Objective. To define the value of immunological monitoring for assessment of condition of patients with spine injuries. Material and Methods. Blood analysis was performed in 111 patients who underwent two-stage surgical treatment for spine injury. The assessment included general clinical blood test, phenotyping of lymphocytes, functional-metabolic activity of neutrophils, the level of circulating immune complexes, immunoglobulins, cytokine concentration (IL- 1α, IL1-β, IL-1ra, IL-8, and FNO-α), acute-phase proteins before operation and at different postoperative terms. Results. Specific dynamics of immunological parameters during surgical treatment of spine injuries allowed the development of criteria for prediction of delayed consolidation and incomplete fusion in the vertebral motion segment when treating spine injury with external fixation apparatus and anterior spinal fusion. A norm, diagnostic sensitivity, diagnostic specificity, and expected predictive value were calculated for each of the offered criteria. Their use in clinical practice helps to predict complications at different stages of treatment (before operation, at third or at tenth day after operation) and to correct the tactic of patient care. Conclusion. Immunological monitoring during treatment of spine injuries can be used for prediction of postoperative complications such as delayed consolidation and fusion failure in motor segment of the spine.

Objective. To analyze application of intraoperative ultrasonography and Doppler ultrasonography in patients with acute spinal cord injury. Material and Methods. A complex of intraoperative ultrasonography examinations was performed in 10 patients before and after spinal cord decompression to study pathological structural and hemodynamic lesions. Dura mater, subdural space, liquor, spinal cord, roots of the spinal cord and cauda equina were studied. Color Doppler mapping and ultrasonic duplex scanning were used to identify the arterial and venous vessels of the spinal cord, their anatomic features, linear and volume velocities of the blood flow, resistive and pulsate indices. Doppler ultrasonography of spinal cord vessels included assessment of Doppler spectrum shape, velocity and resistive parameters of the blood flow in the spinal artery. Results. Complex ultrasonic visualization examinations reliably detected spinal cord compressions, cysts, hematoma, contusion foci and subdural hemorrhages. A vascular mode revealed spinal artery occlusion and stenosis, hyper- and hypoperfusion of spinal vessels, reduced blood flow and venous dyscirculation. Conclusion. Thus, methods of complex intraoperative spinal cord ultrasonography are found to be very effective for evaluation of local structural and hemodynamic disturbances caused by spinal cord injury. These ultrasonic techniques are simple in use, highly informative, and comparable with MRI data. These ultrasonic techniques may be recommended for wide application in acute spinal cord injury diagnostics.

Objective. To detect specific features of gender identity and factors determining this specificity in female adolescents with scoliosis. Material and Methods. We examined 50 female adolescents aged 13 to 16 years (mean age 14.8 years) with Grade IIIIV scoliosis which underwent surgical treatment in Novosibirsk NIITO. Examination included clinical interview, observation, psychodiagnostic testing, and projective techniques. Patients were examined preoperatively in two stages. Results. Specific features of the gender identity in female adolescents with scoliosis include distorted emotional-evaluative body image, reduced repertoire of allowable gender behavioral stereotypes, marked dominance of gender representations corresponding to conventional feminine model of sex-role behavior, external reference, and pronounced selfacceptance dependence on external appraisals. Conclusion. Cosmetic defect significantly influences the identity formation in adolescent. One of the most important factors affecting the feminine-type gender attitude formation is a close codependence between female adolescent and her mother translating a passive feminine position as a compensatory mechanism for overcoming of cosmetic appearance defect.

Objective. To substantiate the use of pulsed magnetic field with predetermined parameters in multimodality treatment of idiopathic scoliosis. Material and Methods. Experimental part of the study was performed in 34 chinchilla rabbits. Clinical study included examination of 277 children at the age of 13–15 years with II–IV grade idiopathic scoliosis which were divided into three groups. Children from groups I and II underwent absolutely equal clinical and instrumental methods of examination: computer optical topography, stabilography, electromyography of the back paravertebral muscles, computer thermovision of the back and extremities. The main method for examination of children from group III was radiography, in some cases, according to indications – EEG and ECG. Results. An experiment in rabbits showed that pulsed magnetic field inhibits proliferation and stimulates differentiation of chondrocytes in growth plates. The targeted impact of pulsed magnetic field with predetermined parameters on growth plates of children with scoliosis can render a therapeutical effect. This is confirmed by results of dynamic observation of patients. Pulsed magnetotherapy is the most effective in patients of 13–15 years of age corresponding to the second half of pubertal period. These findings are in agreement with experimental data. Conclusion. The use of pulsed magnetotherapy reliably increases the efficacy of multimodal conservative treatment of patients with idiopathic scoliosis, has not negative effects, and is safe for a growing body.

