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Objective. To analyze treatment results in patients with osteoporitic fractures of the thoracic and lumbar vertebral bodies. Material and Methods. The study was performed in 301 patients (aged 20 to 81 years) with noncomplicated fractures of thoracic and lumbar vertebral bodies associated with osteoporosis. Compression fractures were diagnosed in 42.5 % of patients, splintered – in 21.3 %, and burst – in 36.2 %. Grade I osteoporosis was observed in 12.6 %, Grade II – in 52.5 %, Grade III – in 27.5 %, and Grade IV – in 7.4 % of patients. Conservative treatment was performed in 188 patients. After pain syndrome relief and fixation with removable spinal brace the patients were discharged for follow-up care. Another 113 patients underwent surgical treatment: transpedicular fixation was done in 15.0 % of cases, transpedicular fixation with osteoplasty – in 50.4 %, two-stage surgical procedure – in 24.7 %, and vertebroplasty – in 9.9 %. Results. The outcomes after conservative treatment for osteoporotic vertebral fractures was good in 13.0 % of patients, satisfactory in 43.0 %, and nonsatisfactory in 44.0 %. Patients showed a progression of osteoporosis and deformity magnitude between 8 and 36 weeks after the treatment. Surgical treatment of veretbral fractures had excellent results in 27.4 % of patients, good results in 51.6 %, satisfactory in 19.7 %, and nonsatisfactory in 1,5 %. Correction of all deformity components of the injured spine segment was observed in the postoperative period. Conclusion. Differentiated treatment for osteoporotic fractures of the thoracic and lumber vertebral bodies associated with osteoporosis improves the treatment results and reduces the treatment failure rate.

Atypical segmental corrective vertebrectomy in the treatment of post-traumatic thoracic kyphosis V.V. Rerikh, K.O. Borzykh, Sh.N. Rakhmatillaev Objective. To analyze results of atypical segmental corrective vertebrectomy in patients with painful thoracic kyphosis treated in the late period of spinal cord injury. Material and Methods. Eight patients with painful kyphotic and shear deformities were operated on during 2012. The method of atypical segmental corrective vertebrectomy was used. Average kyphotic deformity was 43.1° ± 15.0°, the rate of anterior shear displacement varied from 25 to 48 %. Results. The average kyphosis correction was 9.1° ± 5.8° with complete correction of shear deformity. Questionnaire data showed the decrease in pain score from 4.4 ± 1.8 to 2.6 ± 1.6 on VAS, and improvement in functional capacity from 74.4 ± 12.0 to 83.5 ± 9.0 on FIM (Functional Independence Measure) in the follow-up period. Conclusion. Atypical corrective segmental vertebrectomy performed in the late period of spinal cord injury effectively eliminates post-traumatic deformity, and improves functional capacity of patients with complete neurological deficit.

To analyze histogenetic potencies of the 3D chondrograft for correction of artifactual vertebral body lesion. Material and Methods. Osteogenic potencies of the 3D chondrograft isolated from minipig primary cartilage were studied in canine experimental model of artificial vertebral body defect. Results. Tissue specificity of 3D chondrograft was confirmed by the presence of aggrecan, chondroitin sulfates, keratin sulfates, and type I and II collagen in cells and in the matrix, as well as by the expression of aggrecan, biglycan, and lumikan genes, and ultrastructural arrangement of cells and the matrix (chondrometabolic barrier). Transformation of chondrograft occupying the space of bone defect led to complete restoration of vertebral bone structure followed by the formation of organo-specific bone tissue. Restoration of bone tissue was promoted by chondrograft in the way of enhonral osteogenesis, both embryonic and regenerative. Conclusion. High reparative potencies of chondrograft suggest its feasibility in correction of pathologies caused by chondroosteogenesis disorders and dystrophic changes in the osteoarticular system.

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