Objective. To substantiate the possibility of combination of indirect reposition of vertebral body fragments displaced into the spinal canal and posterior spinal fusion, and to identify factors resulting in successful reduction.

Material and Methods. Total of 78 patients with acute fractures of thoracic and lumbar vertebrae accompanied with critical or close to it intracanal retropulsion of fragments were operated on. Two groups of patients were formed. Group I included 38 patients with A3 type burst fractures who underwent anterior spinal fusion and reposition of fragments using suggested technique of spinal canal closed remodelling. Group II included 40 patients with burst fractures accompanied with critical displacement of fragments who underwent transpedicular fixation and ligamentotaxis by means of extension and distraction along the rods.

Results. A higher rate of intraoperation correction of kyphosis was achieved in Group I. However after two-stage intervention in Group II the long-term loss of correction (16.4 ± 3.2 %) was less as compared to that (28.5 ± 6.2 %) in Group I but here the correction was compensated due to initial hypercorrection. The mean reduction of displacement in Group I was 63.3 ± 27.9 % and in Group II – 35. 6 ± 29.1%.

Conclusion. Spinal canal remodelling combined with anterior spinal fusion is an effective and safe technique for burst fractures of thoracic and lumbar vertebrae allowing restoration of spinal canal size without anterior decompression.

Objective. To analyze the outcomes in patients with traumatic injuries of the cervical spine treated using stabilizing implants of hydroxyapatite.

Material and Methods. Total of 101 patients (83.1 % males, 14.9 % females) at the age from 17 to 67 years with traumatic spine injuries were operated on. Spine segments from C2 to T1 were stabilized. Outcomes were analyzed in two groups each made of 30 patients of similar age, gender, having similar injury type and neurological symptoms. Patients of study group underwent stabilization with BAK-1000 implant, and patients of control group – with bone allograft. Postoperative control included X-ray, CT, and MRI examinations. Spinal cord injury severity and neurological status were evaluated with ASIA/IMSOP scales. Follow-up survey was performed on 10th–15th day, and 1, 3, 6 and 8–12 months after the surgery.

Results. Patients in both groups presented positive symptoms. The earlier activation, rehabilitation, improvement in quality of life, and disability reduction were observed in the study group. Formation of osseous-apatite block in patients of this group was observed in 2–2.5 months postoperatively. Patients of the control group could proceed from external immobilization to active rehabilitation only in 6-8 months after surgery.

Conclusion. Hydroxiapatite implants used for cervical spine stabilization are grown through with bone tissue forming a solid bone-apatite block in 2–2.5 months after surgery. Stabilization with BAK-1000 implants allows for 30 % reduction of treatment and rehabilitation time, and for 20 % improvement of neurological outcome.

A case of patient with Bekhterev’s disease who has got a closed trauma of the cervical spine involving C6 transverse fracture with anterior displacement and tilting of a vertebral body fragment, spinal cord compression and contusion, which caused severe tetraparesis. Surgical treatment included anterior spinal fusion with autograft and instrumentation and resulted in early mobilization and rehabilitation of the patient.

Objective. To study the growth dynamics of vertebrae adjacent to the removed hemivertebra depending on the extension of instrumented and osteoplastic fixation. Material and Methods. The growth of fused vertebra was studied by roentgenometry measurements in 39 patients divided into groups depending on a level of hemivertebra and a type of surgery. Thirty five patients were operated on at the age under 5 years, and 4 – older than 5. The long-term results were followed up in 35 patients during the first growth-spurt period, in 7 patients during the growth-plane period, and in 5 patients during the second growth-spurt period. Results. Growth of the fused vertebrae after hemivertebra excision decreased less than 10 % as compare to theoretically possible one. The less number of vertebral motional segments included into the anterior and/or posterior fusion the closer to the norm is a growth of the blocked vertebrae. The vertebral growth is not influenced by the extension of instrumented fixation. Conclusion. Comprehensive approach to excision technique of hemivertebrae in the lower thoracic and lumbar spine of young children provides favorable conditions for the spine growth.

Exocorrector for spinal deformity is presented. Processes of deformity correction in coronal and sagittal planes and derotation are described. Relation between longitudinal force in the tension belt and pressure to the convex body contour is analyzed. Principal procedures of the brace treatment are outlined.

Objective. To analyze the application results of innovator program for the assessment of brain bioelectric activity 3DLocEEG. Material and Methods. The program was run to assess 131 electroencephalograms each recorded from 36 brain slices of 1-cm thickness (12 sagittal, 12 horizontal, and 12 coronal sclices) – a total of 4716 slices. The number of dipole sources in each slice was determined at the thresholds of 25, 50, and 75 % of maximum power. A total of 14148 slices were analyzed. The obtained data of three-dimensional distribution of equivalent dipoles were processed using a statistical software package «Statistica 6.0». Results. The analysis revealed abnormal unusual time-and-frequency pattern of the brain bioelectric activity. Discriminatory analysis of the obtained data showed that different variants of this pattern are reliably correlated with the most offensive characteristic of idiopathic scoliosis – its progressing or nonprgressing development. Detailed analysis allowed identification of brain parts most significant in generation of time-and-frequency pattern of bioelectric activity pathognomic for patients with idiopathic scoliosis. These are basal structures – hypothalamus, hypophysis, and pineal body. Abnormal bioelectric activity in these structures is considered as a sign of disregulation. Conclusion. The revealed signs of disregulation in the brain structures concern the processes controlling longitudinal growth of the spine and its components and can be one of the factors that induce idiopathic scoliosis.

