Saidmirze D. Mirzametov

S. M. Kirov Military Medical Academy

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Co-Authors

ДВ

Д. В. Свистов

S. M. Kirov Military Medical Academy

M N Kravtsov

S. M. Kirov Military Medical Academy

ВП

В. П. Орлов

Voronezh State University

B. V. Gaĭdar

S. M. Kirov Military Medical Academy

V. A. Manukovsky

Saint-Petersburg I. I. Dzhanelidze Research Institute of Emergency Medicine

АВ

А В Голубин

N. P. Alekseyeva

First Pavlov State Medical University of St. Petersburg

АВ

А. В. Нащекин

Ioffe Institute

Maxim N. Kravtsov

Saint-Petersburg I. I. Dzhanelidze Research Institute of Emergency Medicine

Yu. A. Nashchekina

Russian Academy of Sciences

Cooperative Institutions

S. M. Kirov Military Medical Academy

St Petersburg University

Saint-Petersburg I. I. Dzhanelidze Research Institute of Emergency Medicine

North-Western State Medical University named after I.I. Mechnikov

Research Institute of Emergency Care

First Pavlov State Medical University of St. Petersburg

Russian Academy of Sciences

Hospital at Smolensk Station

Ioffe Institute

Physico-Technical Institute

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Percutaneous Transforaminal Full-Endoscopic Removal of Neurinoma of the Fifth Lumbar Nerve Root With Intraoperative Neuromonitoring: A Case Report

Frontiers in Surgery (2022)

Maxim N. Kravtsov V. A. Manukovsky Saidmirze D. Mirzametov Olga Malysheva D. A. Аveryanov

Technical achievements and surgical techniques improvement contribute to the expansion of the endoscopic spine surgery possibilities. However, today there are few reports about the use of percutaneous endoscopy in spinal tumor surgery. A case of percutaneous transforaminal endoscopic removal of the lumbar spinal nerve tumor with intraoperative neuromonitoring is presented.A 59-year-old female was complaining of a left shin and foot pain, weakness, and paresthesia. Preoperative magnetic resonance imaging (MRI) revealed a tumor (neurinoma) at the left L5-S1 intervertebral foramen. Transforaminal endoscopic removal of an extramedullary tumor from an 8-mm skin incision with intraoperative neuromonitoring was performed. Postoperative MRI revealed the signs of total resection of the tumor.The presented case confirms that percutaneous endoscopic removal of lumbar spine intraforaminal neurinomas can be safe and effective.

Intervertebral foramen

Lateral recess

Foramen

10.3389/fsurg.2022.877974

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Citations (7)

Relationship of psychoalgological status and results of neurosurgical treatment of patients with discogenic radiculopathy

Grekov s Bulletin of Surgery (2020)

V. I. Leonov I. O. Kritskaya Д. В. Свистов Elena V. Litvinenko Т. В. Сергеева

The OBJECTIVE was to improve the results of surgical treatment of patients with discogenic radiculopathy by preoperative neuropsychological examination of patients with an increased risk of unsatisfactory outcome of the operation. METHODS AND MATERIALS. Neuropsychological status of 77 patients with discogenic radiculopathy in the preoperative period was studied. For this purpose, we assessed the intensity of pain, levels of personal and situational anxiety and the presence and severity of depression. The obtained data were compared with postoperative results of quality of life assessment for the main parameters, which include the level of pain and adaptation to daily activities. RESULTS. Data from neuropsychological tests were revealed, the presence of which in patients with discogenic pain syndrome suggests the risk of an unsatisfactory assessment of the operation performed by the patient. According to the long-term results of neurosurgical treatment, patients were divided into three groups: 1 – with a good result; 2 – patients with a number of preserved complaints, who rated the result of the operation as satisfactory; 3 – unsatisfactory outcome. In patients with unsatisfactory results of surgical treatment of discogenic radiculopathies with pain syndrome, patterns of psychological indices were found that were significantly associated with the outcome of treatment. CONCLUSION. Conducting a neuropsychological examination prior to surgery with the identification of predictors of chronic discogenic pain and patient dissatisfaction with the results of treatment can influence the surgical tactics and optimize the process of further treatment.

