The aim of the study was to assess the effectiveness of the minimally invasive technique used to reconstruct the vertebral arch with a pedicle screw hook system in grade I isthmic spondylolisthesis in comparison with the traditional technique of segment stabilization with interbody fusion. Materials and Methods The study included 26 patients aged from 11 to 17 years. The follow-up period lasted from 1 to 7 years. Two groups were formed: in group 1 (n=6), segments L 5 –S 1 were stabilized using the traditional technique; in group 2 (n=20), the arch of the L 5 vertebra was reconstructed by means of minimally invasive surgery. The pain syndrome was assessed in each study group using the visual analogue scale and Macnab criteria before and after surgery; blood loss, duration of surgery in minutes, and hospitalization in days were also measured. Results According to the Macnab scale, the two presented techniques did not show any statistically significant differences; however, when the arch synthesis technique was employed the spinal motion segment remained intact. Furthermore, in group 2, the volume of blood loss was smaller (44.0±19.6 compared to 300.0±130.4 ml, p<0.0001), the duration of the operation was 176.0±41.6 compared to 349.2±93.2 min, p<0.0001, and hospital stay was 6.9±1.6 compared to 10.0±2.1 days, p=0.0025 in the control group. Conclusion The technique of vertebral arch reconstruction by a minimally invasive access gives the possibility to stabilize the spinal motion segment and to preserve biomechanics and movements in the spine. This technique allows for shorter inpatient stays for patients as well as earlier recovery and rehabilitation due to reduced surgery time and blood loss.

Objective. To analyze specific features of thoracoscopic discectomy and results of its application in children with thoracic idiopathic scoliosis. Material and Methods. A total of 42 patients (33 females and 9 males) aged 13 to 18 years who had right-sided thoracic idiopathic scoliosis were operated on. All patients underwent one stage endoscopic discectomy with corporodesis through anterolateral approach, and posterior correction of the deformity with multiple-anchor instrumentation accompanied by intraoperative halo-tibial traction and followed by posterior local fusion. The follow-up period ranged from 6 months to 3 years. Results. Postoperative Cobb angle of residual scoliotic deformity was 10-20° as reported by X-ray study. Deformity correction was 79.9 ± 6.5 %. Patients were verticalized on the 3-6th days and discharged on the 8-10th days after surgery to outpatient treatment. The improvement or complete restoration of the trunk balance was achieved. The pain syndrome intensity was 6-7 scores. Conclusion. Indications for thoracoscopic discectomy are rigid curves less than 90 degrees and unfinished growth in a child. Application of endoscopic discectomy at the anterior stage of surgical intervention in patients with idiopathic scoliosis provided insignificant blood loss during discectomy, decreased intensity of postoperative pain syndrome, and improved cosmetic outcome after the surgery.

Выявлены взгляды Л.Н. Толстого на Гаагскую мирную конференцию 1899 года. Рассмотрена критика писателем правительственной политики «государственного пацифизма».