INTRODUCTION: Study of age-specific and topographic features of the skin cover of the back in children and adolescents is an important aspect for understanding physiological processes of this period. Identifying the features of the skin condition will improve the diagnosis and prevention of skin diseases in pediatric practice. AIM: To study the distinctive features of the condition of various skin areas of the back in children at different age periods. MATERIALS AND METHODS: The study included 46 healthy children and adolescents (27 children, 19 adolescents) aged 7 to 17 years: 25 boys and 21 girls. The following research methods were used: anthropometry, visual clinical examination of the skin of the back, photofixation of the skin, Adams’s test, thermometry, laser Doppler flowmetry, elastometry. RESULTS: Visual clinical examination of the skin of the back showed no statistically significant differences in the incidence of signs of connective tissue dysplasia (р 0.05). In children aged 7–11 years, temperature and microcirculation parameters were mostly stably the same in all areas of examination of the back skin. In adolescents, differences in the temperature and blood flow parameters were observed depending on the examination area: decreased skin perfusion in the lower back along the scapular lines on the left by 7.0% (р = 0.0001) and on the right by 6.4% (р = 0.0002), along the paravertebral line on the right by 4.0% (р = 0.02); a mild increase in temperature in the projection of the paravertebral lines in the middle parts of the back (by 0.1°С, р 0.05). The elasticity index had a statistically significant decrease in the lower part relative to the upper one in the projection of the paravertebral lines both in children (by 10%, р = 0.001) and in adolescents (by 10.0%, р = 0.01). In adolescents, the temperature of the skin of the back, capillary blood flow and elasticity were statistically significantly lower than in children (р 0.0001, р = 0.006, р 0.0001, respectively). The skin temperature and elasticity index in all the examination areas correlated with age and had an inverse relationship. The blood flow of the skin of the back had a reliable inverse relationship with age only in the projection of the paravertebral lines at the level of the upper and lower parts. CONCLUSION: In healthy children and adolescents aged 7–17 years, age has a pronounced effect on the condition of the skin of the back (temperature, blood flow, elasticity, visual picture). The features of the topography of the study of the blood flow and temperature are important for the adolescent age. Differentiation of elasticity figures depending on the level of study are characteristic of both children and adolescents.

the lack of convincing evidence of a therapeutic effect. AIM. To evaluate the effect of complex rehabilitation using EPS and activation of the proprioceptive apparatus on the indicators of the functional state of patients with long-term consequences of spinal cord injury with partial spinal cord injury. MATERIALS AND METHODS. A prospective study was conducted with the participation of 29 patients with long-term consequences of spinal cord injury with partial spinal cord injury. The catamnesis of the disease was 3.7 ± 0.5 years. Comprehensive rehabilitation included epidural electrical stimulation by implantable electrode and activation of the proprioceptive apparatus. The neurological (ASIA scale) and functional (CSIM III scale) status of the patient was analyzed. Motor function was evaluated using 10-meter Walk test; M-responses of limb muscles — using electromyography, temperature and pain sensitivity — using esthesiometry. RESULTS. An increase in muscle strength and M-response of the muscles of the extremities, normalization of the motor deficit index, reduction of the walking test time, increase in movement speed and the patient’s independence index were revealed. There is an improvement in temperature and pain sensitivity at the level of damage and in the dermatomes located distally. The effect decreases in dermatomes far from the level of the electrode installation; but with increase in the number of courses the effect increases. DISCUSSION. The results obtained indicate that this rehabilitation complex, including UES, has a positive effect on the functioning of both the motor and sensitive spheres. CONCLUSION. Application of EES and activation of the proprioceptive apparatus improves the functional condition of sensorimotor sphere in the long-term consequences of spinal cord injury with partial spinal cord damage. Repeated rehabilitation courses have cumulative effect.