Depression

10.24884/0042-4625-2020-179-3-13-18

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Citations (1)

Evaluation of the effectiveness of surgical methods for the treatment of recurrent lumbar disc herniation: a cohort retrospective study

Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika) (2021)

M N Kravtsov I. A. Kruglov Saidmirze D. Mirzametov Aleksandr Seleznev N. P. Alekseyeva

Objective. To compare the effectiveness of surgical methods for treating patients with recurrent lumbar disc herniation. Material and Methods. The sample consisted of 160 patients operated on in 2014–2019 for recurrent lumbar disc herniation by percutaneous endoscopic discectomy (Group 1), microsurgical discectomy (Group 2), single-level transforaminal interbody fusion (Group 3) and single-level total intervertebral disc replacement (Group 4). The effectiveness of surgical treatment was evaluated using the NRS-11, ODI, and MacNab questionnaires. Results. Assessment of the pain syndrome severity and the vital activity level of patients revealed significant (p < 0.05) differences in favor of total intervertebral disc replacement. Excellent and good outcomes after arthroplasty according to MacNab criteria were noted in all patients in this group. Similar outcomes were reported in 77.5 % (31/40) of patients in the TLIF group, in 75.1 % (24/32) of patients in the percutaneous endoscopic discectomy group and in 72.6 % (45/62) of patients in the microdiscectomy group. The operation time and length of hospital stay were shorter in the endoscopic and microsurgical discectomy groups (p < 0.001). However, the lower incidence of complications and reoperations was observed in groups of posterior interbody fusion and arthroplasty (p > 0.05). Conclusion. Arthroplasty with the M6-L implant expands the possibilities of surgery for recurrent lumbar disc herniation. Total intervertebral disc replacement and posterior interbody fusion for recurrent lumbar disc herniation are more effective in comparison with decompressive operations, which is reflected in the improvement of clinical treatment outcomes, reduction of perioperative complications and frequency of repeated interventions.

Discectomy

Lumbar disc herniation

Intervertebral Disc

Diskectomy

10.14531/ss2021.2.34-43

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Citations (4)

Surgical treatment of Forestier disease

Bulletin of the Russian Military Medical Academy (2019)

В. П. Орлов Sergey M. Idrichan E. D. Alekseyev Saidmirze D. Mirzametov

Historical information, epidemiology, risk factors, diagnosis and known methods of treating diffuse idiopathic skeletal hyperostosis – Forestier disease – a rare idiopathic non-inflammatory disease of the musculoskeletal system characterized by ossification of ligaments and tendons, gradually leading to ankylosis, are presented. The differential diagnostic criteria for this disease are listed. The clinical picture of vertebral and extravertebral localization of foci of hyperostosis is described. A clinical case of severe recurrent idiopathic hyperostosis of the cervical spine, manifested by dysphonia, dysphagia and pain, is considered. The peculiarity of this case is gross hyperostosis, which is a recurrence of Forestier disease in the cervical spine 12 years after surgical treatment. The indications and the required volume of the operation, as well as the difficulties of re-surgical treatment of Forestier disease with localization of hyperostosis in the cervical spine, are listed. In general, repeated surgical treatment of Forestier disease is associated with a pronounced scar-adhesive process, which increases the duration of the operation and the amount of blood loss. In case of damage to the cervical spine with severe compression of the pharynx, esophagus and respiratory tract, it is enough to perform a decompressive intervention. A stabilizing benefit is not required, due to the lack of signs of instability of the operated vertebral-motor segment both intraoperatively and in the postoperative period. At the same time, surgical treatment with this nosology is not radical and does not cure patients even at the level of surgical intervention. However, the operation is indicated for severe compression of the neck organs and neurovascular structures.

Hyperostosis

Ankylosis

10.17816/brmma20658

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Citations (1)

Short- and long-term results of percutaneous full-endoscopic and microsurgical lumbar discectomy: prospective cohort study

Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika) (2019)

M N Kravtsov Saidmirze D. Mirzametov V. N. Malakhovsky N. P. Alekseyeva B. V. Gaĭdar

