Overestimation of the efficacy of conservative treatment of spine injuries children often leads to unsatisfactory long-term results. The effective correction of post-traumatic spinal column deformities occurs in patients who undergo the operation in the early post-traumatic period. While choosing treatment strategies for children, higher reparative opportunities, which provide early fracture consolidation, including those in faulty positions, should be considered. This study presents a case of surgical treatment for uncomplicated injury of the thoracic and lumbar spine, with long-term compression fragmental fracture of the L1 vertebra body in a 12-year-old child. Due to the long-standing character of the injury right thoraco-frenotomy was conducted with partial L1 vertebral body and resection of the adjacent discs, deformity correction of the thoracic and lumbar spine with a transpedicular system, and ventral spondylodesis with an autograft. This extensive intervention was justified by the peculiarities in the vertebral body damage and the post-traumatic segmental kyphotic deformity that resulted from delayed medical treatment. An anterior approach was chosen to achieve immobilization at the site of the damage before correction using the transpedicular system. Surgical correction of long-term spinal injuries in children, with the use of a combined approach, is usually laborious and traumatic. The prevention of rigid post-traumatic spine deformities with the help of timely diagnostics and appropriate treatment, including surgery, should be a priority to prevent such cases.

Научно-исследовательский институт травматологии, ортопедии и нейрохирургии ФГБОУ ВО «СГМУ им. В.И. Разумовского» Минздрава России, Саратов Грубые посттравматические деформации грудного отдела позвоночного столба -это результат высокоэнерге-тической травмы, которая в последнее время в силу ряда причин все чаще встречается у детей. Данный вид повреждений нередко сопровождается анатомическим повреждением спинного мозга, поэтому лечение таких больных требует особенного внимания в этическом аспекте. Зачастую единственным показанием для хирур-гического вмешательства является функциональная несостоятельность позвоночника. Учитывая данный факт, а также нередко тяжелое соматическое состояние пациентов, травматичность операции должна быть сокраще-на до минимума. Наряду с этим необходимо достигнуть адекватной коррекции деформации, надежной стаби-лизации позвоночного столба и восстановления ликвородинамики. В литературных источниках последних лет все чаще встречаются публикации, посвященные успешному использованию различных вариантов дорзальных вмешательств (P/VCR) при нестабильных повреждениях у детей. В статье представлен клинический случай хирургического лечения грубой посттравматической деформации грудного отдела позвоночника с застарелым переломовывихом позвонка Th 7 у ребенка 15 лет.Ключевые слова: повреждение позвоночника у детей, травма спинного мозга, хирургическое лечение, спондилосинтез. Rigid severe post-traumatic thoracic spine deformities result from frequent, recent high-energy trauma in children with an increasing frequency due to a variety of reasons. These types of injuries are commonly followed by spinal cord anatomic injury; therefore, the treatment of these patients warrants special attention from the ethical viewpoint. Generally, the only indication for surgical intervention is spinal dysfunction. Considering this and the patients' ordinary severe somatic state, surgical trauma should be minimized as much as possible. However, for adequate deformity correction, effective spine stabilization and restoration of liquorodynamics is necessary. Recent studies have reported the successful use of different methods of dorsal interventions (P/VCR) in cases with unstable damages in children. Here, we present the case of a 15-year-old boy who underwent surgical treatment for coarse post-traumatic thoracic spine deformity with chronic fracture-dislocation of Th7 vertebra. SURGICAL TREATMENT OF GROSS POSTTRAUMATIC DEFORMATIONS IN THORACIC SPINE©

Introduction. Vertebral hemangioma is a common pathology, in which 3.7% cases are aggressive. One of the pathogenetic factors contributing to the growth of vertebral hemangioma is mechanical overload. The transitional parts of the spine are the most loaded. Lesions of the transitional cervical-thoracic spine by hemangioma are rare (2%–4% of all vertebral hemangiomas). A common treatment for aggressive hemangiomas is puncture vertebroplasty. Currently, the number of pediatric patients with vertebral hemangiomas has increased, with an incidence close to 8% for individuals aged below 18 years. Exaggeration of the possibilities of conservative treatment for hemangiomas in children often leads to unsatisfactory results. Clinical research on this problem is relevant due to the lack information about the surgical tactics in aggressive spinal hemangiomas in children. Clinical observation. Two patients aged 15 and 17 years old with aggressive hemangiomas of the transitional cervical-thoracic spine underwent operation with the use of open-puncture vertebroplasty. There were no postoperative complications, and good preliminary results were obtained. Discussion. Various approaches in the treatment of aggressive hemangiomas of the transitional cervical-thoracic spine in children, including open-puncture vertebroplasty, were presented and analyzed. Conclusion. Due to the limited information about surgical treatment for pediatric vertebral hemangiomas, the presented clinical cases of surgical treatment for aggressive hemangiomas of the transitional cervical-thoracic spine may be of interest to a wide audience.