Aim: The definition of «muscle contractile reserve» is a prognostic criterion in assessing locomotor capabilities. Material and methods: Groups of adolescents: 1-healthy, 2-idiopathic scoliosis. Research methods: dynamometry, 3D video analysis of gait. Results: In AIS, the relative isometric moment of force is reduced compared to healthy ones: in hip extensors by 36% (p=0.00106), hip flexors by 33% (p=0.0002), hip abductors by 38% (p=0003), leg extensors by 37% (p=3.22E-07), leg flexors by 42% (p=4.15E-06). In healthy adolescents, the muscle reserve at a walking speed of 3.7-4.3 km/h was: in hip extensors and flexors 65-75%, hip adductors 30-40%, hip abductors — 80-90%, leg extensors — 70-80%, leg flexors — 80-90% and dorsal foot flexors — 75-90%. The kinetic values of the plantar flexors exceed the isometric maximum when the foot is placed at an angle of 90° by 30-40%. In AIS the distal muscle groups had no signs of functional damage; proximal muscle groups showed asymmetry (up to 25%) and a decrease in strength in the isometric mode by 33-42%. Muscle reserve at the same speed is reduced for anti-gravity muscles in AIS: in hip extensors by 40% and in leg extensors by 70%. The total joints power did not significantly differ from the control group. Conclusions: In locomotor stereotypes in patients with scoliosis, there was a pattern of adaptive redistribution of the kinetic potential of the contractile function from one joint muscle to another.

Studying the sensitive sphere is not unimportant in determining the degree of injuring the spinal cord and its structures, the nervous system plasticity, and the processes of recovering after injury.However, little attention has been paid in the literature to the instrumental assessment of sensitivity in patients with the consequences of the thoracolumbar spine injury. Purpose of the Work. To study the features of the state of thermal pain sensitivity in patients with long-term consequences of the thoracolumbar spine injury with partial damage to the spinal cord and its structures (type B and C according to ASIA scale). Material and Мethods. A total of 22 patients with long-term consequences of the spinal cord injury in the thoracolumbar spine (type B and C, ASIA) was examined.Clinical analysis of sensory disorders was carried out according to ISNCSCI and ASIA scales. An electric esthesiometer was used to study thermal pain sensitivity in Th10-S2 dermatomes on the right and left. Results. Regardless of the type of injuries (B/C), the similar disorders were determined: hypoesthesia of thermal pain sensitivity; hyperesthesia of pain sensitivity; thermanesthesia; thermanalgesia. However, the degree and level of disordering varied. In the group of patients with type B, significant changes in thermal pain sensitivity were recorded from L1dermatome,in patients with type C – from L4. In the group of patients with type C, in comparison with the values of patients with type B, there was a decrease in the number of cases of thermanesthesia (by 38%, p=0.033) and thermanalgesia (by 64.3%, p=0.004), an increase in the proportion of dermatomes with normal pain sensitivity thresholds (by 443%, p =0.036) and with hypoesthesia of thermal sensitivity (by 52%, p=0.037). Conclusion. In patients with long-term consequences of the thoracolumbar spine injury the level of significant disorders of thermal pain sensitivity depends on the degree of traumatization of the spinal cord. In the group of patients with type B, significant changes in temperature and pain sensitivity are recorded from the dermatome L1, in patients with type C — from L4.