Objective. To analyze immediate and long-term results of percutaneous endoscopic and microsurgical discectomy. Material and Methods. A prospective cohort study in two groups of patients was conducted in 2015–2018. The observation period was 6–42 months. Group 1 included 110 patients who underwent percutaneous endoscopic lumbar discectomy, and Group 2 – 331 patients who underwent microdiscectomy. Efficiency was assessed using NRS-11, ODI, SF-36, and MacNab questionnaires. Results. The operating time, bed day number, and disability period were shorter in Group 1 (p < 0.001). The average effective dose of radiation exposure to the patient was 4.4 mSv in transforaminal endoscopy, and 0.8 mSv in interlaminar and microsurgical discectomy. There were no significant intergroup differences in frequency and types of complications and reoperations. The portion of symptomatic hernia recurrence in Group 1 was 10 %, in Group 2 – 4.8 %. Significant differences in neurological outcomes and quality of life were not revealed. Good and excellent outcomes according to MacNab criteria were noted in 78.2 % and 84.9 %, in Groups 1 and 2, respectively. Conclusion. The percutaneous endoscopic discectomy allows reducing hospital stay length and disability period, while having clinical efficacy equal to that of other disectomy methods. A statistically insignificant increase in the risk of hernia recurrence after percutaneous endoscopic discectomy was noted.

Discectomy

10.14531/ss2019.2.27-34

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Synchronous schwannoma and ependymoma of the cauda equina

Burdenko s Journal of Neurosurgery (2021)

M N Kravtsov Saidmirze D. Mirzametov G Ivanov Д. В. Свистов

The article presents a case of surgical treatment of primary multiple benign tumors of the cauda equine of different histological origin: spinal nerve root schwannoma and ependymoma of the filum terminale.

Cauda equina

Ependymoma

10.17116/neiro20218502175

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Citations (1)

Biocompatibility of an interspinous implant made of titanium alloys

Pediatric Traumatology Orthopaedics and Reconstructive Surgery (2022)

В. П. Орлов Yu. A. Nashchekina А. В. Нащекин Olga N. Ozeryanskaya Saidmirze D. Mirzametov

BACKGROUND: At present, metal implants are widely used in neuro-orthopedics, of which titanium alloys are of particular interest. A team of authors developed an original combined implant for posterior spinal fusion as an import substitution, which can be used from one-way access during minimally invasive operations on the lumbar spine. The implant was manufactured at the Endocarbon Enterprise in Penza. For better osseointegration, it is made of VT6 alloy and titanium nickelide. The middle part of the implant is laser-treated to create an uneven surface in the hope of better integration in the tissues of the body. This study was conducted to assess the cytotoxicity and biocompatibility of this implant for its further application in clinical practice. AIM: To determine the cytotoxicity of an interspinous implant made of titanium alloys for its further introduction into spinal surgery. MATERIALS AND METHODS: To determine the cytotoxicity of titanium samples of interspinous implants, a methyltetrazolium test was conducted to assess the viability of stromal cells in the presence of a nutrient medium after incubation with the test material. The biocompatibility of the material was analyzed using scanning electron microscopy of samples 1 and 7 days after cell culture. RESULTS: The viability of cells cultured in the presence of a nutrient medium after incubation with samples of titanium VT6 was 105% and that of titanium nickelide was 98%, which were comparable to the viability of cells in a standard nutrient medium. With electron microscopy, after 1 day of cultivation, cells form a monolayer on a titanium surface, all cells were well spread out and formed intercellular contacts, and after 7 days of cultivation, the number of cells increased and they formed a dense monolayer. CONCLUSIONS: The interspinous implant, which includes alloys of titanium VT6 and titanium nickelide, is biocompatible with cultured cells and can be introduced into spinal surgery.

Biocompatibility

Simulated body fluid

Titanium alloy

10.17816/ptors104011

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Citations (2)

Experience in the use of dynamic interspinous fixation in the treatment of lumbar spine stenosis

Bulletin of the Russian Military Medical Academy (2020)

