Experience in diagnosis and treatment of 112 patients with spine osteomyelitis is presented. In 8 patients cervical spine, in 23 patients thoracic spine and in 81 patients lumbar spine was involved. Neurological deficit was observed in 45 (40.2%) patients. Forty seven (42%) patients underwent conservative and 65(58%) surgical treatment. Conservative treatment included intraarterial injection of antibacterial drugs. Surgical treatment consisted of radical resection of the osteomyelitis focus followed by stabilization of the spine with autografts. Long-term results were evaluated in terms from 1 to 20 years. In all patients the formation of bone block and regression of neurological symptoms was observed.

Objective - to analyze the results of X-ray, cytomorphometric and immunohistochemistry experimental studies of bone regenerates after osteosynthesis with bioinert and calcium phosphate-coated bioactive implants. Material and methods. The study was conducted on experimental femoral neck fractures in rabbit males. Reparative osteogenesis processes were studied in groups of bioinert titanium implant osteosynthesis and calcium phosphate-coated bioactive titanium implant osteosynthesis. The animals were clinically followed-up during the postoperative period. X-ray, cytomorphometric and immunohistochemistry studies of samples extracted from femoral bones were conducted over time on days 1, 7, 14, 30 and 60. The animal experiments were kept and treated according to recommendations of international standards, Helsinki Declaration on animal welfare and approved by the local ethics committee. All surgeries were performed under anesthesia, and all efforts were made to minimize the suffering of the animals. Results. In the animal group without femoral neck fracture osteosynthesis, femoral neck pseudoarthrosis was observed at the end of the experiment. The results of cytomorphometric and immunohistochemistry studies conducted on day 60 of the experiment confirmed that the cellular composition of the bone regenerate in the group of calcium phosphate-coated bioactive titanium implants corresponded to a more mature bone tissue than in the group of bioinert titanium implants. Conclusion. The results of the statistical analysis of cytomorphometric and immunohistochemistry data show that the use of calcium phosphate-coated bioactive titanium implants allows to achieve significantly earlier bone tissue regeneration.

In the work a retrospective analysis of 201 cards of outpatients who suffered from traffic accidents is carried out. Long-term consequences of whiplash injury have been estimated in 37 patients from 2 to 5 years of age without any traumas and diseases of cervical spine in anamnesis. 20 patients with whiplash injury, who comprise 54 per cent of the total amount of checked people, are classified into a recovering group, with no changes of Neck Disability Index in long-term period. 17 patients (46%) have such complaints as pain in the cervical spine, headache, and are classified into a symptom group. The quality of life decreased in 8 (47%) cases that are classified as mild (5-14 points) and in 9 (53%) patients whose cases are classified as moderate (15-24 points). The statistical analysis reveals that the quality of life in long-time period after the whiplash injury directly depends on a degree of severity of initial injury.

Introduction. The urgency of this problem is caused by the complexity of visualizing the injuries of the posterior support complex of cervical spine (CS). A delay in diagnosis can lead to chronic pain syndrome, CS instability, manifestation of degenerative-and-dystrophic changes, and neurological deficit which aggravate the trauma clinical course and prevent patient’s proper rehabilitation. Purpose. To analyze the long-term results of treating patients with CS posterior support complex injury in case of trauma whiplash mechanism. Materials and Methods. The long-term results of treatment evaluated in 25 patients with CS posterior support complex injury who had trauma whiplash mechanism after road traffic accident without direct impact of the neck with analyzing clinical and X-ray data. Results. All 25 patients started to work at 6 weeks after trauma, and they had no CS-related complains and symptoms. The range of motion in all the patients was 16-18 points that considered as a good result. Degenerated changes at the level of С5-С6, С6-С7 discs observed in 4 (16 %) cases. Consolidation of spinous process fractures occurred in all the cases. Ossification of supraspinous and interspinous ligaments at the level of the spinous process consolidated fractures observed in 17 (68 %) cases, as well as mild-degree disorder of functional adaptation according to Neck Disability Index found. Coclusion. The involvement of the posterior support complex occurs in case of whiplash trauma during road traffic accidents. Radiography should be performed in three views, and it is possible to use CT scans in some cases as a standard diagnostic algorithm in order to rule out CS involvements in patients with whiplash trauma. Conservative treatment of patients with such injuries allows to obtain favorable results.