Objective. To analyze and summarize the data of modern literature on the issues of surgical treatment and natural course of the spine and spinal cord pathology in patients with various types of caudal regression syndrome (CRS). Material and Methods. A systematic review of the literature on the issue of treatment of the spine and spinal cord pathology in patients with CRS was performed. Selection criteria were: articles for the period 2002–2022, original studies of populations/patients with various forms of CRS with a description of treatment methods and long-term results of treatment or observation. A total of 28 articles on the treatment of various forms of CRS with the described results of treatment of 212 patients were analyzed: 29 patients with CRS in combination with open neural tube defects and 183 patients with closed forms of CRS. Evaluation criteria included number of patients, gender, type of spinal cord pathology, type of sacral agenesis, presence of the spine and lower extremities deformities, concomitant pathology, operations performed and their complications, and results. Results. The studied patients underwent the following surgeries on the spine and spinal cord: untethering of the spinal cord, correction and stabilization surgeries on the spine, plasty of the spinal cord herniation, plasty of the terminal meningocele, and removal of the presacarial volumetric mass. The greatest number of complications occurred after operations on the spine and sacrum. The majority of patients (67 %) with sacral agenesis by the end of the follow-up period (average 14 years) walked independently or with the help of devices, and a minority of them (33 %) could not walk. More than half of patients with CRS (67 %) had a neurogenic bladder, urinary incontinence, or suffered from a chronic urinary tract infection. Fecal incontinence and constipation were less common (46 %). Conclusions. Patients with CRS have a good potential for improvement/recovery of walking and pelvic organ dysfunction. This is extremely important to timely carry out multimodality treatment of patients with CRS who have neurosurgical, orthopedic, urogenital and colorectal problems in CRS, and to start early motor rehabilitation and physiotherapy.

Background . Biomechanical studies of both the Ilizarov apparatus itself and the physiological system “apparatus – limb” occupy a significant place in the history of the formation and elaboration of the Ilizarov method, developed in the middle of the last century at the Kurgan Research Institute of Experimental Traumatology and Orthopaedics (nowadays – the world-famous Centre named after its creator). The analysis of the history of biomechanical research in the formation of Ilizarov method is not without interest. The aim . To analyze the history and stages of development of biomechanical research in order to substantiate the effectiveness of the Ilizarov method of transosseous osteosynthesis. Results . The national medical industry did not produce the appropriate equipment for biomechanical research in the early 1970s. That is why a group of engineers was included into the Laboratory of Clinical Physiology and Biomechanics (established in 1971) of the Ilizarov Centre, which created equipment for studying the processes in the tissues of the limbs and in the structure of the Ilizarov apparatus itself during its traction and compression impact on biological structures. The community of physicians, scientists and engineers made it possible to overcome a number of difficulties and problems. In their scientific publications and dissertations, the laboratory staff paid great attention to biomechanical research during transosseous osteosynthesis with the Ilizarov apparatus. At present, the staff of the Ilizarov Centre continues the traditions established by G.A. Ilizarov. For the first time in our country, a computer 3D video analysis of the kinematics and kinetics of orthopedic patients gait was introduced; it was supplemented with embedded software for the preparation of a clinical report of human gait biomechanics. Conclusions . The initial stage of the biomechanical research at the Ilizarov Centre included the creation of the research equipment. Subsequently, the biomechanical studies carried out by the staff of the Centre for almost half a century have shown an applied and functional result of the realization of general biological regularities of the Ilizarov’s discovery. At present, the biomechanical research continues at a higher level with the use of modern high-tech equipment.

Background. The scientific and clinical interest in the problems of osteogenesis imperfecta (OI) has grown in the last decade. However, the analysis of various variants of spinal pathologies in OI received insufficient attention. The study aimed to analyze the current literature on various variants of the spinal pathology in patients with OI. OI is a phenotypically and genetically heterogeneous group of hereditary bone dysplasias. The spine pathology in OI is represented by scoliosis, kyphoscoliosis, anomalies of the craniovertebral junction, instability of the segments and fractures of the vertebral bodies, spondylolysis, and spondylolisthesis. Scoliosis and kyphoscoliosis are the most common forms of spinal pathology. In severe forms and at age 6 years, the prevalence of scoliosis can reach 89%. The exact mechanism of scoliosis formation in patients with OI is complex and incompletely defined. Anomalies of the craniovertebral junction are recorded in 37% of patients with OI and are determined in all four types of OI. Clinical manifestations of the craniocervical junction pathology can vary from asymptomatic to compression of the brainstem, restriction of cerebrospinal fluid circulation, leading to hydrocephalus, syringomyelia, and cranial nerve damage. The pathology of the lumbosacral spine is represented by spondylolysis and spondylolisthesis generally in the L5S1 segment in 5.3%10.9% of cases. The clinical significance and natural course of spondylolysis and spondylolisthesis in patients with OI are not fully defined in the literature, and the information on surgical indications and methods is available only in rare case reports. The changes in the axial skeleton in OI can lead to significant functional disability, pain, and potentially life-threatening complications, such as radicular neurological deficit, decrease in the ventilation capacity of the lungs, and cardiorespiratory complications. The overall severity of OI remains the best criterion for predicting the development of secondary spinal pathology. Given the generalization and heterogeneity of OI, an individual and multidisciplinary approach is necessary when diagnosing and planning the treatment strategy for this group of patients.

