Clinical effectiveness of coccus removal in post-traumatic coccigodinia is evaluated. The study included 34 patients with diagnosed post-traumatic coccigodinia who underwent surgical treatment in resection or coccyx removal volume. A long history of trauma-related pain syndrome and ineffective conservative treatment were noted in all patients. The exclusion criteria were: inflammatory or oncological process, chronic urogenital diseases, previously undergoing operations on the lumbosacral spine, complicated by the course of the hernia of the intervertebral disc with root syndrome and neurological disorders. Before the operation, patients underwent manual examination, radiography (in direct and lateral projections) and computed tomography of the sacrum and coccyx, examination of the gynecologist (for women) and urologist (for men), examination of the proctologist, according to the indications magnetic resonance imaging of the spine in order to exclude hernia of the intervertebral disc with neural compression and dermoid cysts of the copcystic. Evaluation of treatment results was performed using a visual analogue pain scale and a verbal 5-point operation satisfaction scale. The observation period was from 1 year to 4 years. Cupping of pain syndrome after surgery was noted in 28 (82.4%) cases, in 6 (17.6%) patients there was a decrease in the intensity of pain syndrome with discomfort only after a prolonged sitting position. 5 (14.7%) patients were "satisfied" with surgery, 28 (82.4%) patients were "completely satisfied", in one (2.9%) case there was "doubtful satisfaction" with surgery. Thus, surgical treatment of coccigodinia in the volume of partial or complete coccyx removal is indicated in cases of ineffectiveness of conservative treatment in its post-traumatic instability. Surgical intervention leads to the cessation of pain syndrome and allows patients to return to their previous physical activity.

Проведен анализ отдаленных результатов хирургического лечения 47 больных с истинным спондилолистезом. Срок наблюдения составил от 14 до 25 лет. Всем больным был выполнен изолированный передний межтеловой расклинивающий спондилодез костным трансплантатом. Субъективную оценку результатов лечения проводили по шкалам VAS и ODI, объективную-по результатам клинического и рентгенологического исследования, КТ и МРТ. В отдаленные сроки наблюдения хороший результат был отмечен у 20 (42,6%) больных, удовлетворительный-у 15 (31,9%) и неудовлетворительный-у 12 (25,5%). Основными причинами неблагоприятного исхода хирургического лечения были: сохраняющаяся большая степень смещения тела позвонка (17,6%), нарушение стабильности (38,3%) и баланса пояснично-крестцового отдела позвоночника (63,8%), сохраняющаяся компрессия невральных структур (42,6%). Комбинация перечисленных факторов была отмечена у большинства больных на фоне прогрессирующих дегенеративно-дистрофических изменений позвоночника.

Purpose. To demonstrate the effectiveness of an isolated fixation technique of multilevel spondylosis disorders in young patients.Materials and methods. Two military men were operated for multilevel spondylosis of lumbar vertebra (LII, LIV and LIV, LV).Results and discussion. Patients underwent bone autoplasty and osteosynthesis of vertebral arches using hybrid lamina transpedicular system in a screw-rod-hook form. Good anatomic and functional results were got.Conclusion. Avoidance of fixation of intact functional spinal units allows to achieve good treatment results and classify this operation as organ sparing surgery.

Аbstract. Factors predisposing to the development of osteoarthritis in military personnel are analyzed. The physical stress inherent in military labor, for example, in the airborne troops, creates a high load on the joints and can cause the early dismissal of military personnel from the ranks of the Armed Forces of the Russian Federation. Based on the pharmacodynamics of chondroprotectors (stimulation of chondrocyte function, cartilage tissue regeneration processes, inhibition of the synthesis of inflammatory mediators, etc.), it can be argued that they have a significant effect on the pathogenetic mechanisms of the development of osteoarthritis, i.e. the mechanism of action of chondrocytes is reduced to the suppression of catabolic and stimulation of anabolic processes in the joints. The main principles of therapeutic nutrition for osteoarthritis are, a decrease in calorie intake, limiting the amount of carbohydrates, animal fats and salt consumed. A balanced diet, including sufficient macro- and micronutrients, has a therapeutic effect in patients with complaints of joint pain, helping to restore the damaged structure of the elements of the musculoskeletal system. The inclusion of dietary supplements in the diets of patients with complaints of joint diseases ensures the intake of nutrients necessary for the synthesis of glycosaminoglycans. These factors accelerate the rehabilitation of patients after extreme physical exertion and injuries of the musculoskeletal system inherent in military labor. An analysis of the materials of a clinical study a comparative study of the effectiveness of the treatment of osteoarthritis of the knee joint at the initial stage of the disease with the help of a representative of the group of chondroprotectors Аrthra containing chondroitin sulfate, glucosamine and non-steroidal anti-inflammatory drugs, is carried out. The introduction of chondroprotectors as a means of preventing osteoarthritis in the diets of military personnel experiencing extreme joint loads will strengthen the ligamentous-articular apparatus by normalizing cartilage moisture saturation, inhibiting the action of proteolytic enzymes and stimulating the synthesis of glucuronic acid, which improves the elasticity of connective tissue.

Федеральное государственное бюджетное военное образовательное учреждение высшего образования «Военно-медицинская академия имени С.М. Кирова» Министерства обороны Российской Федерации, г. Санкт-Петербург, Россия