Objective. To assess the efficacy of surgical treatment of thoracic and lumbar vertebral fractures associated with systemic osteoporosis.

Material and Methods. Treatment results in 85 patients with vertebral fractures in the thoracic and lumbar spine associated with systemic osteoporosis were presented. Surgical intervention included reduction and fixation in 32 cases, reduction, fixation, and corporodesis in 18 cases, decompression with further fixation in 14 cases of complicated and burst fractures, and puncture vertebroplasty of affected vertebral bodies in 21 cases. Postoperative care was focused on rehabilitation and correction of decreased bone mineral density, with account for osteoporosis type.

Results. Long-term outcomes were followed-up in 69 % of patients. Good results were achieved in 76 % of cases, satisfactory – in 20 %, and unsatisfactory – in 4 %.

Conclusion. Application of different methods of surgical intervention and their combinations should be justified by specific anatomic features and clinical situation. The advantage of surgical treatment of patients with osteoporosis using modern fixing devices is that it allows rapid restoring spine stability and returning patients to activity.

Objective. To assess the growth and development of the fused spinal motion segment in children operated on with application of transpedicular fixation for congenital spinal deformity associated with disorders in vertebral formation.

Material and Methods. The outcomes of surgery in 31 patients aged of 1 year and 9 months to 6 years and 11 months with a single congenital malformation of the spine were assessed. The surgery involved the hemivertebra resection, deformity correction with posterior instrumentation, spondylodesis, and posterior local fusion of fixed spinal motion segments with autobone. The rate of bone block formation and the size of fused spinal motion segment in the region of hemivertebra resection were assessed on the basis of postoperative X-rays. New functional unit of the spine was compared with the adjacent intact vertebral bodies in dynamics.

Results. The mean follow-up period was 60 months. Solid bone fusion was achieved in all patients. The growth and development of the fused spinal motion segment in the region of hemivertebra resection kept pace with the growth of adjacent intact vertebrae.

Conclusion. The fused spinal motion segment develops after hemivertebra resection without delay in increase in height and anterior-posterior size of fused vertebrae. After hemivertebra resection the fused spinal motion segment is developing without delay in growth of height and anterior-posterior size of vertebral bodies involved in the block. New functional unit of the spine consistently develops and enables normal growth and development of the whole spine.

Objective. To study the quality of life and attitude of adolescents with grade II and III idiopathic scoliosis towards brace treatment.

Material and Methods. The SRS-24 questionnaire adapted for brace treatment was used for examination of 120 adolescents aged of 10 to 15 years having grade II and III idiopathic scoliosis and treated with Cheneau brace.

Results. Adolescents receiving Cheneau brace treatment most negatively perceived self-image in a brace, and limitation of peer communication and social activities. These aspects present a target object for psychologist.

Conclusion. To raise motivation for treatment a psychologist should be included into the team of professionals dealing with conservative treatment of scoliosis in adolescents.

Objective. To study possible combinations of spinal deformities in coronal plane associated with pelvic tilt in children and adolescents and create the working classification based on findings of the computer optical tomography.

Material and Methods. Computer optical tomography method was used for examination of 623 patients with pelvic tilts of more than 1.5° inducing coronal spinal curvatures such as functional and compensatory scoliosis, and grade I and II structural scoliosis.

Results. Detected forms of coronal curvatures associated with pelvic tilt are distributed into five types depending on topographical criteria based on quantitative evaluation of pelvic tilt (1.5° and more), maximum lateral deviation of the line of spinous processes (2 mm and more), level of the curvature apex (not above T6), and the tilt of the trunk’s longitudinal axis (1.5° and more).

Conclusion. The suggested classification of coronal spinal curvatures associated with pelvic tilt could help a practicing orthopedist to choose individual treatment algorithm and rehabilitation actions for each patient. Proper treatment produces good results in patients with non-surgical forms of coronal spinal curvatures induced by pelvic tilt.

Objective. To estimate the efficacy of reflex action in complex pathogenetic therapy of neurovascular syndrome resulted from degenerative-dystrophic changes in the spine.

