Oncological radicalism (the scope of surgical treatment) and restoration of the supporting function of the spine remain the most pressing issues of surgical treatment for tumors. Purpose of the work: to analyze the outcomes of surgical treatment of patients with primary tumors of the thoracic and lumbar spine based on the appropriate rating scales. Materials and methods. Forty-three patients, 22 women and 21 men aged 18 to 72 years, with benign and malignant primary tumors and tumor-like lesions of the spine were examined; they were treated at the Department of vertebrology of the Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine. Localization of the lesions was as follows: cervical spine — 5 patients, thoracic — 17, lumbar — 19, sacrum — 2. According to the pathomorphological classification of primary tumors and tumor-like lesions of the World Health Organization, the patients were divided into those with benign (n = 26) and malignant (n = 17) tumors. The results of surgical treatment for primary spinal tumors were analyzed using the American Spinal Injury Association (ASIA) scale, Spinal Instability Neoplastic Score (SINS), Bilsky scale; the localization of tumors in different segments of the spinal column was considered as well. Results and discussion. We evaluated the outcomes of surgical treatment of spinal tumors for the following indications: radical surgery, the presence of complications, the dynamics of neurological and orthopedic disorders, the presence of tumor recurrence and the life expectancy of patients. Radical tumor resection within healthy tissues was performed in 17 of 19 patients, who had indications for the use of this method. Twenty-four patients underwent surgical treatment in the form of decompression of the spinal canal and partial tumor resection to restore the supporting function of the spine. In 2 cases, ablasticity was not achieved. Conclusions. According to the ASIA, SINS, Birsky scales, it was found that surgical intervention in primary tumors of the spine is justified, it prevents neurological complications, significantly reduces existing neurological disorders, and prolongs the life of patients. The choice of the scope of surgical intervention aimed at restoration of the supporting function of the spine according to these scales is not shown. Treatment of primary tumors of the spine should include both radical removal of atypical tissues within the healthy tissues and palliative treatment if indicated. It is important to restore the supporting function of the spine in the area of its damaged segments.

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It is known that metastases in the spine are detected in more than 70% of cancer patients, and in 10% of such patients, compression of nerve structures and severe neurological disorders develop. The role of surgery for metastatic tumors of the spine is in the focus of attention, since the operation can improve mechanical stability, decompress nerve structures and reduce the intensity of pain. However, what role the operation plays in increasing life expectancy and how to correctly assess the results of treatment remains controversial and the opinions of specialists are controversial, since the assessment is often made by oncologists, but it is the surgeon who more fully evaluates the potential risks and benefits of surgical interventions. Therefore, it is important for surgeons to understand what prognostic factors affect the quality and duration of life. This article presents the most cited classifications and assessments before 2009, as well as all classifications and assessments obtained after 2010 regarding metastatic lesions of the spine, as well as classifications used to develop treatment tactics obtained from the electronic databases PubMed, MEDLINE, articles, monographs, abstracts, dissertations and other sources of scientific and medical information. 57 main publications with II and III levels of evidence were selected, 6 classifications and 24 rating scales were considered. In order to construct the necessary tactics of the surgical strategy, the classification / assessment methods were divided into anatomical classification / assessment methods, neurological symptom / instability assessment methods, and assessment systems for predicting life expectancy. The study showed that in the surgical treatment of metastatic tumors of the spine, it is important to use the same rating scales and classifications to select indications and assess the results of surgical treatment, as well as to achieve meaningful comparisons between published series. Conclusion. The classifications and rating scales used for metastatic lesions of the spine do not fully reflect the type of surgical treatment: there is no algorithm for restoring the support ability of the spine, which is very important for this category of patients

To analyze the results of the surgical treatment of primary spinal tumors, based on the appropriate ASIA scales, SINS, Bilsky, considering the location of tumors in various segments of the vertebral column, a retrospective analysis of 43 patients with primary benign and malignant spinal tumours was performed. The results of treatment depending on the histological type of tumors and the possibility of radical removal of tumors within healthy tissues have been studied. It has been established that with timely radical surgical treatment it is possible to prevent neurological complications, improve existing neurological disorders, restore normal anatomical relationships in the affected spinal segment, and create a reliable, rigid stabilization of the spine, which in turn allows prolonging patients’ lives.

Based on mathematical modeling using the finite element method, the paper presents the results of modeling the stress-strain state of endoprosthesis made of carbon after surgical treatment with replacement of damaged tissues to restore the integrity of the thoracic spine.