Objective. To analyze the current literature dedicated to the etiopathogenesis and development of idiopathic scoliosis. Material and Methods. The analysis includes studies on the etiological factors of idiopathic scoliosis. The search was carried out on eLibrary, PubMed and Google Scholar databases. The review includes research and experimental studies, as well as systematic reviews and meta-analyses. The exclusion criterion is a theoretical work without practical research/experiment to confirm the theory. The depth of analysis is 30 years. Results. Out of 456 papers on the research topic, 153 were selected as meeting the inclusion/exclusion criteria. The main theories of the occurrence of idiopathic scoliosis are identified: genetic, neurogenic, theory of bone and muscle tissue defects, biomechanical, hormonal, evolutionary, and the theory of environmental and lifestyle influences. Conclusions. The term “idiopathic scoliosis” combines a number of diseases with different etiopathogenetic mechanisms of development. Idiopathic scoliosis has a polygenic inheritance. Different genes are responsible for its occurrence in different populations, and the progression mechanisms are triggered by various epigenetic factors. Bone and muscle tissue defects, pathology of the central nervous system, biomechanical disturbances, hormonal and biochemical abnormalities may play a dominant role in some cases of idiopathic scoliosis.

BACKGROUND: Little attention has been paid to the study of delayed sensory and motor reactions in adolescents with spinal deformities after surgical treatment. AIM: To study the reactions of the sensorimotor system of adolescents after surgical correction of spinal deformity. MATERIALS AND METHODS: The state of the sensory and motor spheres was analyzed in the immediate postoperative period in 21 adolescents with idiopathic scoliosis and in 13 with congenital deformities of the spine. A complex of methods involving global and stimulation electroneuromyography was used. The amplitude of motor, reflex potentials and interference electromyogram was evaluated at the maximum arbitrary tension of the lower limb muscles. Using an esthesiometer, thermal pain sensitivity in Th1S2 dermatomes was explored. In the process of surgical correction, intraoperative neuromonitoring was performed with registration of motor evoked potentials of the lower limb muscles. RESULTS: At the beginning of surgical intervention, high-amplitude, well-reproducible motor evoked potentials were obtained in all patients. In the group of patients with idiopathic scoliosis, compared with those with congenital deformities, smooth flow of surgery prevailed (p 0.05) without significant changes in motor potentials relative to the baseline (p 0.05). The number of observations of motor potentials decreased in the both groups and did not exceed 10%; the differences were not significant (p 0.05). The study of the reactions of the sensorimotor system in the immediate postoperative period triggered an increase in the amplitude of M-responses of m. rectus femoris, m. flexor digitorum brevis, m. gastrocnemius, and a decrease in the amplitude of the total EMG of m. rectus femoris. Values of H-reflexes remained at the preoperative level. The analysis of thermal pain sensitivity demonstrated the presence of a more pronounced reaction than that of the motor component. Changes in indicators of this type of sensitivity in groups of adolescents with idiopathic and congenital scoliosis were opposite. In idiopathic scoliosis, negative dynamics of the values prevailed, while in adolescents with congenital deformities of the spine, positive dynamics prevailed. This was because the amount of correction of the main and compensatory curves of the deformity in the group with idiopathic scoliosis was 48% greater (p = 0.0004) and 51% greater (p = 0.011), respectively. CONCLUSIONS: After surgical correction of spinal deformities in adolescents, the reactions of the sensory system of thermal pain sensitivity were more pronounced than those of the motor sphere.

