To perform histological verification of osseointegration of porous bioceramic granules using scanning electron microscopy and energy-dispersive spectroscopy. Material and Methods. The experiment was conducted in six mongrel dogs weighing 15 to 18 kg which underwent implantation of hydroxyapatite bioceramic granules in the lumbar vertebral bodies. After 6-month follow-up period specimens were examined histologically using light microscopy, scanning electron microscopy, and energy-dispersive spectrometry.Results. Histological examination of the implantation zones revealed trabecular bone tissue in spaces between the granules fitting closely to their surfaces. There was no connective tissue capsule on the border between the bone tissue and hydroxyapatite granules. Conclusion. Morphological studies using light microscopy and scanning electron microscopy, as well as energy-dispersive spectrometry are basic methods for verification of osseointegration.

Objective. To analyze results of surgical treatment and correction of deformities associated with flexion-distraction injuries of the subaxial cervical spine. Material and Methods. A retrospective analysis of treatment results in 78 patients who underwent anterior and combined stabilization of subaxial dislocations in 2010-2016 was carried out. The data of clinical examination and of MRI and MSCT studies were subjected to statistical processing. Results. Significant (p < 0.05) loss of the achieved intraoperative correction of shearing and kyphotic types of deformities was noted after 3 months in the group of patients with unilateral and bilateral articular process fractures treated by anterior spinal fusion. Conclusion. Unilateral or bilateral articular process fractures accompanied by bilateral dislocations at the level of damaged spinal segment are risk factors for the loss of post-traumatic deformity correction achieved after isolated anterior stabilization.

Objective. To identify factors leading to the loss of correction and re-dislocation of the vertebrae after isolated anterior reconstruction and stabilization in the surgical treatment of subaxial cervical dislocations. Material and Methods. A retrospective cohort STROBE-type study was carried out using data of 175 patients with dislocations of vertebrae in the subaxial cervical spine who were operated on in 2010-2019. The key parameters of the study were the relevant indices of the cervical sagittal balance and morphological characteristics of the injury: thoracic inlet angle (TIA), T1 vertebra slope, neck tilt, regional cervical C2-C7 lordosis, fracture of the vertebral body, and fracture of the articular process at the level of dislocation. Statistical analysis of the obtained data was carried out in the RStudio program. Results. At preoperative TIA value of 74.5°, the risk of correction loss corresponds to 28 %. In the group with TIA < 74.5° and that with TIA ≥ 74.5°, the risk of correction loss is 17.3 % (95 % CI: 7-37 %) and 85.7 % (95 % CI: 60-96 %), respectively. With an increase in TIA Цель исследования. Выявление факторов, приводящих к потере коррекции и редислокации позвонков после изолированной передней хирургической реконструкции и стабилизации при вывихах субаксиальной локализации. Материал и методы. Проведено ретроспективное когортное исследование типа STROBE данных 175 пациентов с вывихами шейных позвонков на субаксиальном уровне, оперативное лечение которых проведено в 2010-2019 гг. Ключевыми параметрами исследования являлись релевантные показатели сагиттального баланса шейного отдела позвоночника и морфологические характеристики повреждения: угол входа в грудную клетку (TIA), наклон Th 1 позвонка, шейный наклон, регионарный шейный лордоз C 2-C 7 , перелом тела позвонка, перелом суставного отростка на уровне вывиха. Статистический анализ полученных данных проводили в программе RStudio. Результаты. При значении предоперационного параметра TIA = 74,5° риск потери коррекции соответствует 28 %. В группах с TIA < 74,5° и с TIA ≥ 74,5° риски потери коррекции равны 17,3 % (95 % ДИ: 7-37 %) и 85,7 % (95 % ДИ: 60-96 %) соответственно. При увеличении показателя TIA на 10° шансы рецидива повышаются в 23,3 раза. Влияние перелома суставного отростка на потерю коррекции эквивалентно увеличению показателя TIA на 10°, а именно увеличивает шансы рецидива в 20,7 раза. Параметр «давность травмы» имеет влияние на потерю коррекции, однако он статистически незначим (p > 0,05). Заключение. TIA, а также перелом суставного отростка на уровне повреждения являются статистически значимыми факторами, определяющими инициальную стабильность при изолированной передней хирургической реконструкции и стабилизации позвоночника на нижнешейном уровне при флексионно-дистракционных повреждениях типа 3 по Allen. Ключевые слова: передняя шейная дискэктомия и стабилизация, вентральный спондилодез, шейный сагиттальный баланс, вывихи шейных позвонков, рецидив вывиха, редислокация, потеря коррекции, флексионно-дистракционное повреждение.

Objective. To analyze the features of bone tissue formation during plasty of vertebral body defect or fracture with an allogeneic bone graft in an experiment in vitro. Material and Methods. Models of the vertebral body defect (fracture of the cranioventral part with penetration into the nucleus pulposus) were created in an experiment on 20 mini-pigs of the same age. Plasty of traumatic defects was performed with allogeneic bone graft or autologous bone. CT, histological, and spectrometric studies of microscopic specimens were carried out at 14, 30, 90, and 180 day. Reparative osteogenesis, X-ray density, Ca and P content, and microhardness were studied. Results. After implantation of allogeneic bone graft, an organ-specific bone similar to the recipient’s bone in morphological structure, X-ray density, mineral composition and microhardness, was formed on the 90th day (P = 0.01). After transplantation of autobone, the regenerate formed by this day in the central part was in a phase of resorption and restructuring with lower indices of X-ray density, content of Ca and P, and microhardness (P = 0.01). Conclusion. Аfter plasty of vertebral body traumatic defects with allogeneic bone graft, the organ-specific bone tissue is formed at an earlier time and reliably exhibits greater mineralization and strength.

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