The sets of new implants of Nitinol, intended for dynamic spinal stabilization for its injuries and degenerative diseases have been theoretically proved and developed. The implants made of Nitinol simulate the function of the bone and soft-tissue structures being replaced (ligaments, disks).

Experimental studies of “Kollapan” and “Kostma” materials are presented in this article. The experiments were performed in 97 laboratory rats of Wistar line, involving their tail spine. The change in reparative osteogenesis was traced for penetrating fractures of vertebral bodies with biocompositional and osteoplastic material plasty using roentgenological, morphological, densitometrical methods of study dynamically, that demonstrated the materials to be biocompatible, gradually resorbed matrices, on the surface of which new bone was formed.

The results of surgical treatment have been analyzed in 100 patients with comminuted penetrating fractures of the bodies of inferior thoracic and lumbar vertebrae. The periods of surgical intervention made up from the first day to 3 months from the time of injury. Patients’ age ranged from 15 to 60 years. Transpedicular spondylosynthesis procedure was used in all patients: 20 of them were operated on using an external fixator, 80 – with internal transpedicular fixators and an original repositional device. Interbody spondylodesis with autograft was performed as a second stage in some patients of both groups if there were strict indications.

The technique of little-invasive ventral spondylodesis and percutaneous submersible transpedicular fixation has been worked out and successfully used in 45 clinical cases of treatment for non-complicated injuries of lower thoracic and lumbar vertebrae.

Сопоставили нейрофизиологические характеристики состояния сенсомоторной иннервации мышц нижних конечностей у больных с различным уровнем локализации повреждения в грудном и поясничном отделах позвоночника. Проанализированы данные глобальной (тесты: «расслабление», «максимальное произвольное напряжение») и стимуляционной (М-ответы, Н-рефлексы) ЭМГ у 48 больных (36 – мужского и 12 женского пола) в возрасте от 11 до 55 лет, распределенных по уровню повреждения позвоночника на три группы: 1 гр. (DIV-DVIII) 4; 2 гр. (DIX-DXII) 10; 3 гр. (LI-LV) 32. Выявлены особенности функциональных сдвигов в спинном мозге у больных с последствиями позвоночно-спинномозговой травмы различной локализации, отраженные в послеоперационной динамике взаимодополняющих ЭМГ-характеристик посттравматического сенсомоторного дефицита. Наиболее отчетливые ЭМГ-признаки функциональной недостаточности в до- и послеоперационном периодах отмечены у больных с повреждением позвоночника на уровне DIX–DXII, что топологически соответствует локализации мотонейронных ядер, т.е. расположению сегментарных моторных центров контроля произвольной и рефлекторной активности мышц нижних конечностей.

The data of the functional status of peripheral neuromotor structures have been analyzed in 32 patients at the age of 19-67 years, admitted to RISC ―RTO‖ for treatment with the purpose of electromyographic assessment of the effectiveness of complex neurorehabilitation in patients with brachiplexopathies of traumatic genesis on the basis of direct electrical stimulation of brachial plexus nerve trunks. It has been revealed that after treatment completion, as well as in the periods of nearest and long-term control the increase takes place concerning such total EMG parameters as the average amplitude and frequency of oscillation propagation along the majority of leads from the muscles of the limb involved, which is reliably significant in some cases. All this shows the positive effect of direct electrostimulation on brachial plexus nerve trunks, which is supposedly based on the increase of extra- and intraneural blood flow in injured structures, thereby initially contributing to conductive property recovery of chronically ischemized nerve fibers and in the long-term periods after treatment – to more favourable process of reinnervation.

Treatment outcomes were studied in 35 patients with scoliosis of different severity who were treated with OIM system of internal transpedicular fixation (Vertebra Stabilization System Ø 5,5-6,35) (Turkey). The results obtained showed that there was no correction loss one year after surgery. 2-5º change in the deformity angle in patients above 20 years was associated with spine degenerative changes. There were no complications related to soft tissue inflammation, hardware breake in this group of patients. All the patients were satisfied with cosmetic and functional outcomes.

Clinical-and-genealogical studies of Scheuermann disease (SD) and idiopathic scoliosis (IS) have been performed comparatively in 35 families of probands with SD (532 subjects). 35 probands with SD at the age of 14-19 years have been subjected to clinical-and-roentgenological examination/ as well as 212 members of their families of 1st-3th relation degree at the age of 14-65 years. The clinical-and-genealogical and clinical-and-roentgenological examinations of proband relatives have revealed 124 (58,5%) patients with both SD and IS, among them 84 (67,7%) patients suffered from SD and 40 (32,3%) – from IS. As it turned out, SD was observed mainly in male subjects and idiopathic scoliosis – mainly in female ones. The results of the study made demonstrated mixed inheritance of SD and IS in a separate family.