INTRODUCTION: In the long-term course of traumatic spinal cord disease (TSCD), neuroplastic adaptive and maladaptive changes occurred on different structural levels of the nervous system, which leads to a shift in the activation and strength characteristics of the limb muscles. The standard neurological assessment is approximate; therefore, objective instrumental studies of the motor sphere of patients with partial damage to the cervical spinal cord have not lost their significance. AIM: To study the activation and strength characteristics of the limb muscles of patients with partial injury of the cervical spinal cord in the long-term course of the disease (type B on the American Spinal Cord Injury Association (ASIA) scale). MATERIALS AND METHODS: The study enrolled 28 patients with fractures of the cervical spinal cord vertebrae in the late period of the TSCD of ASIA type B. The amplitude of motor responses (M-responses) of the upper and lower limbs was assessed using electroneuromyography. The strength of the upper limb muscles was evaluated using manual dynamometers. RESULTS: M-responses were absent in 9% and 64% in the upper and lower limbs, respectively. The amplitude of the most recorded M-responses of the upper and lower limb muscles was reduced relative to the norm. The reduction was not uniform, with significant differences in different leads. The average values of the amplitude asymmetry of M-responses did not exceed the norm. Moreover, 61% of the patients could perform hand-grip functions and hold the wrist dynamometer. Only 59% of the patients could make an effort and the results of strength measurement were obtained, whereas in 41% of cases, zero values were obtained. Statistical analyses revealed a clear relationship between the motor deficiency index of the upper limb and hand-grip strength. CONCLUSION: The degree of preservation of M-responses and evident asymmetry of evoked electrical activities of the upper and lower limb muscles indicate the existence of a certain level of neurotrophic interaction in the muscle fibermotor neuron system. The level of reduction of the hand-grip strength and its relationship with the motor deficiency index allows discussion about the partial preservation of the voluntary control of the motor function of the upper limbs.

Introduction Among the ranges of electromagnetic waves used in clinical practice, electromagnetic waves of the terahertz range (EMWTHR) have promising applications. The experimental and clinical studies show that they are able to provide correction of the main pathophysiological disorders of a living organism such as hypoxia, hypercoagulation, and immunodeficiency. Purpose To study the effectiveness and safety of terahertz electromagnetic waves in the complex treatment of patients with the consequences of fractures of the humeral condyle Methods Clinical, radiological, physiological and laboratory studies were conducted in 30 patients with consequences of fractures of the humeral condyle (post-traumatic deformities, osteoarthritis of the elbow joint). Surgical treatment of patients with consequences of injuries of the elbow joint was classical and consisted of corrective osteotomies and osteosynthesis with the Ilizarov apparatus of the humerus and forearm. The main group consisted of 15 patients who underwent 10 sessions of EMWTHR exposure to the osteotomy zone, and 15 patients did not undergo physiotherapy. Results It was found that in patients of the main group, the average values of the intensity of pain and the deficit in the range of motion were significantly lower than the findings of the comparison group in the short term after treatment. The use of EMWTHR therapy led to differences in metabolic processes in the compared groups. There were no significant changes in radiological, physiological and laboratory parameters, as well as clinical signs that could be attributed to adverse events or complications associated with the use of EMWTHR. Conclusion The results of the comparative study allow us to recommend the EMWTHR therapy in the system of complex treatment of patients with the consequences of fractures of the humeral condyle and can be used as a means for local stimulation of reparative processes in target patients.

