Objective. To analyze the effect of developed methods of diagnosis and treatment on the improvement of outcomes in patients with secondary spinal deformities associated with hereditary systemic skeletal diseases.

Material and Methods. The treatment experience of 36 patients with spinal deformity associated with hereditary systemic skeletal disease is presented. Individual diseases causing secondary scoliosis are characterized. The algorithm of examination and tactics of these patients are presented. Particularities of posterior, anterior, and multifunction surgical approaches are described.

Results. The use of combined approaches and new instrumentation provides good outcomes in patients with spinal deformities associated with hereditary systemic skeletal diseases. The mean deformity angle before operation was 105 degrees, after operation — 47 degrees. Mean correction in the postoperative period reached 56%.

Conclusion. Wide introduction of the modern segmental instrumentation allowing for multiplane correction of spine deformity along side with application of anterior, posterior, and combined approaches, as well as cooperation of specialists in hereditary systemic skeletal diseases and specialists in spine medicine provide good outcomes in these patients.

Objective. To determine the thorax rib frame changes in patients with progressive scoliotic curvatures to study the peculiarities of deformity process.

Material and Methods. The radiograms of 731 patients with idiopathic scoliosis were analyzed, at which spine deformity with main arches of 41 to 168° was determined at the age of 4 to 20 years. Radiological visual analysis with comparative measurements of chosen contra-lateral parts of the thorax rib frame was used.

Results. The revealed radiological changes in the thorax rib frame in patients with surgical scoliotic deformity demonstrate a definite stage character of orthopaedic pathology development depending on a damage degree of physiological anatomico-biomechanical resources of the spine.

Conclusion. The findings on dynamics of the thorax rib frame changes should be regarded and considered as objective diagnostic data to specify scoliotic deformity peculiarities and prognosis of its real development, and to determine adequate treatment and rehabilitation recommendations for concrete clinical situation.

Objective. To study the effect of modern methods of spinal instrumentation for treatment of tuberculous spondylitis on growth of vertebrae after deformity correction in extensively growing children.

Material and Methods. A total of 28 preschool age children were operated on for tuberculous spondylitis complicated by kyphosis exceeding 50°. Eight patients were operated on without posterior instrumentation, 20 patients - with additional posterior compressive implants. More than one year follow-up included assessment of the following metric parameters: anterior and posterior vertical size of fusion, anterior and posterior vertical size of the intact vertebra caudal to the anterior fusion inside and outside the instrumented zone.

Results. Degenerative changes in the initially intact spinal motion segments within fixation zone were observed for 2 years after surgery in 17 out of 20 patients operated on with posterior instrumented fixation. These changes were presented by a sharp decrease in the intervertebral disc height and by a sclerosis of adjacent end plates.

Conclusion. Children operated on with application of modern implants have not still reach the age of the growth stop, though follow-up periods are sufficiently long. This does not allow predicting the spine development in the adolescence.

Objective. To evaluate the influence of congenital intervertebral foraminal lumbar stenosis on the outcome of surgical treatment of radicular compression syndrome caused by disc herniation combined with spondylarthrosis.

Material and Methods. The study involved 116 patients operated on for radicular compression syndrome caused by disc herniation accompanied by degenerative lumbar spondylarthrosis. Patients from control Group A had no congenital lateral stenosis. Patients with congenital stenosis were divided into 2 groups: Group B included patients who underwent disc herniation removal added by partial facetectomy (foraminotomy); group C – patients who underwent disc hernia removal without foraminotomy.

Results. Favorable outcomes in Group B prevailed by 18.6 % those in Group C. There were no statistically significant differences between outcomes of surgery for disc herniation combined with foraminotomy, and without foraminotomy in patients without congenital stenosis.

Conclusion. Compression syndromes caused by combination of hernia protrusion and osteochondrous growth of vertebral joints, combined with intervertebral foraminal stenosis, necessitate the performance of surgical decompression and foraminotomy.

Objective. The analysis of diagnostics efficiency of the spine and spinal cord lesions in children.

Material and Methods. A retrospective analysis of 622 cases of stable spine lesions without spinal cord compression in children was performed. Sensitivity and specificity of clinical, radiological and neurophysiologic methods of diagnostics were estimated at each stage of pathological process. The importance of each diagnostic method at various stages was evaluated.

Results. A tendency to specificity enhancement of clinical and radiological examinations, growth of prognostic value of positive results and decline in importance of negative results with time was revaled. Sensitivity and specificity of primary clinical examination results are rather high, but prognostic value of positive and negative results is low. Time dependence factor is well-defined at diagnosis of spinal cord lesions.

Conclusion. To determine a degree of lesion the data of clinical and radiological examinations are more valuable at clinical subcompensated and decompensated stages, additional methods (MRI, ENMG) are more important at the stage of clinical compensation.

Objective. To offer the use of the symptom of non-typical hair growth (SNHG), which looks as an eddy, in the region of the scapula for early screening diagnostics of Congenital High Position of Scapula (CHPS).

Material and Methods. We found non-typical hair growth in 12 children among 20 patients suffering from Sprengel’s disease: hair growth in the region of the scapula is similar to the growth of the hair in the parietal region of the head resembling the shell of a snail. To project this sign on the bone structures a tip of metal injection needle was located in the middle of hair eddy before radiography. Patients with CHPS underwent computed topography of the back, EMG, ECG, ultrasonography, and spirography.

Results. The center of the symptom is placed in the lower corner of the scapula on the side of patology. The same sign was revealed in spine projection in children with costae cervicalis, displastic and congenital scoliosis. Children with initial degrees of CHPS are given early permanent conservative treatment, which lead to good functional and cosmetic results. For diagnostics of severe degrees of Sprengel’s disease the use of SNHG is less important as the main symptoms of the disease are clearly seen.

Conclusion. SNHG is the indicator of dysplastic defects of skeleton development. It is reasonable to use SNHG in a scapula region during the screening examinations from babyhood with the purpose.

Objective. To study changes in the levels of direct potential (LDP) and electrospinogramm (ESG) at spinal cord local compressive injury.

Material and Methods. The study was performed in 13 outbred male rats. A local compression spinal cord injury was modeled by graduated compression of the spinal cord at the T10 level during 15 minutes. Registration of bioelectric activity was carried out by Ag/AgCl electrodes by means of a 4‑channel DC amplifier with 1 MOhm input resistance.

Results. Simultaneous LDP and ESG registration is an effective method of spinal cord functional diagnostics. The isolated assessment of ESG or LDP changes has much less prognostic and diagnostic value; therefore complex registration of these parameters should be performed for more exact assessment of a spinal cord functional state.

Conclusion. The suggested procedure for functional assessment of the spinal cord extends the possibilities of purposive search and study of new medicines for prophylaxis and treatment of patients with ischemic and traumatic lesions of the spinal cord.