[Comparative analysis of the results of anterior decompression-stabilization techniques in the treatment of degenerative stenosis of the cervical spine in elderly patients: a retrospective study.]

The purpose of the study was to compare the clinical and radiological efficacy of 2-level anterior cervical discectomy and fusion (ACDF) and 1-level anterior cervical corpectomy and fusion (ACCF) in the treatment of two-segment degenerative stenosis of the cervical spine in elderly patients. The retrospective study included 74 elderly patients (over 60 years old), two cohorts were identified: the 1st (n=38) - patients who underwent staged 2-level ACDF; the 2nd (n=36) - patients operated on using the technique of 1-level ACCF. For comparative analysis, we used general information about patients (gender, age, body mass index, physical status according to ASA), characteristics of surgical interventions (time of surgery, volume of blood loss), features of the postoperative period, clinical data, radiological outcomes, and the presence of complications. Analysis of the results was carried out in a minimum period of 36 months. As a result, it was found that 2-level ACDF in the treatment of two-segment degenerative stenosis of the cervical spine in older patients is associated with less blood loss and the level of local pain syndrome. At the same time, better clinical outcomes and fewer revision interventions after 1-level ACCF were recorded in the long-term postoperative period.

[Results of minimally invasive lumbar fusion in professional athletes: a single-center retrospective study]. / Rezul'taty minimal'no invazivnogo poyasnichnogo spondilodeza u professional'nykh sportsmenov: odnotsentrovoe retrospektivnoe issledovanie.

Professional athletes have a high basic level of physical fitness and significant motivation for returning to previous rhythm of functional activity within the shortest period after trauma without deterioration of baseline level of sportsmanship. Despite the well-presented results of lumbar spine fusion in general population, these data among professional athletes are not well understood. OBJECTIVE: To analyze the results of minimally invasive lumbar fusion in professional athletes. MATERIAL AND METHODS: A retrospective study included 27 athletes (19 men and 8 women) aged 29 (26; 34) years after minimally invasive lumbar spine decompression and fusion via anterior, lateral and posterior approaches. Total lumbar lordosis, degenerative changes in adjacent segment, area of multifidus muscle, perioperative complications and timing of sports rehabilitation were analyzed within 3-5 (mean 4) years after surgery. RESULTS: We found an increase of total lumbar lordosis from 35.2° to 44.1° (p=0.02), no significant muscle atrophy (<30%) and degeneration of adjacent segment (p>0.05). There were 5 perioperative complications (18.5%). Mean period of sports rehabilitation was 14 (9; 17) weeks. One (3.7%) patient did not return to his previous sports career. CONCLUSION: Minimally invasive short-segment lumbar interbody fusion in professional athletes is characterized by low risk of fixation element failure, no significant degeneration of adjacent level and postoperative muscle atrophy. This procedure ensures early rehabilitation and returning to sports.

[Comparison of open and minimally invasive techniques in the surgical treatment of intradural extramedullary spinal tumors in elderly and senile patients.]

With an increase in the average life expectancy of the population, some histological types of symptomatic IEMT are more common in elderly and senile patients. Of the 45 patients included in the study, 27 (60%) patients underwent a microneurosurgical resection of the tumor tissue using minimally invasive techniques (minimally invasive group) and 18 (40%) to patients using the classical open method (open group). The duration of operative intervention in both cohorts of respondents is comparable and is 245,4±117,1 min and 261,1±108,6 min for open and minimally invasive groups, respectively (p=0,71). The volume of blood loss in the minimally invasive group of patients (139,6±44,6 ml) was statistically significantly lower than in the open technique group (539,2±127,5 ml) (p<0,01). The total degree of resection of tumor tissue was achieved in 97,4% of patients in the open group and 92,8% in the minimally invasive group (p=0,81). The incidence of recurrence of IEMT in the study cohort of patients was 6,6%. At the same time, in 1 case the relapse of IEMT was verified in an open group of patients and in 2 cases in patients of the minimally invasive group. The average duration of hospitalization of patients of the minimally invasive group was 9,6±2,7 days, and the open group 13,5±3,1 (p<0,01). The comparison of the incidence of adverse events between the two groups of patients did not show significant differences (p=0,61).