 ◽  
pp. 041-045
Author(s):  
Panayot Tanchev ◽  
L. . Stefanov ◽  
Luben Stokov ◽  
Dobrin Dikov ◽  
Assen Dzherov ◽  
...  

2021 ◽  
pp. 128-132
Author(s):  
Y. V. Tielushko ◽  
V. I. Pertsov ◽  
S. I. Savchenko

Summary. Inflammatory lesion of the sternoclavicular joint (SCJ) is a rare disease that requires surgical treatment. Traditional radiography reveals osteolysis and osteosclerosis, however, at the onset of the disease, such changes are absent. Difficulties in diagnosing this disease require further study of the problem and the development of new therapeutic and diagnostic approaches. Aim of the work: to study the role of sonography in the diagnosis of purulent arthritis of SCJ and the choice of treatment tactics. Materials and methods. Prospective single-center study of 28 cases of acute nonspecific arthritis of SCJ. The patients were divided into 2 groups: the first included patients who received drug therapy, the second included patients subject to surgical treatment. Results and discussion. Ultrasound scanning of SCJ identified 3 sonographic variants of the lesion: exudative, destructive with synovial hyperperfusion, and destructive with synovial hypoperfusion. The duration of hospital stay in both groups did not differ statistically: 12 (12; 13.5) vs 14 (12; 14) days, p = 0.194. Analysis of long-term results in patients of the first group established the progression of the disease with the development of osteomyelitis or recurrence of arthritis in 3 cases (30 %). Among the patients of the second group, no complications or recurrence were detected during the indicated observation period. Conclusion. Sonography is diagnostically significant in the diagnosis of SCJ arthritis. It allows you to determine the group of patients subject to mandatory surgical correction. Intravenous drug addiction associated with bacteremia is a predictor of poor drug treatment outcomes and an indication for active surgical tactics.


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