Aleksandr Vasyura

Novosibirsk Scientific Research Institute of Traumatology and Orthopedics. Ya.L. Tsivyan

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Vyacheslav Novikov

South Ural State University

Mikhail Mikhailovsky

Novosibirsk Scientific Research Institute of Traumatology and Orthopedics. Ya.L. Tsivyan

M. V. Mikhaylovskiy

Novosibirsk Scientific Research Institute of Traumatology and Orthopedics. Ya.L. Tsivyan

Lebedeva Mn

Novosibirsk Scientific Research Institute of Traumatology and Orthopedics. Ya.L. Tsivyan

Inga Udalova

Novosibirsk Scientific Research Institute of Traumatology and Orthopedics. Ya.L. Tsivyan

ЕВ

Е. В. Губина

Novosibirsk Scientific Research Institute of Traumatology and Orthopedics. Ya.L. Tsivyan

ВЛ

В. Л. Лукинов

Institute of Computational Mathematics and Mathematical Geophysics

Vasily Suzdalov

Novosibirsk Scientific Research Institute of Traumatology and Orthopedics. Ya.L. Tsivyan

M. A. Sadovoy

Ural State Law University

A. Yu. Sergunin

Novosibirsk Scientific Research Institute of Traumatology and Orthopedics. Ya.L. Tsivyan

Cooperative Institutions

Novosibirsk Scientific Research Institute of Traumatology and Orthopedics. Ya.L. Tsivyan

ORCID

Ministry of Health of the Russian Federation

Novosibirsk State Medical University

Institute of Computational Mathematics and Mathematical Geophysics

Siberian State University of Telecommunications and Informatics

Meshalkin National Medical Research Center

Novosibirsk State University

State University of Telecommunications

Moscow State University of Civil Engineering

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RESULTS OF SURGICAL TREATMENT OF SCHEUERMANN’S KYPHOSIS USING SEGMENTAL INSTRUMENTATION

Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika) (2011)

Mikhail Mikhailovsky Artyom Sorokin Vyacheslav Novikov Aleksandr Vasyura Lebedeva Mn

Objective. To analyze results of surgical treatment of Scheuermann’s kyphosis using segmental instrumentation. Material and Methods. Sixty eight operated patients were divided into two groups. Patients from Group 1 underwent only posterior procedure in skeletal traction, and patients from Group 2 - anterior and posterior procedures. In 18 (26.4 %) cases, patients were treated using segmental vertebrotomy and formation of compression anchor at the apex of deformity. The caudal anchor of instrumentation using transpedicular screws was formed in 10 (14.7 %) patients. Results. Kyphosis decreased from 76.2° ± 11.3° to 42.4° ± 10.4° in Group 1, and from 80.1° ± 11.5° to 39.5° ± 12.2° in Group 2; the loss of correction at 1 year after surgery was 7.9° ± 4.4° in Group 1, and 2.9° ± 5.8° in Group 2. The use of transpedicular fixation reduces the length of instrumentation by one segment. Conclusion. Two-stage surgical treatment including skeletal traction from calvarial bones to supramalleolar area, discectomy and interbody fusion with bone autograft at the apex, and correction of spinal deformity with segmental instrumentation, is the most effective treatment technique for severe progressive kyphosis in Scheuermann’s disease.

Kyphosis

Discectomy

10.14531/ss2011.4.27-34

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Хирургическая коррекция деформаций позвоночника на почве синдрома Элерса - Данло

Mikhail Mikhailovsky Vyacheslav Novikov Aleksandr Vasyura Lebedeva Mn

A total of nine patients with spinal deformities owing to Ehlers-Danlos syndrome were oper-ated on during the period of 2003–2013. Mean age of pa-tients was 12.5 years. One patient undergoes multistage treatment with VEPTR instrumentation, and eight patients underwent corrective posterior surgery using third-gener-ation segmental instrumentation. Posterior correction was preceded by anterior stage including discectomy and inter-body fusion with bone autograft in six cases.

