Городская больница № 1 им. М.Н. Горбуновой, КемеровоПредставлены клинические случаи лечения оперативными способами нейрофибромы поясничного отдела позвоноч-ника с его последующей задней и передней стабилизаци-ей. Отдаленные результаты лечения прослежены в течение пяти и двенадцати лет.Ключевые слова: нейрофиброма, хирургическое лечение, стабилизация позвоночника.Neurofibroma of the lumbar spineI.P. Ardashev, V.R. Gatin, O.A. Statsenko, V.P. Noskov, O.A. Kalish, T.N. Starikov, E.I. ArdashevaThe paper presents clinical cases of neurofibroma of the lum-bar spine treated surgically with consequent posterior and anterior stabilization of the spinal column. Long-term treat-ment outcomes were analyzed for follow-up periods of five and twelve years.Key Words: neurofibroma, surgical treatment, stabilization of the spine.Hir. Pozvonoc. 2008;(3):56–60.

The paper presents clinical cases of neurofibroma of the lumbar spine treated surgically with consequent posterior and anterior stabilization of the spinal column. Long-term treatment outcomes were analyzed for follow-up periods of five and twelve years.

Open subacromial decompression was performed in 40 patients. Surgical treatment with arthroscopy technique was carried out in 130 patients. Assessment of ultimate results Kvas performed in the period of 6 months to 4 years with UCLA system - in 30 patients with open and in 65 patients - with subacromial decompression. With open surgical operations excellent results were obtained in 6 (20 %), good ones - 16 (53 %), satisfactory - 5 (17 %) and unsatisfactory - 3 (10 %). On arthroscopy subacromial decompression were obtained in 30 (46 %), good ones - 25 (39 %), satisfactory - 8 (12 %) and unsatisfactory - 2 (3 %).

Parallel with cliniconeurological diagnostics radial (including roentgenography, contrast myelography, CT scanning, MRI - tomography), laboratory and pathomorphological research methods were being used. All the patients were operated on the front and back parts of the spine with stabilization to follow. Two-phase spondylactomy was being carried out in case of the whole vertebra segment being affected. To stabilize the front parts of the spine prosthetic devices made of titanium and porous nickelide of titanium were being used. The stabilization of the back parts of the spine was made by means of metal plates and by transpaedicular fixation. Surgical treatment of patients having benign tumors allows to achieve complete recovery. Surgical treatment of patients having malignant growth allows to prevent neurological complications, to improve quality of patients' life.

The authors present their analysis of stability of the "scoliotic arch--Tarrington's distractor" system in various versions of surgical stabilization. A modification of Tarrington's technique is suggested which improves the initial fixation strength and reduces the risk of complications.