[Facet joint distraction as a risk factor for poor clinical outcomes in older patients after anterior cervical discectomy and fusion.]

The search for literature sources in domestic and foreign databases showed the absence of works devoted to the study of the influence of the degree of distraction of the facet joints in elderly and senile patients who underwent anterior cervical discectomy and fusion (ACDF). The purpose of the study was to study the effect of the degree of facet joint distraction on clinical outcomes in patients of the older age group who underwent ACDF. A single-center retrospective study included 47 elderly and senile patients who underwent ACDF for radiculopathy due to degenerative diseases of the cervical spine. A statistically significant correlation was found between the differences in the value of the interfacet distance and the severity of pain in the cervical spine according to VAS (p<0,01). Patients with X-ray semiotics of facet distraction more than 0,55 mm 12 months after the operation were significantly more likely to experience increased pain in the cervical spine according to VAS (p=0,028) and significantly limited daily activities due to pain in the neck NDI (p=0,043). The choice of indications for ACDF in patients of the older age group should be based on a rigorous analysis of facet distraction, cervical sagittal parameters in combination with the functional status of patients.

[Quality of life after reconstructive procedures for esophageal strictures]. / Otsenka kachestva zhizni bol'nykh posle rekonstruktivnykh operatsii pri rubtsovykh suzheniyakh pishchevoda.

OBJECTIVE: To study the long-term results of reconstructive procedures for esophageal strictures and evaluate quality life after each type of esophageal repair using own criteria. MATERIAL AND METHODS: The study was conducted among patients who underwent esophageal repair with gastric transplant (172), colonic transplant (25), intestinal transplant (14) and repair of short cervical strictures (7). The age of patients ranged from 5 to 60 years. All patients underwent X-ray and endoscopic examination. Survey also included external respiration function and cardiac function, digestive function, measurement of height and weight, analysis of social aspects (work, study), female genital function. Five-score scale for quality of life assessment was developed. RESULTS: Long-term results were studied in 218 patients for the period from 3 months to 31 years (2002-2017). Excellent and good results were obtained in 180 patients. The best results were obtained after repair of short cervical strictures (4.42 scores), good results - after esophageal repair with gastric (4.14 scores) and intestinal (4.07 scores) transplants. Colonic repair was followed by satisfactory outcome (3.16 scores). CONCLUSION: Gastric and small bowel grafts are preferred for total esophageal repair due to better quality of life in long-term postoperative period.