Saratov JOURNAL of Medical and Scientific Research

neurosurgery

Modern principles of treatment of recurrences of hernias of intervertebral disc of lumbar spine (review)

Year: 2020, volume 16 Issue: №3 Pages: 769-772
Heading: neurosurgery Article type: Review
Authors: Chekhonatsky V.A., Dreval O.N., Kuznetsov A.V., Chekhonatsky A.A., Gorozhanin A.V., Shestakov A.A., Sidorenko V.V.
Organization: Clinical Hospital n. a. S. P. Botkin, KSMA — branch of the Russian Medical Academy of Continuous Professional Education, Saratov State Medical University
Summary:

The review of data on the study of the effectiveness of modern methods of treatment of recurrent intervertebral hernias of the lumbar spine according to research by specialists involved in the treatment of degenerative diseases of the spine. The search for medical literature was carried out from 2010-2019 using available databases: PubMed, eLibrary, Cochrane in the number of 31 sources. This publication presents the main methods of surgical treatment of recurrent herniated disc, describing both positive and negative aspects of each method.

Keywords: recurrence, treatment
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The choice of performing tactics of dorsal decompressive-stabilizing interventions on the lumbar spine for the prevention of degenerative disease of an adjacent segment

Year: 2020, volume 16 Issue: №3 Pages: 762-768
Heading: neurosurgery Article type: Original article
Authors: Byvaltsev V.A., Kalinin А.А., Pestryakov Yu.Ya., Spiridonov A.V.
Organization: Clinical Hospital "Russian Railways Medicine", Irkutsk State Medical University, Krasnoyarsk Regional Clinical Hospital, Russian Railways
Summary:

Purpose: Comparative analysis of the results of dorsal decompressive-stabilizing interventions (DDSI) on the lumbar spine for substantiating the method of prevention of adjacent segment degenerative disease (ASDd). Material and Methods: 79 patients were included in the retrospective research, 2 groups were identified: in group I (n=41) single-level research, in group II (n=38) two-level DDSI, with rigid stabilization of the spinal motion segment, in the presence of signs of its degeneration was made. Clinical outcomes, instrumental data and surgical complications were evaluated. Results: It was a decrease of pain syndrome in the postoperative period, an improvement in the quality of life in two groups (p<0.001). In the inter-group comparison of the visual analog scale (VAS) — back, legs, ODI, SF-36 in group II, the results at discharge were lower than in group I (p<0.001), after 3.6.12 months there is a comparable improvement in a quality of life and a decrease in pain by VAS in both groups (p>0.05). In the distant period (24, 36 months), clinical results are better in-group II (p<0.05). The number of late surgical complications and revision interventions is higher in a group II (17.1 and 4.0%) (p<0.05). Conclusion: Preventive rigid stabilization of adjacent segment with signs of initial degeneration improves long-term results, reduces the number of repeated operations, despite the larger volume of primary medical intervention.

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Some features of pathogenesis of the course, diagnosis and treatment of radicular and myelopathic syndromes of cervical osteochondrosis (review)

Year: 2020, volume 16 Issue: №1 Pages: 64-68
Heading: neurosurgery Article type: Review
Authors: Chekhonatskiy А.А., Komleva N.E., Chekhonatskiy V.A., Bubashvili A.l.
Organization: KSMA — branch of the Russian Medical Academy of Continuous Professional Education, Saratov Scientific Research Institute of Agricultural Hygiene, Saratov State Medical University
Summary:

The review of the literature data on the peculiarities of the pathogenesis of radicular and myelopathic syndromes of cervical osteochondrosis is presented. The issues of differentiated diagnosis of radiculopathic and myelopathic syndromes are considered. The characteristic of various methods of treatment is given. The efficiency and possibility of using electrostimulation of the spinal cord for the treatment of radicular and myelopathic syndromes of cervical osteochondrosis have been studied.

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Possibility of frameless biopsy of deep and remote brain tumors and impact of its results on treatment strategy

Year: 2019, volume 15 Issue: №2 Pages: 312-317
Heading: neurosurgery Article type: Original article
Authors: Shabunin A.V., Gorozhanin A.V., Vakatov D.V., Shestakov A.A., Chekhonatsky V.A.
Organization: Clinical Hospital n. a. S. P. Botkin
Summary:

Purpose: to assess the possibilities of frameless biopsy of brain tumors with deep and hard-to-reach localization and its impact on the treatment strategy. Material and Methods. 56 patients with supratentorial brain tumors of deep and hard-to-reach localization who underwent biopsy using frameless neuronavigation according to accepted standards. Results. In 9 (16.1 %) cases there was a discrepancy between the data of the preliminary MRI examination and the histological conclusion of the punctate after the biopsy, which changed the tactics of treatment. Conclusion. Biopsy of brain tumors of deep and hard-to-reach localization allows you to accurately and least invasive to establish the correct diagnosis. Conducting a frameless biopsy with subsequent immunohistochemical verifcation of the biopsy allows planning adequate further treatment, increasing the duration and quality of life of patients with brain tumors of deep and hard-to-reach localization.

