Objective. To analyze the results of surgical treatment of patients with injuries and diseases of the cervical spine operated on using transpedicular fixation with free-hand technique.Matherial and Methods. A total of 97 patients with unstable injuries, congenital and acquired deformities, as well as with tumorous lesions of the cervical spine were examined. All patients were evaluated for the stability and reliability of transpedicular fixation in the long-term period, with the analysis of mistakes and complications that arose during treatment.Results. Positive results were obtained in 94.8 % of cases, and signs of fixation instability were absent in all patients. Despite 125 cases of pedicle wall perforation, only four patients required revision surgeries. A low rate of complications was noted, including no damage to the vertebral artery. The pain syndrome in patients decreased.Conclusion. The obtained results prove high efficiency and sufficient safety of the free-hand technique for the cervical spine fixation. At the same time, the technique requires careful preoperative preparation and examination of patients, thorough knowledge of anatomy of the operated area, and experience and qualification of the surgeon.

Цель исследования: сравнение результатов лечения спондилолизного антелистеза с использованием различных хирургических технологий. Материал и методы: двумя способами оперировано 84 пациента со спондилолизным антелистезом 1-3 степеней (по H.W. Meyerding) в возрасте от 19 до 67 лет. Пациентам первой группы выполнены передняя декомпрессия и стабилизация из внебрюшинного доступа; больным второй группы-заднебоковой спондилодез с транспедикулярной фиксацией. Оценивались степень послеоперационной адаптации пациентов, регресс вертеброневрологической симптоматики в послеоперационном периоде. Результаты: полученные данные свидетельствуют о сопоставимости функциональных результатов передних и задних декомпрессивно-стабилизирующих операций и оправданном их дифференцированном использовании при лечении спондилолизного спондилолистеза 1-3 степеней.

There are collected and analyzed recognized and claimed in the work scales and algorithms used to evaluate the prognosis and condition of cancer patients with metastatic spine damage. An attempt was made to generalize and combine multidisciplinary approaches to improve prognosis in treatment of patients of this category.

In the article initial experience of spinal cord stimulation for chronic pain syndromes is described. The trial was done for 62 patients, in 52 cases trial was successful and subcutaneous pulse generator were implanated. Maximal follow-up is 26 months. The level of pain evaluates at VAS. Permanent pain-relieve results were achieved in 46 patients (74,2%). These results correspond to literature data.

The aim is to analyze the data obtained during biopsy of primary and secondary lesions and pathological fractures of the cervical vertebrae and their influence on the tactics of treatment of patients. Evaluation of the effectiveness of biopsy of pathological processes in the cervical vertebrae. Materials. The results of biopsies of 20 patients with lesions of the cervical vertebrae of unknown etiology or with the presence of pathological fractures with compression of the spinal cord and roots by a vertebra or a soft tissue component were analyzed. The following results were obtained: the presence of a secondary lesion of the cervical vertebrae was revealed: metastatic nature – 10, primary tumors – 1, lymphoproliferative tumors – 3, no tumor lesion was detected – 3, not enough material for the study – 3. Conclusion. The results obtained indicate the high efficiency and sufficient safety of puncture biopsy in diagnosing lesions of the cervical vertebrae, even in complex localizations (C2).  Revealing the nature of vertebral lesions in the absence of absolute indications for decompression and stabilization interventions significantly affects the tactics and order of treatment of the patient.