Discectomy

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Efficacy of anterior and posterior multilevel vertebrotomy in adolescents with Lenke type 1 and 2 idiopathic scoliosis operated on using pedicle screw fixation with various implant density

Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika) (2020)

Aleksandr Vasyura Е. В. Губина M. V. Mikhaylovskiy

Objective. To analyze the efficacy of posterior and anterior multilevel vertebrotomy in adolescents with Lenke type 1 and 2 idiopathic scoliosis operated on using pedicle screw and hybrid instrumentation with varying implant density (ID). Material and Methods. The immediate and long-term results of surgical treatment of 271 adolescents with Lenke type 1 or 2 idiopathic scoliosis (with primary thoracic curve) operated on using one of three surgical techniques: instrumental correction and posterior fusion (n = 212), the same technique supplemented with discectomy and interbody fusion (n = 30), and that with posterior vertebrotomy (n = 29). In all three groups, the relationship between age, initial Cobb angle, mobility, ID, and treatment outcomes assessed using X-ray data and SRS-24 questionnaire was studied, including the construction of linear regression models. Results. In all groups, significant predictors of deformity correction were initial Cobb angle and ID, while the indicators of mobility and age did not demonstrate significance. The study showed no effect of anterior and posterior vertebrotomy on the magnitude of correction and its maintenance in the long-term period, as well as on the patient-reported outcomes (SRS-24). The combination of all indicators in the model explains 51 % to 74 % of the achieved correction variability. The explanatory power of the ID for the achieved correction is at least three times less than the explanatory power of the initial Cobb angle. Conclusion. Anterior discectomy with interbody fusion and posterior vertebrotomy as methods of spine release in surgery for adolescent idiopathic scoliosis do not provide additional correction of the thoracic scoliosis. Herein, the number of anchoring elements used for polysegmental fixation (implant density) does not play a role in maintaining the corrective effect.

Cobb angle

Idiopathic scoliosis

Discectomy

10.14531/ss2020.3.43-52

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SELECTION OF OPTIMAL LEVEL OF DISTAL FIXATION FOR CORRECTION OF SCHEUERMANN’S HYPERKYPHOSIS

Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika) (2012)

Mikhail Mikhailovsky Artyom Sorokin Vyacheslav Novikov Aleksandr Vasyura

Objective. To analyze the efficacy of the method for selecting the distal level of fusion in treatment of thoracic hyperkyphosis in Scheuermann’s disease. Material and Methods. Treatment results in 36 patients operated on in the Department of Children and Adolescent Spine Pathology during 2007-2010 were analyzed. Patients were divided into two groups: in Group 1 (n = 29) a lower instrumented vertebra corresponded to the sagittal stable one, and in Group 2 (n = 7) this vertebra located proximally. Results. The mean preoperative magnitude of kyphosis was 79.3° ± 11.6°, postoperative - 40.6° ± 11.9° (correction 49.9 %), and loss of correction was 4.9° ± 7.0°. Sagittal balance changed from -0.3 ± 3.2 cm before surgery to -1.7 ± 2.1 cm. Distal junctional kyphosis developed in 1 case (4 %) in Group 1, and in 5 cases (71 %) in Group 2. Conclusion. Distal level of instrumentation ending at the first lordotic vertebra is not justified and causes violation of sagittal balance and development of distal junctional kyphosis. Including sagittal stable vertebra in fusion prevents the development of distal junctional kyphosis. Hir. Pozvonoc. 2012;(2):24-29.

