[Analysis of dynamic implants use in surgical treatment of degenerative lumbar spine stenosis].

AIM: To improve the results of surgical treatment of lumbar spine stenosis. MATERIAL AND METHODS: Surgical treatment of 84 patients was analyzed. There were 2 groups consisting of 48 and 36 patients respectively. Advanced decompression and fusion were performed in group 1, minimally invasive decompression (flavectomy, marginal arch resection, facetectomy) with implantstion of interspinous dynamic implants DIAM -- in group 2. Patients with isthmic spondylolisthesis were excluded. RESULTS AND DISCUSSION: Both methods did not show difference in efficacy of leg pain relief during follow-up (1.7--8.5 years). 16.7% of patients after fusion of more than 2 segments had pain above and below fusion area in long-term postoperative period. Such pain was not observed in group 2. One patient of the 1st group had fixation system destruction that required repeated intervention. Groups have not difference in back pain severity after surgery on 1 segment. Also less intraoperative blood loss and duration of surgery were established in group 2. CONCLUSION: Minimally invasive decompression with implantstion of interspinous dynamic implants is effective and safe alternative to advanced decompression and fusion in lumbar spine stenosis management.

[Cryodestruction in neurosurgery].

The study aimed to work out the method of cryodestruction of brain tumors. 10 patients with neuroepithelial brain tumors were prospectively operated on with the use of cryodestruction. MRI was performed before and after the operation. The operation strated from tumor biopsy under the ultrasound control with further injection of cryoprobe with further destruction. The study demonstrated that ultrasound navigation is an effective means of the cryodestruction control on all stages. The cryodestruction itself is a miniinvasive, easily controlled and effective method, applicable for tumors, located in functionally important regions of the brain, where major surgery could be mutilating.

[Rare combination of acromegaly, syringomyelia and Chiari I malformation].

Chiari I Malformation (CM) is a congenital pathology of rombencephalon development characterized by disparity of brain structures and bony compartment in posterior fossa. The incidence of Chiari I malformation ranges from 3.3 to 8.2 in 100 000. In 80% of cases CM is combined with syringomyelia. Combination of CM and pituitary adenoma (PA) is rare condition with just a few cases described in literature. Current article represents a case of successful treatment of patient with CM and PA combination and a 5-year follow-up.

[Radiological diagnosis of liver hemangiomas: look at the problem of surgical clinic].

AIM: To define significance of radiological diagnostics in detection and characterization of hepatic hemangiomas. MATERIALS AND METHODS: Analysis of 176 patients with liver hemangiomas was performed. All patients were investigated or consulted in hepato-pancreato-biliary surgical department. US, CT, MRI, angiography, scintigraphy and liver biopsy were compared. RESULTS: Contemporary noninvasive diagnostics disclose liver hemangiomas with high confidence without need for tumor biopsy. MRI and CT with intravenous enhancement are the most efficient modalities for detection of hepatic hemangiomas.