No abstract

A detailed analysis of the literature on the structure and functions of the paraspinal structures of human thermoregulation involved in maintaining temperature homeostasis is presented. It is shown that in the process of evolution, a peculiar paraspinal morphofunctional complex is formed around the spinal center of thermoregulation, including thermal- generating structures (adipose and muscle tissue); venous thermal distribution rings formed by paraspinal venous plexuses and thermoregulatory nervous apparatus (meningeal and posterior branches of the spinal nerves and their nerve endings). It was found that the heat-generating structures are represented by adipose tissue of the epidural space, adipose tissue of the bone marrow, paravertebral and interscapular adipose tissue, back muscles and intercostal muscles). Bone marrow fatty tissue plays an important role not only in thermoregulation, but also in bone remodeling. Fatty tissue mainly includes components of white and a small amount of brown adipose tissue. Heat from muscles through the venous system of the spinal column affects the functioning of the spinal center of thermoregulation by contractile thermogenesis. It has been shown that around the center of thermoregulation of the spinal cord, venous vessels form four thermal distribution rings. The first of them is the venous bed of the soft membrane of the spinal cord and cerebrospinal fluid of the subarachnoid space; the second is the internal vertebral venous plexus; the third - intraosseous (intraorgan) venous plexuses of the vertebrae; the fourth is the anterior and posterior external vertebral venous plexuses. All four thermal distribution venous rings anastomose among themselves, forming a single thermal distribution system around the spinal center of thermoregulation. The innervation of thermal generating structures and thermal distribution of venous rings is carried out by somatic and autonomic nerve fibers.

Objective: to study the morphoscopic and morphometric characteristics of the LV-SI intervertebral disc according to magnetic resonance imaging. Materials and methods. The analysis of magnetic resonance imaging of 90 patients (66 men, 24 women) who did not have diseases of the lumbar spine was performed. Various morphometric parameters of the intervertebral disc (IVD) and nucleus pulposus (NP) at the LV-SI level were measured using software for processing images created on an MRI machine. The obtained data were compared between men and women, asthenics, normosthenics, hypersthenics and young (from 18 to 44 years old) and middle-aged (from 45 to 60 years old) people. In addition, morphoscopic characteristics were studied: the shape of the IVD and NP in the axial plane. Results. It was found that in normal IVD LV-SI is most often represented by elliptical (54,5%) less often kidney-shaped (45,5%) forms. Normally, the NP has an oval (57,8%) and kidney-shaped (42,2%) shape. It was shown that in men, the dorsal height of the IVD, its width, anteroposterior size, square as well as the longitudinal-transverse index of the NP were significantly higher. It has been proven that there are no significant differences in the shape of the IVD between asthenics, normo- and hypersthenics, while the height of the IVD in the center, its ventral, dorsal heights and most lateral IVD height are significantly greater in hypersthenics. It has been proved that the kidney-shaped form of NP was significantly more common in asthenics, and the oval form - in hypersthenics, while the morphometric parameters of NP did not significantly differ between extreme body types. A tendency to a decrease in IVD height in middle-aged people compared to young people was shown. Conclusion. The results obtained are necessary when planning the operation, as well as for the manufacture of rigid implants and artificial discs for arthroplasty and interbody fusion.

In the anatomical part of the study on 50 non-embalmed and 50 polymer-embalmed anatomical preparations of the knee joint of an adult were studied the degenerative-dystrophic changes in the bone and auxiliary elements of the knee joint with deforming arthrosis of the I and III stage. The objects of the clinical part of the study were patients with degenerative-dystrophic changes in the knee joint of varying severity who underwent x-ray examination (150 people), magnetic resonance imaging (60 people), diagnostic arthroscopy (35 people). For determine the stage of gonarthrosis in patients, the classification of N.S. Kosinskaya (1961) was used. Identified in the study of anatomical preparations of the knee joint with I stage of gonarthrosis degenerative-dystrophic changes were present in all patients with a similar severity of arthrosis of the knee joint and were confirmed by the results of their additional examination. It study is shown that for the diagnosis of degenerative meniscus ruptures and degenerative changes in the cruciate ligaments of the knee joint, the most informative method is magnetic resonance imaging, and diagnostic arthroscopy does not provide an exhaustive diagnosis of these manifestations. The performed comparison of vital and post-vital morphological manifestations of I stage gonarthrosis, as well as an analysis of the effectiveness of the applied diagnostic techniques convincingly indicates the need for this category of patients to perform x-ray studies and magnetic resonance imaging of the knee joint. When performing magnetic resonance imaging of the knee joint with III stage gonarthrosis trabecular edema of varying severity was found, localized mainly in the subchondral bone tissue of the internal condyles of the tibia and femur, and signs of avascular necrosis of the condyle of the condyle were revealed. The analysis of the intravital diagnostic methods used in patients with III stage gonarthrosis and comparing their results with the data of anatomical studies of knee joint preparations with the same stage of the degenerative-dystrophic process, indicated sufficient visualization capabilities of each from presented methods for additional examination.