Objective. To analyze biomechanical structure of walking in patients with II and III grade C-type and S-type idiopathic scoliosis. Material and Methods. Computer-based biomechanical testing was used to obtain main, temporal, kinematic, and dynamic characteristics of walking by means of electropodography, electrogoniography, and electrodynamography. Results. The following changes in locomotion structure were found: diminution of step length and average walking velocity, increase in duration of a double-support phase, decrease in τ-interval on a concave side of the curvature, expansion of rotatory movements of the pelvis and shoulder girdle, and reduction of extreme values of support reactions. The walking structure disturbances are increasing with scoliosis transfer from II to III grade and are more expressed in C-type curvature. Conclusion. Most of changes in biomechanical parameters represent the compensatory response of the body to walking stability decrease caused by the spine deformity and progressing trunk muscle weakening..ru

The paper reviews the literature on experimental models of intervertebral disc degenerative-dystrophic diseases. Basic principles of biological modeling of disc pathology are presented. Literature analysis includes discussion of current approaches and methods for verification of pathomorphological processes in disc tissues, their shortcomings, and ways of improving.

Objective. Comparative assessment of clinical results and pharmacological cost-efficiency of muscle relaxant application in spine medicine. Material and Methods. Retrospective (100 patients) and prospective (230 patients) analysis of anesthetic management during elective surgeries in traumatologic-orthopaedic patients was performed. Hemodynamic indices were monitored: SBP, DBP, MAP, HR, gas exchange, breathing mechanics, and neuromuscular conductivity. Pharmacological economic and statistical analyses of muscle relaxant efficiency were performed. Results. Use of only nondepolarizing muscle relaxants provided a high quality of general anesthesia and promoted the process of consciousness recovery, adequate spontaneous respiration through a tracheal tube and reduced the duration of artificial lung ventilation thus reducing a number of complications, and resulted in reduction of monitoring equipment depreciation value and medical staff load. Conclusion. Application of nondepolarizing muscle relaxants can be the option for myoplegia during a general anesthesia in trauma and orthopaedic patients.

The paper presents the need for a complex assessment of statodynamic function of musculoskeletal system as a whole in patients with idiopathic scoliosis. Advantages and prospects for usage of such techniques for musculoskeletal biomechanics study as optical topography, stabilography, dynamic plantography, and video-based motion analysis are discussed.

Objective. Stady of new composite material with plastic consistency having an osteostimulative and local antibacterial effects; experimental study of the material efficacy. Material and Methods. Experiments were performed in 36 mature male rats aged 5–6 months. The first series of experiment included the study of osteogenesis processes in induced bone defects without application of osteoplastic material. In the second series the bone defects were filled with Kostma – a new osteoplastic material. Experimental and morphological techniques were used in research. Osteogenic process was studied in histological specimens stained with hematoxilin-eosin and van Gieson’s in 14, 30, and 90 day after operation. Results. In the first series a formation of osteoid bone regenerate with spongy structure from periphery to the center of defect was observed at all observation terms. The second series of the experiment showed the process of osteoclastic resorption and osteoblastic osteogenesis on the basis of Kostma osteoplasic material at all observation terms. Conclusion. The study has proved that Kostma composite osteoplastic material can serve as a matrix for bone formation.

The main characteristic of any process is its result (product or service). Since a positive result can be achieved by multiple repetition of the process until a product or service meeting the requirements is obtained, the processes of the quality management system must be effectively governed. Quality Management System based of principles of total quality management and harmonized with requirements of International Standard ISO 9001-2000 is successfully operating at Novosibirsk NIITO during some years. Positive dynamics in all processes of the system is achieved due to application of the process approach.

Practical realization of basic postulates of general management allowed initiation of quality management system development in 2003. The assessment of outer and inner situation became a basis for definition of a goal, formulation of a longrange development program and specification of its main components. This activity resulted in integration ties with leading national institutions, increase in the number of patients, up-to-dating of health facilities, and intensification of medical and diagnostic process. The main direction of further improvement of activity will be an innovation policy based on process approach providing monitoring of key processes.

Significance and actuality of issues of planning, management and financial provision of medical assistance, including hightechnologic one, are considered. Economic evaluation of diagnostic and treatment techniques along with prediction of treatment effect, standardization of medical services and technologies are the basis for quality rating, and calculation of economic indicators which should be used for planning in public health care during a period of national public health system reforming. It is demonstrated that financing of patient care and prophylactic institutions on the basis of clinical-expense groups (clinical-economic standards) provides the most efficient use of patient care institution’s potential, and restraining of sheer growth of costs for medical care, including for expensive medical technologies.

The glossary presents terms that are currently or have been recently used in the literature on orthopaedics, neuropathology, arthrology, and roentgen diagnostics. The treatment of some terms suggested in the glossary differs from conventional one what stems from natural progress of medical technologies, accumulation of new knowledge, and critical assessment of currently available one.