Kyphosis

Vertebra

10.14531/ss2012.2.24-29

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USE OF TRANEXAMIC ACID IN SCOLIOSIS SURGERY

Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika) (2016)

Lebedeva Mn Anastasia Ivanova A. V. Palmash И А Стаценко Aleksandr Vasyura

Objective. To assess the effectiveness of tranexamic acid in the surgical correction of idiopathic scoliosis. Material and Methods . The study included a retrospective analysis of intraoperative and postoperative blood loss during surgical correction of idiopathic scoliosis in 198 patients. In 70 patients, the operation was performed without administration of tranexamic acid. In 58 patients, tranexamic acid was administered 15 minutes before the skin incision at a dose of 10 mg/kg, and continued uninterruptedly at a dose of 1 mg/kg/h. In 70 patients, tranexamic acid was administered continuously during the operation at a dose of 10 mg/kg. Patients underwent surgery in a prone position with full decompression of the anterior abdominal wall. Results . The registered intraoperative blood loss in most cases corresponded to Class I (no more than 750 ml or 15 % of blood volume) and Class II (no more than 750-1500 ml or 15-30 % of blood volume) according to the WHO classification of severity. The volume of intraoperative blood loss was not statistically different between groups. Significant differences were detected only in assessing parameters of postoperative blood loss. Conclusion . The use of tranexamic acid in surgical correction of scoliosis does not affect the bleeding index of tissues at the surgical site and the total intraoperative blood loss. Using tranexamic acid in spine surgery is a technological procedure allowing for significant reduction in postoperative blood loss.

Idiopathic scoliosis

10.14531/ss2016.4.84-89

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A multimodal approach to intraoperative neuromonitoring of the spinal cord during spinal deformity correction

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

А. В. Бузунов Aleksandr Vasyura Denis Dolotin A. Yu. Sergunin Vyacheslav Novikov

Objective. To analyze the results of a multimodal approach in intraoperative neurophysiological monitoring during surgical correction of spinal deformities. Material and Methods. The paper describes a variant of intraoperative neurophysiological monitoring of the spinal cord and nerve root functions which was used in the correction of scoliotic deformity of the spine in 138 patients. Surgery was performed in 83 patients aged 10 to 17 years and in 55 patients older than 17 years. The average age of patients was 20.23 ± 8.3 years. There were 41 male and 97 female patients. The primary scoliotic curve was localized in the thoracic spine in 90 cases, in the thoracolumbar spine in 27 cases, and in the lumbar spine in 21 cases. Results. In the early postoperative period, two patients developed neurological deficit, the electrophysiological predictors of which were recorded during intraoperative neurophysiological monitoring. In one case, the deficit gradually regressed completely due to the measures taken by the operating team during surgery; in the second case, a persistent neurological deficit in the form of lower paraplegia persisted, despite the measures taken during the surgical treatment. In other cases, intraoperative neurophysiological monitoring did not reveal any changes in the spinal cord and nerve roots, which in the early postoperative period would lead to the appearance or aggravation of motor deficit. Conclusion. A multimodal approach to intraoperative neurophysiological monitoring provides an operating surgeon with an objective assessment of the state of the spinal cord and nerve roots at any stage of surgery, which allows timely identification and elimination of the causes of their damage, thereby reducing the likelihood of neurological deficit development or aggravation in the postoperative period.

Intraoperative neurophysiological monitoring

Paraplegia

Neurophysiology

Evoked potential

Neurological deficit

10.14531/ss2021.1.31-38

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INTRAOPERATIVE TRACTION IN SURGERY FOR ADOLESCENT IDIOPATHIC SCOLIOSIS

Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika) (2017)

M. V. Mikhaylovskiy Vyacheslav Novikov M. A. Sadovoy Aleksandr Vasyura Vasily Suzdalov

Objective. To analyze the effectiveness of intraoperative traction in the treatment of adolescent idiopathic scoliosis, including in relation to the initial magnitude of scoliotic curve. Material and Methods . Data on patients meeting the following criteria were selected from the electronic database and analyzed: idiopathic scoliosis (Lenke types I, III, V); age 10 to 20 years; surgery performed through posterior approach; hook or hybrid (using of pedicle screws only in the lumbar spine, at 2-4 levels) fixation; no previous history of spine surgery; and follow-up period at least two years. Results . Flattening of thoracic kyphosis and alignment of lumbar lordosis during surgical correction were significantly more pronounced in the traction group. Postoperative changes in the sagittal contour of the thoracic and lumbar spine did not differ significantly between the traction and no-traction groups. Intraoperative traction was associated with significantly reduced blood loss, though operation time decreased statistically insignificantly. Normalization of the frontal imbalance in the immediate and long-term postoperative periods was different in the two groups, but these differences were insignificant. Intraoperative traction was most effective in the group with deformities of 50° to 75°, although it also increased the achieved correction in patients with scoliosis of a smaller and greater magnitude. Conclusion . The operation performed with intraoperative traction allows achieving greater correction during an intervention and smaller loss of correction during a long follow-up period than that without a distraction influence. This applies equally to both primary and secondary curvatures.

