Purpose: In this study, we investigated the relationship between the results of thoracic curve correction using minimally invasive surgeries in 35 patients and open surgical correction in 47 patients with adolescent idiopathic scoliosis. Methods: The correlations between the Cobb’s angle of the primary and postoperative curves, angle of thoracic kyphosis and lumbar lordosis, correction percentage, derotation values, estimated blood loss, duration of surgery, and period of hospitalization after surgery were assessed by calculating the mean and standard deviation. Calculation and comparison were performed using Pearson correlation. Results: The Cobb’s angle correction ranged from 53.4° ± 11.8° to 6.7° ± 5.2° ( p < 0.001) in the open surgical correction group and from 51.2° ± 11.4° to 11.7° ± 5.8° ( p < 0.001) in the minimally invasive surgery group before and after surgery, respectively. The percentage of curvature correction was 88.2% ± 8.0% and 77.7% ± 10.7% ( p < 0.001) in the open surgical correction and minimally invasive surgery groups, respectively. The estimated blood loss was higher in the open surgical correction group than in the minimally invasive surgery group (208.7 ± 113.4 vs 564.3 ± 242.7 mL). Axial rotation was changed from 29.1°± 7.5 to 17.1°± 6.8 ( p < 0.001) in the open surgical correction group and from 28.9°± 7.8 to 19.4°± 6.4 ( p < 0.001) in the minimally invasive surgery group. The duration of surgery was shorter in the open surgical correction group than in the minimally invasive surgery group (266.6 ± 64.3 vs 346.2 ± 70.5 min). A positive correlation between time of operation and Cobb’s angle correction (in °) in open surgical correction ( r = 0.37) and minimally invasive surgery ( r = 0.43) was found. Conclusion: The open surgical correction procedures were more effective than minimally invasive surgery in correcting the spinal curve. The increase in the duration of open surgical correction increases the estimated blood loss, but it also more significantly improves the correction of Cobb’s angle. Level of evidence: III.

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Rotator cuff impingement syndrome (SURM) of the shoulder is considered one of the most common causes of pain in the shoulder joint in people of working age, mostly males. Due to the absence of characteristic signs of this pathology of the shoulder joint at the initial stage of the disease, fibrotic changes in the subacromial space (FI SAP) are detected late. The aim of the study was to evaluate the effectiveness of ultrasound navigation in the diagnosis and verification of fibrous changes in the subacromial space in patients with rotator cuff entrapment syndrome. Materials and methods. An analysis was made of 86 patients with cuff impingement syndrome, in whom fibrotic changes in the subacromial space are was initially detected according to ultrasound data. In group N1 (n1 = 42), the study data were analyzed without a minimally invasive intra-articular treatment procedure at the stage of conservative treatment, and in group N2 (n2 = 44) – with ultrasonic navigation of the subacromial space during a minimally invasive intra-articular treatment procedure. The comparison group (N3; n3 = 25) represented individuals without shoulder joint pathology. All patients underwent an ultrasound examination of the shoulder joint (Philips Sparq ultrasound scanner, linear high-density multifrequency transducer 5–13 MHz). Verification of the results of ultrasound of the shoulder joint is confirmed by the data of other methods of radiation imaging. Results. Ultrasound examination of the shoulder joint using dynamic functional tests before the start of therapeutic manipulations in patients with fibrotic changes in the subacromial space (in groups N1 and N2) visualization of the thickening of the supraspinatus tendon in combination with a decrease in the thickness of the subacromial space correlated with limitation of movement of the upper limb in the shoulder joint (p < 0,001). Comparative results in the study groups showed that the use of ultrasound diagnostics and navigation technologies during a minimally invasive intra-articular treatment procedure for fibrotic changes in the subacromial space provides an improvement in clinical manifestations. Conclusions. The possibility of ultrasonic visualization of the supacromial space in normal conditions without pathological changes in the shoulder joint and with fibrous changes in the subacromial space allows us to recommend the proposed method of ultrasound examination of the shoulder joint to be included in the treatment and diagnostic algorithm for the syndrome of incarceration of the rotator cuff of the shoulder. Ultrasound navigation as an effective method for diagnosing and verifying subacromial fibrosis in patients with rotator cuff entrapment syndrome.

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