Objective. To analyse the results of treatment of patients in whom, after fixation of the thoracic spine, contact of screws with the aorta with its wall injury was revealed.Material and Methods. Three own observations and literature data were analysed.Results. Three patients with potential (1 case) and true (2 cases) injury to the thoracic aorta by a transpedicular screw underwent simultaneous surgical intervention including thoracic endovascular aortic repair (TEVAR) followed by remounting (2 cases) or removal of the transpedicular fixation system. An analysis of publications on this topic is presented.Conclusion. Intramural hematoma caused by screw malposition is an indication for aortic repair due to the risk of its dissection or rupture.It is advisable to give preference to endovascular methods of treating vascular injuries under conditions of local anesthesia as the first stage, and then to perform the revision of transpedicular fixation system under anesthesia.

Analysis of surgical treatment of 193 patients with complicated injury of cervical, thoracic and lumbar spine was performed. Optimum time for surgery, approaches, operation stages as well as necessity of injured segments fixation are considered. In cervical spine injuries decompression, spondylodesis with autobone and CSLP (AO) plate fixation were performed. In thoracic and lumbar spine injuries decompressive laminectomy, revision, meningomyeloradiculosis when indicated, suturing of injured radicis with following transpedicular fixation using USS (AO) system were carried out. High efficacy of surgical treatment for complicated spine injuries is proved in availability of minimum time after injury, rational preoperative planning, adequate anesthesiology provision, wide decompression, and accurate choice of implanted metal device.

Ten years experience in microdiskectomy for the treatment of degenerative spine diseases (about 900 patients) is presented. Seven hundred and seventeen patients have been operated on by traditional W.Caspar technique and 21.4%) out of them required not only diskectomy but radiculolysis, resection of the arch margins and posterior longitudinal ligament. In some patients side by side with microdiskectomy, spondylodesis via interarch approach using CAC system combined with transpedicular system USS (AO) was performed. The same technique was used in patients with lumbar vertebra spondylolisthesis. Positive results were achieved in 88.2% of cases.

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