Background. The standard neurological assessment in patients with long-term consequences of spine-and-spinal cord injury and severe neurological deficit does not allow to accurately identify changes in sensitivity that determine the level, degree and nature of spinal cord injury, as well as to evaluate the minimal dynamics of these disorders with different treatment options. As a result, an objective instrumental assessment of the sensory sphere in the long-term period of spinal cord injury has not lost its relevance.The aim. To conduct an instrumental study of the temperature-pain sensitivity condition in patients with partial gross damage to the cervical spinal cord in the long-term period of the disease (type B on the ASIA scale).Methods. We examined 23 patients with consequences of vertebral fractures of the cervical spine in the late period of traumatic spinal cord disease, Grade B on the ASIA scale ASIA. The clinical analysis of sensitive disorders was performed according to ISNCSCI and ASIA scales. While studying the temperature-pain sensitivity the threshold of thermal sensitivity and the threshold of pain from hot were determined in СIV–SI dermatomes on the right and on the left using an electricesthesiometer.Results. The examined patients had hypesthesia of heat and pain sensitivity, hyperesthesia of pain sensitivity, thermoanesthesia and thermoanalgesia. The degree of changes in the temperature-pain sensitivity depended on the topographic localization of dermatomes. The more distally the study area was located from the level of damage, the more pronounced the disorders were. In 30.4 % of patients, the pain sensitivity from hot in the chain of dermatomes from CIV to SI was preserved on at least one side. The combination of thermoanesthesia with thermoanalgesia was observed in 69.6 % of cases in dermatomes with ThVII and distally.Conclusions. The instrumentally registered level of the temperature-pain sensitivity disorder did not correspond to clinically determined localization of sensory disorders. The range of discrepancy ranged from 2 to 12 dermatomes, with defining the sensitivity subclinical deficit over the area of clinical sensory disorders.

Background. The scientific and clinical interest in the problems of osteogenesis imperfecta (OI) has grown in the last decade. However, the analysis of various variants of spinal pathologies in OI received insufficient attention. The study aimed to analyze the current literature on various variants of the spinal pathology in patients with M. OI is a phenotypically and genetically heterogeneous group of hereditary bone dysplasias. The spine pathology in OI is represented by scoliosis, kyphoscoliosis, anomalies of the craniovertebral junction, instability of the segments and fractures of the vertebral bodies, spondylolysis, and spondylolisthesis. Scoliosis and kyphoscoliosis are the most common forms of spinal pathology. In severe forms and at age >6 years, the prevalence of scoliosis can reach 89%. The exact mechanism of scoliosis formation in patients with OI is complex and incompletely defined. Anomalies of the craniovertebral junction are recorded in 37% of patients with OI and are determined in all four types of M. Clinical manifestations of the craniocervical junction pathology can vary from asymptomatic to compression of the brainstem, restriction of cerebrospinal fluid circulation, leading to hydrocephalus, syringomyelia, and cranial nerve damage. The pathology of the lumbosacral spine is represented by spondylolysis and spondylolisthesis generally in the L5-S1 segment in 5.3%-10.9% of cases. The clinical significance and natural course of spondylolysis and spondylolisthesis in patients with OI are not fully defined in the literature, and the information on surgical indications and methods is available only in rare case reports. The changes in the axial skeleton in OI can lead to significant functional disability, pain, and potentially life-threatening complications, such as radicular neurological deficit, decrease in the ventilation capacity of the lungs, and cardiorespiratory complications. The overall severity of OI remains the best criterion for predicting the development of secondary spinal pathology. Given the generalization and heterogeneity of OI, an individual and multidisciplinary approach is necessary when diagnosing and planning the treatment strategy for this group of patients.

BACKGROUND: Insufficient attention has been paid to the analysis of the use of instrumental methods of examination in assessment the long-term results of surgical treatment of spondylolisthesis in middle-aged and elderly patients. AIM: To show the peculiarities of strength characteristics of lower limb muscles and temperature and pain sensitivity in the dermatomes of the cauda equina roots in middle-aged and elderly patients in the distant terms after surgical treatment of spondylolisthesis depending on the etiology of the disease. MATERIALS AND METHODS: An analysis of the results of functional studies of 21 patients with spondylolisthesis aged 41 to 74 years (12 with degenerative, 9 with isthmic) is presented. The research done before treatment and 7599 months after surgery. The following research methods were used: analysis clinical (neurological status), visual analog scale (VAS), Oswestry Disability Index (ODI), radiology (functional X-ray examination), magnetic resonance imaging, anthropometry, the lower limb muscles dynamometry, esthesiometry, statistical. RESULTS: In the long term after surgical treatment, patients with isthmic spondylolisthesis had a predominant increase in the moment of force in all muscle groups (3975% of cases). Negative dynamics prevailed in the group of patients with degenerative spondylolisthesis a decrease in muscle strength characteristics in 5094% of cases. According to esthesiometry, more pronounced negative changes in the values of temperature and pain sensitivity thresholds were observed in patients with degenerative spondylolisthesis. CONCLUSION: The analysis of muscle strength characteristics and esthesiometry data determined a different degree of compensation and recovery during surgical treatment of patients with spondylolisthesis, depending on the etiology of the disease.

