Saratov JOURNAL of Medical and Scientific Research

Ostrovsky V.V.

Saratov State Medical University n.a. V.I. Razumovsky Scientific and Research Institute of Traumatology Orthopedics and Neurosurgery, Department of Neurosurgery and Vertebrology Candidate of Medical Sciences

Long-term results of posterior anchorage of subaxial vertebra in acute unstable trauma

Year: 2018, volume 14 Issue: №3 Pages: 501-504
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Bazhanov S.P., Ulyanov V.Yu., Ostrovskiy V.V., Likhachev S.V.
Organization:
Summary:

Aim: to study long-term results of posterior anchorage of subaxial vertebra in acute trauma. Material and Methods. We conducted an analysis of long-term results of posterior anchorage of subaxial vertebra in 17 patients with acute unstable trauma which had undergone complex clinical neurological and instrumental investigation, surgical treatment performed from dorsal approach, and the estimation of long-term results in preoperative period. Results. The obtained data indicate the method of transarticular anchorage to be effective and safe and not to have any negative effect on biomechanical properties of cervical spine in the long-term postoperative period. Conclusion. The use of posterior anchorage in acute unstable trauma is most reasonable in subaxial injuries accompagnied by the deformities of medial and posterior spinal columns.

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The tactics of surgical treatment in metastatic lesions of upper cervical spine.

Year: 2018, volume 14 Issue: №3 Pages: 498-501
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Bazhanov S.P., Gulyaev D.A., Ulyanov V.Yu., Ostrovskiy V.V., Tolkachev V.S.
Organization: The Almazov National Medical Research Centre, Head of Second Cerebral and Spinal Cord Tumors Department, Doctor of Medical Sciences
Summary:

We demonstrated a successful case of surgical treatment of the patient with metastatic lesion of upper cervical spine with respect to multidisciplinary approach. We performed simultaneous two-stage surgical intervention, the first stage being occipitospondylodesis by multi-segment construction; and second —tumor resection from expanded combined access. It has been stated that the proposed surgical tactics allows performing curative resection in one surgical session without neurological deficit buildup in the postoperative period.

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Personalized approach to diagnostics and treatment of patients with posttraumatic and degenerative diseases of cervical spine

Year: 2018, volume 14 Issue: №2 Pages: 244-250
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ostrovsky V.V., Shchanitsyn I.N.
Organization:
Summary:

Aim: to develop a personalized approach to diagnostics and treatment of patients outcomes with degenerative and post-injury deformities of cervical spine. Material and Methods. Between January 2009 and January 2016, 520 patients at the age of 15-80 years with degenerative (227) and traumatic (293) lesions of cervical spine were treated in neuro-surgical department. We conducted a comparative analysis of two groups of patients: treated in the period from 2009 to 2012 (group 1: 235 patients) and in the period from 2013 to 2016 (group 2: 285 patients). The developed diagnostic algorithm was used in patients of group 2 when the operation was planned. Results. The frequency of all complications was significantly lower in group 2. In the analysis of complications it was revealed that more often in group 1 there were: dysphagia, dysphonia, severe postoperative pain in the neck and upper limbs; breakdown or malposition of the screw, graft or plate. Conclusion. The comprehensive algorithms for diagnosis and treatment of patients with degenerative and post-injury deformities of cervical spine that take into account their individual morphometric and functional data allow to form an effective personalized program of surgical rehabilitation and reduce the number of perioperative complications from 35 to 9%.

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A comprehensive evaluation of cervical spine surgery outcomes

Year: 2017, volume 13 Issue: №2 Pages: 266-273
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ostrovsky W, Schanitsyn IN, Bajanov SP, Fedonnikov AS.
Organization: Saratov State Medical University
Summary:

Aim: study of diagnostic value of different assessment scales to evaluate outcomes of surgeries in degenerative and post-injury deformities of cervical spine. Material and Methods. Between January and December 2015, 110 consecutive patients with degenerative and traumatic lesions of cervical spine were selected for surgery and results of treatment were followed. Preoperatively and 12 months postoperatively the patients filled in a questionnaire that included a VAS, Odom's scale, NDI, modified JOAand the Zung Depression Scale. To assess the results of the intervention, the concept of "effect size" was used. Distribution of different scores classified according to Odom's criteria as excellent/good and fair/poor. Results. All scores improved in all group of patients. For VAS, NDI and modified JOA scores the effect size was largest. NDI, JOAand ZDS seemed to correlate well with the classification of outcome by Odom. Conclusion. It is suggested many scales to assess the outcomes of the cervical spine surgery based on different criteria; nevertheless, there are no generally accepted and validated methods that can be used to analysis the outcome of cervical spine surgery. We conclude that investigated

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Towards the causes of secondary post-traumatic deformations of thoracic and lumbar spine

Year: 2015, volume 11 Issue: №4 Pages: 570-575
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shulga А.Е., Zaretskov V.V., Ostrovsky V.V., Arsenievich V.B., Smolkin A.A., Norkin I.A.
Organization:
Summary:

The purpose of the study is to analyze and systematize main causes of secondary spine deformations forming in patients who had operations due to thoracic and lumbar spine damages. Material and Methods. The analysis of poor surgical results of 155 patients previously operated due to various thoracic and lumbar spine damages has been conducted. All patients had complications associated with secondary spinal column deformations at various time after the intervention. Standard investigation included the analysis of patients' complaints, their previous history, somatic, neurological and orthopedic status. Results. The intensity of spinal column deformation was defined due to the character and level of primary trauma structurally characterized predominantly by unstable damages. However as it has been found in this research the main cause of this complicated pathology lied in the number of tactical and technical pitfalls of primary surgical treatment. Conclusion. Surgical operations due to secondary post-traumatic deformations in most cases are laborious and are accompanied by significant surgical trauma therefore systematization and analysis of the main causes of poor results of primary spine surgery may contribute to the preventive treatment of this type of pathology.