O N Ozeryanskaya В. П. Орлов Saidmirze D. Mirzametov А В Голубин Д. В. Свистов

The results of surgical treatment of lumbar stenosis using the dynamic intercostal fixator Coflex in the period from September 2016 to February 2019 were analyzed in 36 patients, 25 of them with monosegmental stenosis, 11 with two levels. Caudogenic intermittent claudication was observed in 27 patients. Dynamic interspinous fixation was performed on38 vertebral-motor segments of the lumbar. Assessment of the quality of life and the intensity of pain in the back and leg before and after the operation, as well as the outcome of the operation in the distant period after the operation, was carried out by validated scales and questionnaires. There were no intraoperative complications. In the distant period after surgery, the results of control functional spondylography of the lumbar revealed a direct dependence of the mobility of the operated vertebral-motor segment on the value of the disk height index. In all observations, a decrease in the mobility of the operated level was noted, which indicated the high-quality functioning of the interspinous implant. An increase in the height of the intervertebral foramen additionally provided indirect decompression of the spinal nerve in all cases. Syndrome of caudogenic intermittent claudication by the time of discharge regressed in all cases. For the period of observation of cases of development of postoperative instability and restenosis at the operated level was not noted. Satisfactory outcomes were obtained in 33 (91,7%), and unsatisfactory outcomes in 3 (8,3%) cases. Unsatisfactory outcomes in two cases were due to chronic pain in the lower back due to symptomatic stenosis of the spinal canal at an adjacent level, and in one observation, severe pain in the right leg due to the formation of sequestered herniated discs at an adjacent level. In general, interspinous dynamic stabilization has proven itself in the treatment of spinal stenosis of the lumbar spine, as the completion of the operation after the decompression phase.

Intermittent claudication

Claudication

Intervertebral foramen

10.17816/brmma25970

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Citations (0)

Case Report: Full-Endoscopic Surgery for Bullet Wounds of the Spine: A Report of Three Cases

Frontiers in Surgery (2022)

Maxim N. Kravtsov V. A. Manukovsky G. G. Bulyshchenko Saidmirze D. Mirzametov Vadim A. Byvaltsev

Objectives To determine the feasibility and evaluate effectiveness of full-endoscopic surgery in gunshot wound of the spine. Methods Three clinical cases of lumbar and thoracic spine bullet wounds made by firearms and traumatic weapons are described. Percutaneous endoscopic surgery was performed to extract bullet from the spinal canal. The results are compared to the data from literature. Results Percutaneous endoscopic approach to spinal canal with a possibility to extract a bullet, decompression of nerve roots, defect closure of the dura mater is demonstrated. Conclusion Good clinical outcomes allows to recommend percutaneous endoscopic surgery to manage similar lumbar and thoracic spine bullet wounds at the tertiary care level.

10.3389/fsurg.2022.873365

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Citations (7)

Опыт применения динамической межостистой фиксации в лечении стеноза поясничного отдела позвоночника

Bulletin of the Russian Military Medical Academy (2020)

О Н Озерянская В П Орлов Saidmirze D. Mirzametov А В Голубин Д В Свистов

Проанализированы результаты хирургического лечения поясничного стеноза с использованием динамического межостистого фиксатора «Coflex» в период с сентября 2016 г. по февраль 2019 г. у 36 пациентов, из них 25 - с моносегментарными стенозами, 11 - с двухуровневыми. Каудогенная перемежающаяся хромота наблюдалась у 27 больных. Динамическая межостистая фиксация выполнена на 38 позвоночно-двигательных сегментах поясничного отдела. Оценка качества жизни и интенсивности болевого синдрома в спине и ноге до и после операции, а также исхода операции в отдаленный период после операции проведена валидизированными шкалами и опросниками. Интраоперационных осложнений не было. В отдаленном периоде после операции по результатам контрольной функциональной спондилографии поясничного отдела выявлена прямая зависимость мобильности оперированного позвоночно-двигательного сегмента от величины индекса высоты диска. Во всех наблюдениях отмечено снижение мобильности оперированного уровня, что свидетельствовало о качественном функционировании межостистого имплантата. Увеличение высоты межпозвонкового отверстия дополнительно обеспечивало непрямую декомпрессию спинномозгового нерва во всех случаях. Синдром каудогенной перемежающейся хромоты к моменту выписки регрессировал во всех наблюдениях. За период наблюдения случаев развития послеоперационной нестабильности и рестеноза на оперированном уровне не отмечено. Удовлетворительные исходы получены в 33 (91,7%), а неудовлетворительные - в 3 (8,3%) наблюдениях. Неудовлетворительные исходы в двух случаях были обусловлены хроническим болевым синдромом в нижней части спины из-за симптомного стеноза позвоночного канала на смежном уровне, а в одном наблюдении - выраженным болевым синдромом в правой ноге в связи с образованием секвестрированной грыжи межпозвонкового диска на смежном уровне. В целом межостистая динамическая стабилизация хорошо зарекомендовала себя при лечении стеноза позвоночного канала поясничного отдела позвоночника в качестве завершения операции после декомпрессивного этапа.

10.17816/brmma25970-20117

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