Idiopathic scoliosis

Lumbar lordosis

10.14531/ss2017.2.8-13

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Selection of the Optimal Distal Fusion Level for Correction of Scheuermann's Hyperkyphosis*

Mikhail Mikhailovsky А. Н. Сорокин Vyacheslav Novikov Aleksandr Vasyura

Objective. To analyze the efficacy of the method for selecting the distal level of fusion in treatment of thoracic hyperkyphosis in patients with Scheuermann’s disease. Material and Methods. Over the period of 2007–2010 years 36 patients were operated in the Department of Children and Adolescent Spine Pathology. Patients were divided into two groups: in Group I (n = 29) a lower instrumented vertebra (LIV) corresponded to the sagittal stable one and in Group II (n = 7) this vertebra located proximally. Results. The mean preoperative magnitude of kyphosis was 79.3° ± 11.6°, postoperative – 40.6° ± 11.9° (correction 49.9 %), loss of correction was 4.9° ± 7.0°. Sagittal balance changed from -0.3 ± 3.2 cm before surgery to -1.7 ± 2.1 cm. Distal junctional kyphosis (DJK) developed in 1 case (4 %) in Group I, and in 5 cases (71 %) in Group II. Conclusion. Distal level of instrumentation ending at the first lordotic vertebra is not justified and causes violation of sagittal balance and development of distal junctional kyphosis. The inclusion of a sagittal stable vertebra in fusion prevents the development of distal junctional kyphosis.

Kyphosis

Vertebra

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Adolescent idiopathic scoliosis with Lenke type V and VI curves: possibilities of modern segmental instrumentation

Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika) (2017)

M. V. Mikhaylovskiy Aleksandr Vasyura Vyacheslav Novikov V N Sarnadskiy Е. В. Губина

To analyze long-term results of surgical correction and postoperative quality of life in patients with Lenke type V and VI deformities of the spine. Material and Methods. The treatment results of 61 patients (average age 15 years) with Lenke type V–VI spinal deformities and mean follow-up period of 3.3 years were analyzed. The average length of anterior fusion was 12.7 segments. The average length of the primary curve instrumented with pedicle screws was 4.9 segments. Results . The primary curve was 56.6°, after surgical intervention it was reduced to 15.1° (73.3 % correction). Postoperative progression within 3.3 years was 2.1°. Thoracic countercurve was 40.6°, after surgery it was corrected to 15.0° (63.0 % correction). At the final follow-up examination, the thoracic curve was 17.3° (progression 2.3°). Thoracic kyphosis and lumbar lordosis were within the normal ranges. The frontal imbalance was 22.1 mm before surgery and 12.2 mm at the final follow-up examination. The SRS-24 questionnaire data showed a significant score increase in all seven domains. Conclusion . Transpedicular fixation allows achieving a high degree of Lenke type V–VI spinal deformity correction with a stable result and significant improvement in the quality of life of patients.

Kyphosis

Idiopathic scoliosis

Lumbar lordosis

Spinal Curvatures

10.14531/ss2017.4.18-26

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Surgical treatment of severe congenital kyphosis in an adult patient: rare clinical observation and a brief literature review

DOAJ (DOAJ: Directory of Open Access Journals) (2018)

Vyacheslav Novikov A. Yu. Sergunin В. В. Белозеров Lebedeva Mn Aleksandr Vasyura

Kyphosis

10.14531/ss2018.4.21-26

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