Material and Methods. Overall 97 patients with nerve root syndromes associated with intervertebral disc hernia were followed up. All patients, after general clinical examination, were divided in two groups depending on treatment particularities. Control group patients underwent drug therapy, and in study group patients drug therapy was accompanied with acupuncture, myostimulation, and therapeutic massage. Pain syndrome and neurologic functions were evaluated at 1, 5, 10 and 15 day of treatment.

Results. After 10 days of treatment clinical improvement expressed in pain relief was observed in 96.4 % of study group patients and in 87.6 % of control group ones. Palpation of spinous processes and paravertebral muscles showed relaxation and pain relief in 100.0 % of cases in both groups at 5 day of treatment. Stretch symptom regressed in all patients of both groups by 15 day. Above well marked relief in pain intensity a pronounced regression of neurological symptoms was observed in patients of the study group.

Conclusion. Complex treatment including drug-free therapy provides relief in pain intensity, and accounts for better restoration of peripheral blood circulation for shorter treatment duration.

Objective. To analyze results of surgical and brace treatment of eosinophilic granuloma of the spine.

Material and Methods. Seventy two patients with pathologic vertebral fractures associated with eosinophilic granuloma of the spine were treated; brace treatment was performed in 42, and surgical – in 30 patients.

Results. All surgically treated patients showed good results. Infectious complications and device instability were not observed. Anterior fusion was achieved within 12 to 16 weeks after surgery, which allowed returning a patient to active life. There were no postoperative neurological disorders. Brace treatment in most cases provided partial repair of the affected vertebral body due to its immobilization and unloading.

Conclusion. Brace treatment does not result in complete restoration of the affected vertebral body. Surgical treatment allows reducing treatment duration and quickly returning a patient to the active life.

Objective. To assess the influence of etiological factor on the intensity of ENMG manifestation of sensory-motor deficit in patients with lumbar spondylolisthesis.

Material and Methods. Complex neurophysiological examination (total EMG, M-responses, H-reflexes, transcranial evoked potentials) was performed in 88 patients aged 13 to 77 years with spondylolisthesis of different etiology: dysplastic (Group I) – 11 patients, isthmic (Group II) – 42, degenerative (Group III) – 31, and traumatic (Group IV) – 4.

Results. The study showed that general (sensory-motor deficit index – SMDI) and particular ENMG characteristics of sensory- motor deficiency depend on the etiology of the spine disease. Namely the total SMDI, calculated for each patient as a mean value of relative ENMG indices, expressed as a percentage of control group (healthy subjects), was 86.5 ± 5.6 % in Group I, 91.6 ± 2.8 % in Group II, 77.6 ± 2.9 % in Group III, and 88.3 ± 10.2 % in Group IV.

Conclusion. The most pronounced ENMG manifestations of neurological symptoms were observed in patients with degenerative spondylolisthesis, the least – in ones with isthmic spondylolisthesis.

Objective. To clarify specific signs of idiopathic scoliosis progression that may be associated with change in glycosaminoglycan turnover.

Material and Methods. Blood serum samples from 180 adolescents aged 11–14 years with grade I–IV idiopathic scoliosis were tested for sulphated glycosaminoglycan levels, and for activity of lysosomal glycosidases (hyaluronidase, N-acetyl- β-D-glucosaminidase, β-glucuronidase, and α-galactosidase) and cathepsine D.

Results. Reduction in serum sulfated glycosaminoglycan levels, as compared to the levels of healthy subjects, was revealed in 25 % of adolescents with early stages of spinal deformity development, and in more than 70 % of those with idiopathic scoliosis of grade III–IV. Activity of α-galactosidase in adolescents with high grade of deformity 3–10 times exceeded that of in normal subjects. Any correlation between a change in the activity of other blood lysosomal glycosidases and a degree of scoliosis was not revealed.

Conclusion. The obtained data demonstrate that levels of examined sulphated glycosaminoglycans and α-galactosidase activity are in certain correlation with a grade of scoliotic deformity of the spine. Thus, these characteristics may be considered as a kind of biochemical markers of idiopathic scoliosis progression, and further study of glycosaminoglycan and galactose metabolism may be one of the prospective directions in studies of idiopathic scoliosis pathogenesis.