The most important mission of present-day medicine consists in the development of the new medical preventive and treatment-and-health improving technologies, directed to significant increase of health potential, as well as to prolong human active and creative life-span. This aim should be reached through prophylactic medical examination, extensive measures on sanitary-and-hygienic education with active patient’s participation. The aim of this study was to determine the amount and structure of dorsopathy inpatient treatment expenses and the costs of organizing the preventive measures, which would allow to delay or eliminate patient’s hospitalization for this disease.

Retrospective study of 464 patients with spinal osteochondrosis has been performed. On the basis of analyzing the results of treatment using traditional discectomy intraoperative complications have been revealed in 72 patients (bleeding from epidural veins, dural damage, root injury), immediate postoperative complications – in 86 patients (hematoma, liquorrhea, wound suppuration, spondylodiskitis, instability, non-eliminated hernia) and long-term ones – in 90 patients (hernia recurrence at the operated and/or adjacent levels, epidural fibrosis, spondyloarthrosis and stenosis, instability). Surgical intervention was performed by traditional interlaminar approach with expansion to hemilaminectomy and laminectomy. Studying the data obtained has demonstrated that the unsatisfactory results of surgeries and significant number of disease recurrences are accounted for standard using techniques of the same type for patients of heterogenous group. For the purpose of the best results of patients’ medical and social rehabilitation the authors propose to make decompression-and-stabilizing surgeries performed by posterior surgical approach.

Implants of porous titanium nickelide can be successfully used for various types of interbody spondylodesis alongside with implantis of other known kinds. Application of the implants of porous titanium nickelide decreased surgical traumaticity and did not require additional use of autobone tissue.

Compression neuropathies – injuries of peripheral nerves as result of compression, which influences either by an external force or by a nearby anatomical structure. At present the problem of compression neuropathies is a very urgent one due to a lot of patients suffering from this disease. Carpal tunnel syndrome and cubital tunnel syndrome are the most common CNs. 36 patients with carpal tunnel syndrome (29 females, 7 males) and 17 patients with cubital tunnel syndrome (1 female, 16 males) have been operated on in the Togliatti clinical hospital No. 5 within the period of October 2006-October 2008. Positive dynamics was observed in all the patients in early postoperative period, during control examinations and electromyographic studies.

The work deals with the author’s experience of surgical treating 54 patients at the age of 20-70 years with lumbar disc herniae. Microsurgical discectomy was performed according to Caspar's technique and with the help of Aesculap set of microsurgical instruments. Indications for surgical treatment have been worked out, and the results of treatment have been analyzed. By the author's findings, microsurgical discectomy is a modern and highly effective method of treatment. Good and satisfactory results have been achieved in 54 (100 %) patients as a result of microsurgical discectomy use.

The condition of cerebral hemodynamics and microcirculation has been studied in 105 children at the age of 7-10 years with episodic and chronic headaches of muscle tension type. The changes in the tone of arterial bed vessels up to spasm condition (with the predominance of increased vascular tone of mainly vertebrobasilar area in children with chronic headache) are demonstrated in the article, as well as the tension of regulatory mechanisms in microcirculation system which leads to sharp decrease of microvascular reactivity, on the one hand, and, on the other hand, to venous outflow impediment, that are accompanied by capillary blood flow decrease. Possibly, the factors revealed play a defining role in the development and progress of cephalalgic syndrome in chidren of primary school age and require correction.

Circulation rate at rest and during functional respiratory tests has been studied in 30 patients with insult consequences and in 32 subjects without brain blood supply pathology. The value of linear circulation rate along the medial cerebral artery has been found not to reflect the degree of brain structure involvement. The values of blood flow along the arteries of brain contralateral side can’t be considered as norm standard. The vascular reactivity decrease of the brain side involved begins for cyst size > 5 cm3, and the decrease of circulation rate absolute values – for brain cyst size > 50 cm3.

The long-term results of total replacement of the hip have been studied for its different severe pathology in 45 patients subjected to 47 surgeries of “Altimed” construction implantation. Reoperations were performed in 2 patients out of 45 ones on account of unsatisfactory result of endoprosthetics using “Altimed” construction. Good results were obtained in 42 cases, satisfactory – in 1 case and poor or unsatisfactory results – in 2 cases. The said 2 patients were subjected to repeated endoprosthetics procedure using “Altimed” construction of larger dimension-type.