Introduction. The urgency of this problem is caused by the complexity of visualizing the injuries of the posterior support complex of cervical spine (CS). A delay in diagnosis can lead to chronic pain syndrome, CS instability, manifestation of degenerative-and-dystrophic changes, and neurological deficit which aggravate the trauma clinical course and prevent patient’s proper rehabilitation. Purpose. To analyze the long-term results of treating patients with CS posterior support complex injury in case of trauma whiplash mechanism. Materials and Methods. The long-term results of treatment evaluated in 25 patients with CS posterior support complex injury who had trauma whiplash mechanism after road traffic accident without direct impact of the neck with analyzing clinical and X-ray data. Results. All 25 patients started to work at 6 weeks after trauma, and they had no CS-related complains and symptoms. The range of motion in all the patients was 16-18 points that considered as a good result. Degenerated changes at the level of С5-С6, С6-С7 discs observed in 4 (16 %) cases. Consolidation of spinous process fractures occurred in all the cases. Ossification of supraspinous and interspinous ligaments at the level of the spinous process consolidated fractures observed in 17 (68 %) cases, as well as mild-degree disorder of functional adaptation according to Neck Disability Index found. Coclusion. The involvement of the posterior support complex occurs in case of whiplash trauma during road traffic accidents. Radiography should be performed in three views, and it is possible to use CT scans in some cases as a standard diagnostic algorithm in order to rule out CS involvements in patients with whiplash trauma. Conservative treatment of patients with such injuries allows to obtain favorable results.

Objective. To analyze the results of surgery for cervicothoracic deformity fractures in patients with ankylosing spondylitis. Material and Methods. Retrospective review of treatment for fractures of cervicothoracic deformity in 6 patients with ankylosing spondylitis was performed. All patients had transdiscal fractures caused by low-energy trauma, most frequently at C5–C6 and C6–C7 levels. Each patient had at least one comorbidity. The spinal cord was injured in 100 % of cases. Results. Postoperative complications were registered in all patients. Analysis of postoperative x-rays showed that spinal deformity was corrected in most cases, and the stable fixation was achieved at the operated level of the spine. Three patients who had underwent anterior fixation showed the regression of neurological symptoms. Patients classified as Frankel A died of cardiopulmonary insufficiency at 2–7 days after surgery without any signs of neurological symptom regression. Autopsy revealed severe spinal cord injury. Mortality rate was 50 %. Conclusion. Surgical treatment of cervical spine fractures providing a stable fixation reduces the risk of complications and allows for early activation of patients with ankylosing spondylitis.

Objective - to analyze the long-term results of surgical treatment of patients with injuries of middle- and lower cervical spine in diving. Materials and methods. An analysis of surgical treatment of 27 patients and assessment of the long-term results of 20 patients in a period of 6 months to 6 years were performed with analysis of clinical, neurological, radiographic data and mortality. Results. Mostly the C5 vertebra was damaged - in 17 patients (63%). Compression fractures of vertebral bodies met in 6 (22%), compression-comminuted fractures - in 16 (59%) patients, dislocations - in 5 (19%). All patients had neurological disorders. All observations noted rigid stabilization of the spine with an implant made of porous nickel-titanium, the presence of bone-metal block at the level of the damaged vertebral body Mortality in the postoperative period was 26%. In the long-term period the initial neurological symptoms were observed in 7 (30%) patients, 13 (48%) patients had marked regression of neurological symptoms. Full functional maladjustment was observed in 6 patients with no motor function below the damaged segment, originally belonging to groups A and B on the classification of H.L. Frankel. Moderate and mild degree of functional adaptation disorders were present in 5 and 4 patients respectively. In the remaining patients we did not reveal a functional maladjustment. Range of motion in the cervical spine in all patients was considered as good. Conclusions. Anterior decompressive-stabilizing surgeries on the spine with an implant made of porous nickel-titanium and metal plate CSLP allows reliably stabilization of the injured spine and the rehabilitation of this severe category of patients.

The article presents the analysis of treatment results in 61 patients after osteosynthesis of femoral neck with cancellous screws in the period of time from 1 to 6 years after surgery. Low invasive osteosynthesis with cancellous screws provides knitting, so it can be one of the methods of choice at femoral neck fractures, but only as one of the variants of osteosynthesis with parallel holders, for it cause femoral neck shortening.

Hir. Pozvonoc. 2012;(4):8–18. Обзор литературы посвящен часто встречающемуся повреждению шейного отдела позвоночника – хлыстовой травме. В данной работе выделены и систематизированы современные данные по истории, механизму, диагностике, лечению, прогнозу хлыстовой травмы и заболеваний, связанных с ней. Ключевые слова: хлыстовые повреждения, лечение травм шейного отдела позвоночника, цигапофизиальный болевой синдром.