Objectives. To analyze results of multichannel neuromuscular electrical stimulation after total lumbar disc replacement with titanium nonfunctional implants in the early postoperative period. Material and Methods. The study included 70 patients with degenerative disease of the lumbar spine which underwent surgical replacement of intervertebral disc by titanium nonfunctional implant. Thirty five patients (Study Group) received multichannel neuromuscular electrical stimulation since the 10th postoperative day. Another 35 patients (Control Group) did not have electrical stimulation. Both groups were identical in age (mean age of 43.6 years), gender, time of disease onset, hernia localization, and severity of neurological and orthopedic disorders. The comparative evaluation of treatment outcomes was carried out on the basis of clinical, X-ray, and EMG examination in patients of both groups in 3, 6, and 12 months after surgery. Results. The residual vertebral pain syndrome was revealed in 5 patients of Study Group and in 26 control patients in 6 months after application of neuromuscular electrical stimulation. The moderate radicular pain with radiation to dermatome area was noted in 6 patients of Study Group in 3 months, and in 2 patients in 6 months after surgery. In Control Group these parameters were 18 and 9, respectively. Conclusion. The use of multichannel neuromuscular electrical stimulation after total intervertebral disc replacement by titanium nonfunctional implants allows early elimination of residual vertebral and radicular pain syndromes, and 3–5 months shortening of rehabilitation period.

Objectives. To study anamnesis and pain syndrome in patients with acute and chronicle nonspecific osteomyelitis of the spine (NOS). Material and Methods. Total of 125 patients with NOS were treated. Out of them 74 patients underwent complex conservative treatment, and 51 patients – radical reconstruction surgeries. Patients’ complaints are analyzed and a pain syndrome is assessed on admission and after treatment. Results. Terms of diagnosis formation varied from 3 days to 2 years. Pain syndrome peculiarities of a sharp and chronic NOS were revealed. In a sharp NOS the pain reached the maximal value of 72.3 ± 7.6 % (according to Visual Analog Scale). It was «excruciating, gnawing, pulsating, burning, shooting» according to patients’ definition. Chronic course of inflammatory process is accompanied by less intensive pain (48.0 ± 4.8 %, Visual Analog Scale) characterized by patients as «aching, dull and extended». Modified Zung test revealed a high level of uneasiness (25–35 points) in patients with NOS. Сonclusion. Pain syndrome diagnosis allows both assessing the dynamics of therapy efficiency and substantiating the prescription of analgetic therapy taking into account a probability of development of uneasiness and mental disorders.

Minimally invasive posterior lumbar interbody fusion (PLIF) with endoscopic technique and special device for this procedure are presented. The technique allows reducing intraoperative injury of paravertebral tissues, primarily muscles, and can improve the treatment results in patients with degenerative diseases of the spine.

Principal requirements to bone grafting materials are formulated in accordance with current concepts. The notions of bioactivity, bioinertness, osteointegration, and osteogenic activity of bone grafting materials are determined. The properties of grafting materials «Deprotex», «Kostma», and «Deproteinized Bone Graft» are evaluated.

Objective. To study experimentally the efficacy of deproteinized bone allograft in anterior spinal fusion. Material and Methods. Spine specimens from adult mongrel dogs after anterior fusion with multipurpose deproteinized bone allograft were studied. Radiological and microscopic examination was performed in 1, 3, 6, and 12 months after surgery. Dynamics of bone block formation was analyzed. Strength properties of allogenic deproteinized tubular compact bone were studied determining the allograft breaking point in compression and resistance to bending. Results. The study revealed a formation of a solid bone block. Strength properties of allogenic deproteinized tubular compact bone being close to those of porous NiTi allow for its usage as a supporting fixator in anterior spinal fusion. Conclusion. Spinal interbody fusion with multipurpose deproteinized bone allograft results in formation of a solid interbody bone block during 12 months period without any significant changes in anatomical relations within the operated spine segment.

The paper presents the peculiarities of spinal column structure, development, and partly biomechanics in view of current concepts of its normal anatomy. Osseous structure of the spine, vertebra architectonics, anatomy of intervertebral discs, joints, ligaments of the cervico-occipital junction, and long and short paraspinal ligaments are consistently described. Muscular system and blood supply of the spine, vascularization variants of different parts of the spinal cord, anatomy of the spinal cord and its meninges are considered. Represented data on a normal spine anatomy would help a clinician to detect pathomorphological changes occurring after injury or disease, and to choose pathogenetically based treatment.