Background. The problem of the effect of adolescent idiopathic scoliosis on the functional condition of the lower limb muscles is still highlighted insufficiently.Aim. Analysis of the degree of involvement of the lower limb muscles in the pathological process in adolescents with idiopathic scoliosis.Methods. A comparative analysis has been made on the results of examination of 209 adolescents: 25 adolescents with idiopathic scoliosis; 170 normal adolescents; 14 adolescents with congenital scoliosis. The moments of force ofthe lower limb muscles were evaluated using dynamometric stands. Electrophysiological characteristics of the lower limb muscles were registered by the method of global and stimulation electroneuromyography.Results. The decrease in the amplitude of voluntary EMG of the femoral muscles in adolescents with idiopathic and congenital scoliosis is accompanied by dropping the moments of force relative to the values of the control group. The leg muscles are characterized by the preservation of the values of force at the level of normal test subjects under the conditions of the reduced voluntary EMG of high frequency. The amplitude of the M-responses of the indicator muscles and the values of the excitation propagation velocity along the motor fibers were also preserved. There are no statistically significant correlations between the amount of the spine deformity, on the one hand, and the values of asymmetry of the characteristics of the muscles in adolescents with idiopathic scoliosis.Conclusion. In adolescents with idiopathic scoliosis the function of femoral muscles is decreased, and there is no relationship between the amount of the spine deformity and the values of asymmetry of the characteristics of the lower limb muscles. The similar character of muscle function changes in adolescents with idiopathic and congenital scoliosis can testify that the cause of the observed changes is not the disease etiology, but the insufficient level of motor activity.

Introduction Morphological, biochemical and histopathological characteristics of paraspinal muscles have been well described in patients with idiopathic scoliosis. However, there is a paucity of literature on morphological picture of paraspinal muscles in patients with severe idiopathic scoliosis. Objective To explore how the magnitude of thoracic spine deformity affects morphological characteristics of paraspinal muscles in patients with severe idiopathic scoliosis. Material and methods A total 21 patients with idiopathic scoliosis were reviewed. The patients were assigned to two groups depending on magnitude of preoperative thoracic spine deformity. A major group consisted of patients with scoliosis of ≥ 60º (n = 11) and control group included patients with a curve < 60º (n=10). Biopsy samples were taken from muscle fragments (multifidus muscle) at the apex of the curve (major arc) at the Th6-Th10 level on the convex side while approaching to the posterior spinal structures during surgical correction of kyphoscoliosis using light microscope. The specimens were examined histologically with light microscope. Results Patients with severe idiopathic scoliosis (≥ 60º) showed evident muscle fiber atrophy and dystrophy of different extent. There were nucleus free areas and homogenized muscle fragments observed with connective tissue layers being swollen and frayed with multiple fibroblasts seen in nearly all the samples. Arterial walls were normally fibrotized. Structural changes ranged from minimal with a curve of 60º to degrading muscles with the fibers replaced by fat and connective tissues with a curve angle of 145º. Conclusion Morphological characteristics of paraspinal muscles have been shown to be severely affected by the magnitude of thoracic spine deformity in patients with severe idiopathic scoliosis. The findings should be considered in surgical correction of kyphoscoliosis with special focus on postoperative vascular and neurotropic therapy to allow wound healing and lower complication rate.