[Staged correction of spinal deformity in a patient with incontinentia pigmenti syndrome].

Case presentation of staged surgical treatment of patients with spinal deformity in incontinentia pigmenti syndrome. As a result of surgical procedure proper sagittal balance of the body was restored.

[Surgical treatment of patients with spinal deformities with shortening of the lower limb].

AIM: Determination of the optimal diagnostic and treatment strategy in patients with scoliosis and having an anatomic shortening of the lower limb. PATIENTS AND METHODS: Surgical correction of scoliosis held 8 to patients with lower limb shortening caused by congenital dislocation of the hip (n = 3), anatomic shortening of the lower extremities due to the hip (n = 1), the shin bone (n = 4). Shortening before correction and fixation of scoliosis ranged from 6 to 14 cm, after surgery on the spine has been reduced by 2-4 cm achieved reduction or removal of pelvic obliquity. The second stage, after 8-12 months, performed surgery to address shortening of the lower extremity. Osteotomy of the femur with the imposition of a spoke - rod device held 4 tibial osteotomy with the imposition of external fixation device Spoke - and 4 patients and in the subsequent limb lengthening was performed by compression-distraction osteosynthesis. RESULTS: After the dorsal stabilization and fixation of the spine scoliosis correction averaged 64% (from 76 to 27 degrees), the value of breast/thoracolumbar kyphosis after surgery failed to bring to the physiological (average 43 degrees). Misalignment of the pelvis is reduced by 67% (from 24 to 8 degrees), which reduced the shortening of the lower limb by an average of 3 cm (compensation relative shortening by reducing or eliminating the distortion of the pelvis). Further compensation shortening held on the second stage of treatment, representing an osteotomy and subsequent elongation of the femur or tibia bones by transosseous compression-distraction osteosynthesis by Ilizarov. CONCLUSIONS: Multi-stage treatment reduced the degree of spinal deformity, to normalize the balance of the body, restore the function of distance without the use of orthotic devices and means of support.

[Vascular disturbances in craniovertebral pathology in children and adolescents]. / Sosudistye narusheniia pri kraniovertebral'noi patologii u detei i podrostkov.

The peculiarities of craniovertebral abnormalities and dysplasias in children and adolescents have been studied. Different diagnostic methods (dopplerography of spinal arteries, ultrasonography, remote infrared thermography, laser doppler flowmetry, etc) were compared. The outlines for treatment the patients with cervical dysplasias are described.

[Halo-traction efficacy in surgery on the cervical spine]. / Effektivnost' galotraktsii v khirurgii sheinogo otdela pozvonochnika.

The paper deals with the use of a halo-apparatus in lesions and diseases of the cervical vertebra. The halo-apparatus was used in 70 patients. It was most commonly employed in lesions of the upper cervical vertebra, such as fractures of the odontoid process and C2 vertebral arches. Analyzing the clinical findings showed halo-traction to be highly effective.

[The pathogenesis of elevated intracranial pressure in children and adolescents with craniovertebral pathology]. / O patogeneze povysheniia vnutricherepnogo davleniia u detei i podrostkov pri kraniovertebral'noi patologii.

The paper deals with intracranial hypertension in children and adolescents. Thirty-six patients with the upper cervical dysplasia and identified associated intracranial hypertension were examined. Magnetic resonance imaging and functional tests were used. Some patients were diagnosed as having a thickened ligamentous apparatus at the level of craniovertebral junction, which was a cause of spinal fluid dynamic disorders and led to elevated intracranial pressure.

[Diagnostic value of myeloscintigraphy in lesions and diseases of the spine]. / Diagnosticheskaia tsennost' mielostsintigrafii pri nekotorykh povrezhdeniiakh i zabolevaniiakh pozvonochnika.

Twenty-seven myeloscintigraphic examinations were carried out in 24 patients aged 6 to 66 with various diseases and involvements of the spine. Seven patients suffered from scoliosis complicated by neurologic symptoms, 2 from compression fractures of the L2 vertebra, 1 from a benign tumor of the spinal cord, 13 from various dislocations of the upper cervical segments of the spine, and 1 from a chronic fracture of the spinous process of C2 vertebra. Myeloscintigraphic examinations revealed different disorders of the spinal cord subarachnoidal space patency. The findings evidence higher diagnostic potentialities of myeloscintigraphy in a number of cases as against x-ray contrast myelography, for it permits the detection of patency disorders in the spinal subarachnoidal space, undetectable by x-ray contrast myelography.

[Atlanto-axial instability in injuries of the ligament system in children and adolescents]. / Atlantoaksial'naia nestabil'nost' pri povrezhdeniiakh sviazochnogo apparata u detei i podrostkov.

There has been carried out an experiment with 6 craniovertebral blocks with contrasting of the vertebral arteries and studying of the influence of different damages of ligamentous apparatus on blood flow in vertebral arteries. In all cases there has been discovered significant vertebrogenic influence. Experimental data have been corroborated with clinical material. There have been examined 31 patient with different damages of ligamentous apparatus of craniovertebral segment, with 21 of them has been detected significant vertebrogenic influence at ultrasound dopplerography of vertebral arteries.

[Functional computed tomography in the diagnosis of injuries to the ligamentous apparatus of the upper cervical spine in children and adolescents]. / Funktsional'naia komp'iuternaia tomografiia v diagnostike povrezhdenii sviazochnogo apparata verkhnesheinogo otdela pozvonochnika u detei i podrostkov.

Altogether 40 children and adolescents were investigated after injuries of the upper cervical spine using radiograms through the open mouth, functional radiograms of the cervical spine, and functional CT. Various injuries of the ligamentous apparatus of the upper cervical spine were revealed in 31 patients.

[Clinical aspects, diagnosis and surgical treatment of developmental anomalies of the cervical spine]. / Klinika, diagnostika i khirurgicheskoe lechenie anomalii razvitiia sheinogo otdela pozvonochnika.

The examination of 20 patients with abnormal cervical spine has identified Klippel-Feil disease in 12 of them, isolated vertebral synostoses of the cervical spine in 8. In 2 patients with Klippel-Feil anomaly neurovascular syndrome was reported which resulted from compression of the neurovascular bundle by extra cervical ribs. Indications to surgical treatment in Klippel-Feil disease are specified. The authors performed operations to correct the cosmetic defect and relieve compression of the neurovascular bundle in neurovascular syndrome.