The work deals with the constructive features of SLPS ZAO ―Altimed‖ (Belarus) hip endoprosthesis, its advantages and shortcomings, technological aspects of acetabular and hip component implantation and removal in the process of primary and revision interventions. Long-term results of 708 (650 total and 68 hybrid) primary implantations were analyzed as follows: excellent results were obtained in 171 (24,1%) of cases, good ones – in 453 (64%) of cases, satisfactory – in 59 (8,4%) of cases and unsatisfactory results (prosthesis instability) – in 25 (3,5%) of cases. The author propose engineering solutions, which allow to improve the results of endoprosthetic surgeries with the help of this system (SLPS ZAO ―Altimed‖) as well as to reduce intraoperative blood loss, intervention time and invasiveness.

Aim: To determine differentially with in vitro model the influence of positioning non-observation and that of the proper error of apparatus-programming complex on the results of projection BMD (PBMD) study using DEXA method for the hip endoprosthetics with cemented fixation (CPT model, Zimmer). It has been revealed that in case of incorrect positioning with femoral rotation ±5o the error average values in the Gruen zones increased in the following sequence: the Gruen zone 4, 1, 3, 5, 2, 6, 7. The maximal error of DEXA complex reproducibility was observed in zone 6, amounting to 6,2%. To take it down to clinically insignificant values (±1%) the following algorithm has been suggested. At first two consecutive measurements should be made without changing the position, and after that, according to the results obtained, PBMD Mav1 should be calculated in every Gruen zone. If both results are within the boundaries of Mav1 (±1%), there is no need in further measurements. Otherwise one more measurement should be performed. Then, on the basis of the all three measurements Mav2 is calculated in each Gruen zone, and it is compared with Mav1. If the difference between them is less 1% the number of measurements is considered sufficient. If it exceeds 1% one more procedure of PBMD estimation is necessary, and so on until the difference between Mav of the previous and that of the last measurement amounts to ≥ 1%. This algorithm allows a physician to control the amount of reproducibility error of the apparatus-programming complex.

Integral clinical-and-roentgenological indicial evaluation of the knee dysplasia has been developed in the clinic of RISC ―RTO‖. The use of the scheme developed allows to standardize the pathology character dynamically and simplify its usage with scientific and practical purposes. For the first time morphoroentgenometric measurements have been introduced into evaluation.

The work deals with structural changes occurring in the knee and ankle in case of tibial shaft defect of different genesis. The revealed clinical-and-roentgenological signs of articular deforming arthrosis evidence the severity of the concomitant degenerative process, which complicates patients’ rehabilitation and requires performing individual tactics of osteosynthesis with an external fixator. Underestimation of these factors can decrease the effect of organ-saving treatment and delay it for many years.

The work deals with proposed by the authors biochemical methods of reparative osteogenesis evaluation in patients with injuries of different severity and localization both in posttraumatic period and in the dynamics of treatment by the Ilizarov method.

The authors demonstrate a combined technique of femur and leg length recovery in patients with trauma consequences and developmental defects, which allows to achieve segment length recovery, to reduce the periods of external fixation and inpatient treatment, to obtain good functional result.

The authors have observed 51 children with congenital anomalies of leg bone development for the last 20 years. While treating them they have used various techniques of hardware-and-surgical treatment. Long-term results have been studied in 41 patients. As a result of the treatment performed 36 children have begun to walk independently with functional weight-bearing of the lower limb involved.

Within the framework of clinical studies the condition of children with achondroplasia has been analyzed biochemically before treatment and during bifocal cross lengthening of femur and leg. Serum phosphomonoesterases activity in patients with achondroplasia has been revealed to be reliably higher in comparison with the analogous values in normal children of the same age. The level of electrolytes in children with achondroplasia does not exceed the bounds of physiological norm in spite of bone metabolism disorders.

The analysis of lower limb x-rays has been made in the process of treatment, after treatment and in the long-term period in 92 patients at the age of 4-38 years for the purpose of studying the characteristic features of bone tissue reorganization at different stages of surgical treatment and revealing the roentgenological backgrounds of deformity recurrence development in patients with rickets-like diseases (30 patients with vitamin D-deficient rickets and 62 patients with vitamin D-resistant rickets /phosphate-diabetes/).

181 patients with acquired forefoot deformity have been treated on the basis of the traumatological department of Nongovernment Public Health Institution Railway Clinical Hospital of the Chelyabinsk station of “Russian Railway” Open Joint Stock Company; the patients were subjected to correction of 324 feet. The total number complications was 9,9% (32 cases. While analyzing the causes of complications, 4 main groups of errors were found: errors of preoperative planning; intraoperative errors; errors of postoperative management; combined errors. Among them the greatest number was associated with the errors of preoperative planning (density – 43,8%) and postoperative management (density – 28,1%). Careful preoperative planning and the developed technological card of patient management in the postoperative period have allowed to reduce the number of complications.