Среди всех нарушений мозгового кровообращения ишемический инсульт в вертебробазилярном сосудистом бассейне составляет 25-30 % случаев, а преходящие нарушения мозгового кровообращения-70 % [2, 3, 5, 11, 13], в половине случаев они предшествуют ишемическим инсультам, рассматриваются как предынсультные состояния.

Objective. To assess feasibility of the proposed anterior decompression and stabilization surgery without meningoradiculolysis for recurrent herniation of the lumbar intervertebral disc. Material andMethods. Prospective randomized controlled study involved comparative evaluation of two essentially different surgical interventions performed in 130 patients with recurrent disc herniation during 2005-2012. The control group included 62 patients who underwent posterior decompression and stabilization surgery with meningoradiculolysis for the removal of herniated disc. The study group included 68 patients who underwent the proposed anterior decompression and stabilization surgery, which differs by an obligate opening of the spinal canal and intervertebral foramen to remove the disc herniation through an anterior approach without meningoradiculolysis. Results. Immediate results of anterior and posterior decompression and stabilization operations are comparable, though posterior interventions are more frequently associated with iatrogenic injury to posterior nerve roots caused by intervertebral implant insertion and meningoradiculolysis required before the disc herniation removal. Long-term outcomes of anterior operations are reliably better. Conclusion. Anterior decompression and stabilization operationsfor recurrent disc herniation compare favorably to posterior ones, since they are less traumatizing to the nerve roots and prevent herniation recurrence and epidural fibrosis progression.

To analyze long-term results of applying three surgical techniques and dynamics of certain symptoms in patients with vertebrogenic lesion of vertebral arteries. Material and Methods. Catamnestic and long-term outcomes in 283 patients operated on using decompression and stabilization (n = 103), decompression and plasty (n = 59), and decompression without discectomy and fusion (n = 121) were studied. Criterion for patient inclusion was the absence of clinically significant non-vertebrogenic stenotic and occlusive lesions of vertebral and carotid arteries. Results. Comprehensive assessment of long-term surgical results revealed recovery in 74 patients (26.1 %), good result in 124 (43.8 %), satisfactory-in 78 (27.6 %), and the absence of dynamics in 5 patients (1.8 %). Two patients (0.7 %) presented with aggravation of neurologic symptoms in the postoperative period due to recurrent stroke. Surgical treatment of patients with recurrent transient ischemic attacks (TIA) and cerebral hypertensive crises was the most effective. Excellent and good results were observed in 91 % of these patients. Conclusion. Long-term results of decompressive interventions (without discectomy and fusion) showed their substantial advantages over decompression and plasty and over decompression and stabilization.