Objective. To analyze long-term results of surgical correction of idiopathic scoliosis and congenital spinal deformity using the patient self-assessment SRS-24 questionnaires.

Material and Methods. The study included 121 patients operated on for idiopathic (106) and congenital (15) scoliosis using third generation segmental instrumentation (112 cases) and Harrington distraction rod (9 cases). Patients completed the SRS-24 questionnaire in 6, 12, 24 and more than 60 months after surgery. A total number of 448 questionnaires were analyzed.

Results. Girls’ assessment of surgery outcome at five year follow-up was in whole higher, though they had more pronounced pain syndrome. Patients with congenital scoliosis gave lower estimates in most domains than those with idiopathic scoliosis. Segmental instrumentation in all seven domains had the advantage of the Harrington distraction rod. As the follow-up period increased the estimate of the achieved effect raised. Rib hump resection caused increase in patient self-assessment of the treatment result in all cases.

Conclusion. Patient-reported outcome survey using SRS-24 questionnaire is simple, easy to interpret, and effective method. The obtained data showed the high quality of achieved results.

Objective. To analyze feasibility of computer optical topography in determining of pathogenetic effect of leg length inequality on posture and stereotypes of adaptive activity of the spine.

Material and Methods. The study included 59 patients aged from 4 to 29 years with congenital and acquired lower limb shortening of 2–17 cm. Spatial characteristics of the trunk and the spine in orthostatic position were studied using 5–10 topographic images obtained at 10–20-second time intervals during prolonged standing for up to 5 minutes in the setting of fully or partially compensated leg length discrepancy. Topographic monitoring of the spine with marker was performed before and after surgical correction of limb shortenings.

Results. Standing in orthostatic position was associated with alteration of spatial characteristics of the trunk, namely variations in orientation and shape of the trunk and the spine. The prolonged study of postural activity allows for instrumental evaluation of stereotypes of the spine adaptive activity and determination of changes in its kinematic lability using functional tests.

Conclusion. Coefficients of variation of parameters describing deformity angles represent rigid properties of curvatures, and can serve as criteria of motor pathology in stereotypes of the spine postural activity. Pathogenetically, deformity rigidity and low kinematic lability of vertebral motor segments can be considered similar to the prolonged articular immobilization which leads to stiffness, myogenic contracture (functional scoliosis), and ankylosis (fixed scoliosis).

Objective. To analyze principal parameters of sagittal spinopelvic relations in patients with hip-spine syndrome.

Material and Methods. Clinical examination protocols and X-ray images of 42 patients with unilateral or bilateral grade 3 hip arthrosis and vertebrogenic pain syndrome were analyzed. Four principal sagittal parameters of spino-pelvic balance were measured, statistically processed, and compared with normal values.

Results. The positive correlation was found between the sacral slope and the lumbar lordosis. Normal spino-pelvic relations were noted in 6 (14.3 %) cases, an excessive anteversion of the pelvis with compensatory hyperlordosis – in 34 (81.0 %), and retroversion of the pelvis with flattening of the lumbar lordosis – in 2 (4.7 %) cases.

Conclusion. Changes in hip joints cause compensatory responses of the spine. Unilateral or bilateral hip joint arthrosis in most cases leads to excessive anteversion of the pelvis and hyperlordosis of the lumber spine with overloading of its segments. Another variant of compensatory posture is retroversion of the pelvis with a loss of lumbar lordosis. Both types of compensatory vertical posture are associated with vertebrogenic pain syndrome and degenerative-dystrophic changes in the spine.

Objective. To present and assess the efficacy of the method of primary stabilization of the spine using combined bonecarbon implant in surgical treatment of patients with tuberculous spondylitis.

Material and Methods. Mechanical properties of the Gargo carbon-carbonic implant were studied and clinical application of newly developed combined implant was analyzed. The clinical stage of the study included analysis of surgical treatment results in 20 patients with tuberculous spondylitis operated on using combined bone-carbon implant (Group 1). Results of surgical treatment of 31 patients with tuberculous spondylitis who underwent anterior fusion with bone autograft were used for comparison (Group 2).

Results. Experimental study showed that carbon-carbon implant bears greater static loads as compared with autografts. The engineered combined bone-carbon implant possesses a significant strength margin and biological compatibility. The incidence of bony ankylosis was greater in Group 1 (90.0 %) than in Group 2 (67.7 %). The treatment efficiency was 83.3 % in Group 1 and 71.1 % in Group 2, and excellent and good results were achieved in 88.2 % and 77.8 % of cases, respectively.

Conclusion. Results of application of combined bone-carbon implant for tuberculous spondylitis showed its high efficiency when compared with conventionally used osteoplasty.

Objective. To analyze histogenetic potencies of the 3D chondrograft for correction of artifactual vertebral body lesion.

Material and Methods. Osteogenic potencies of the 3D chondrograft isolated from minipig primary cartilage were studied in canine experimental model of artificial vertebral body defect.

Results. Tissue specificity of 3D chondrograft was confirmed by the presence of aggrecan, chondroitin sulfates, keratin sulfates, and type I and II collagen in cells and in the matrix, as well as by the expression of aggrecan, biglycan, and lumikan genes, and ultrastructural arrangement of cells and the matrix (chondrometabolic barrier). Transformation of chondrograft occupying the space of bone defect led to complete restoration of vertebral bone structure followed by the formation of organo-specific bone tissue. Restoration of bone tissue was promoted by chondrograft in the way of enhonral osteogenesis, both embryonic and regenerative.

Conclusion. High reparative potencies of chondrograft suggest its feasibility in correction of pathologies caused by chondroosteogenesis disorders and dystrophic changes in the osteoarticular system.