Keywords: treatment
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The study of surgical activity dynamics at patients with hypertensive intracerebral haematoma using simulation analysis in the Chuvash Republic

Summary:

Objective: improving the efciency of treatment for patients with hypertensive intracranial hematomas by means of planning optimization, epidemiological evidences simulation analysis and dynamics of surgical treatment indices. Material and Methods. 225 patient charts with hypertensive intracerebral hematomas have been analyzed. All patients were examined and treated in Cheboksary Republican Clinical Hospital January 2008 to December 2017 Results. The retrospective analysis revealed decrease in the number of surgeries for hypertensive intracerebral hematomas from 35 to 19 From 2011 to 2017 mortality in the group of patients with 30 to 60 ml hematomas decreased as well. Surgeries in the group of patients aged 50–70 who had strokes most frequently in 2010–2017 got fewer. Conclusion. Introduction of decision-making system at diagnosis stage enables applying diferentiated approach for choosing surgical treatment approach.

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Techniques of augmentation and full-endoscopic decompression in the treatment of patients with vertebral fractures of osteoporotic origin

Year: 2018, volume 14 Issue: №3 Pages: 412-416
Heading: neurosurgery Article type: Case report
Authors: Kravtsov M.N., Mirzametov S.D., Svistov D.V.
Organization: Military Medical Academy n.a. S. M. Kirov
Summary:

The article highlights debatable questions concerning the effectiveness of surgical treatment of osteoporotic vertebral fractures. The reasons of unsuccessful outcomes of vertebroplasty are analyzed. A combined method of surgical treatment is proposed, including vertebroplasty and full-endoscopic foraminotomy with a combination of local and ra-dicular pain syndrome caused by stenosis of the intervertebral foramen. A clinical example is given.

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Algorithm of surgical treatment of pain and spastic syndromes in patients after spinal cord injury

Year: 2015, volume 11 Issue: №3 Pages: 297-302
Heading: neurosurgery Article type: Original article
Authors: Ninel V.G., Smolkin А.А., Shchukovsky V.V., Korshunova G.A.
Organization:
Summary:

Objective: to develop an algorithm for surgical treatment of pain and spasticity in patients with consequences of spinal cord injury. Materials and Methods. The basis of the algorithm initiated a retrospective study of results of surgical treatment of 273 patients with pain and spastic syndromes after spinal cord injury, which consistently met neuromodula-tion techniques and destructive surgery. Results. The developed algorithm tested in 166 patients with pain and spastic syndromes provided positive results in 88.6% of cases with spastic and in 80.4% of observations for pain and spastic-pain syndromes. Conclusion. The proposed algorithm allows systematizing neuromodulation methods and so-called «radical» destructive operations in the treatment of pain and spasticity, and thereby improving the results of rehabilitation of patients with consequences of spinal cord injury.

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Factors for surgery indications in children with Chiari malformation Type I combined with scoliosis without syringomyelia

Year: 2014, volume 10 Issue: №3 Pages: 419-421
Heading: neurosurgery Article type: Original article
Authors: Glagolev N.V., Kozlitina T.N.
Organization: Voronezh Regional Children Clinical Hospital № 2
Summary:

Objective: Specification of indications for surgical treatment of Chiari malformations Type I (CMI) in combination with scoliosis without syringomyelia. Material et Methods: The article describes the results of treatment of children with Chiari malformations Type I (CMI) in combination with scoliosis without syringomyelia. The decompression surgery of the posterior fossa was made in 30 patients with CM I. All patients varied in the degrees of scoliosis. Results were evaluated including clinical and radiological survey, data of computer angiography and ultrasonic diagnostics of head and neck vessels in the preoperative and postoperative periods. The behavior of the angle of the spinal deformity in patients after decompression surgery of the posterior fossa was evaluated. Results: It has been found out that scoliosis convincingly regresses after this operation, if the angle of curvature of less than 30 degrees. Conclusion: The presence of vascular pathology at the level of the cranio-vertebral joints should be taken into account in the determination of indications for surgical treatment of patients with CMI in combination with scoliosis.

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