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Коррекция трофологической недостаточности у больных с синдромом компрессионной миелопатии различной этиологии на уровне верхнешейного отдела позвоночника

Year: 2012, volume 8 Issue: №3 Pages: 825-830
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Bajanov S.P., Uljanov V.Yu., Ostrovsky V.V., Shchukovsky V.V., Makarkina E.V., Uljanova E.V.
Organization:
Summary:

Objective: To improve the treatment results of patients with traumatic injuries, and neoplastic lesions of the upper cervical spine on the basis of a differentiated algorithm of nutritional-metabolic therapy. Materials and methods: Based on clinical and instrumental methods of examination typical metabolic characteristics have been studied in 21 patients with compressive myelopathy at the level of the upper cervical spine. Results: Due to the received data differentiated algorithm of nutritional-metabolic therapy has been worked out. Conclusion: The use of nutritional-metabolic therapy in patients with compressive myelopathy at the level of the upper cervical spine may improve the treatment.

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Topographic and anatomic features of transverse foramen of cervical vertebra in age and sex aspect

Year: 2012, volume 8 Issue: №2 Pages: 177-181
Heading: Macro- and Micromorphology Article type: Original article
Authors: Anisimov D.I., Norkin I.A., Nikolenko V.N., Anisimova E.A., Aleshkina О.Yu., Ostrovsky V.V.
Organization: Saratov State Medical University, Saratov Scientific Research Institute of Traumatology and Orthopedics, First Moscow State Medical University n.a. I.M. Sechenov
Summary:

Purpose: to reveal regularities of variability of morphometric parameters of foramen of transverse process of cervical vertebra. Materials and Methods. Method of osteometry was used to determine size of transverse process of cervical vertebra at 112 adult skeletons. Results. Sexual dimorphism of size of transverse process of cervical vertebra, topographic variability of size, form and foramen orientations were revealed. Conclusion. Foramen size prevail at men over women by 0,5-1,5 mm and has characteristic of fluctuating dissymmetry

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Morphometric substantiation of a fixation method choice at surgical correction of spondylolisthesis

Summary:

The purpose was to reveal patterns of morphometric characteristics variability of lumbar vertebrae and sacrum for a choice of more adequate selection of standard sizes and introduction orientation of corrigent metalware at surgical treatment of spondylolisthesis. Preparations of lumbar vertebrae and sacrum of 60 skeletons, 110 Kt-grams of men and women of the first and second periods of mature age without visible pathology of a backbone and 300 Kt-grams of patients with spondylolisthesis. The data on age variability and sexual dimorphism of lumbar vertebrae and sacrum were obtained. The analysis of results of surgical treatment of 288 patients with spondylolisthesis during 1995-2008 was carried out. 160 patients were managed with preoperative planning, taking into account morphometric characteristics of vertebrae and sacrum since 2003. It is necessary to install and arrange metalware at reduction taking into account features of back structures and forward basic complex of lumbar vertebrae and sacrum; that allows to receive adequate decompression of neurovascu-lar structures in 85-90% cases, reliable correction and stabilization of damaged lumbosacral segments

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Experience of surgical treatment of unstable СII vertebral fractures

Year: 2010, volume 6 Issue: №2 Pages: 432-435
Heading: Traumatology and Orthopedics Article type: Short message
Authors: V.V. Ostrovskiy, V.G. Ninel, A.E. Shulga, A.A. Smoljkin, E.A. Anisimova
Organization: Saratov State Medical University, Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

CII arch fractures are divided into groups according not to anatomical localization, but to the instability degree resulted from the trauma. Effendi et al classification became greatly widespread. |t is based on the same stability criteria, but it is simpler, intelligible and gives the plan of treatment. All the fractures according to this classification are divided into three types: the first one consists in stable fractures in which even in functional images there is no any rough deformation at the level of CII segment; the second one consists in damages with significant angular (more than 11°) or shift (more than 3,5 mm) deformations, that indirectly indicates damage of soft tissue structures, and first of all diskoligamentous complex. The services of the authors of the present classification are also that they were the first who had defined fracture-dislocation of CII arch, attributed it to the third type. Choice of surgical procedure in unstable CII-III vertebral fractures is ventral spondylosyndesis of CII-III carried out by submaxillary approach after the preliminary closed elimination of deformation of upper cervical part of spine. The differentiated approach to the implant choice with an allowance for morphometric data allows to receive adequate decompression of nervous - vascular structures and reliable stabilization of the damaged segment

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NEW ASPECTS FOR OPTIMISATION OF SURGICAL TREATMENT OF DISCOGENIC ALGETIC SYNDROMES IN PATIENTS WITH LUMBAR OSTEOCHONDROSIS

Year: 2007, volume 3 Issue: №1 Pages: 92-94
Heading: Traumatology and Orthopedics Article type: Original article
Authors: V.V. Ostrovskiy, I.A. Norkin, V.G. Ninel, V.N. Ivanchenkо
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

Results of surgical treatment of intervertebral disk herniations in 58 patients with discogenic algetic syndromes are giver in the article. Introduction of drug compound through the catheter placed in the epidural cavity with direct electrostimulatior of affected spinal nerve roots optimize the results of treatment in 92,8% of patients after repeated surgery.
Key words: intervertebral disk herniations, pain syndromes of spinal nerve roots, epidural application of drugs, direc, electrostimulation of spinal nerve roots.

Keywords: ostheochondrosis