Лечение высокоэнергетических повреждений грудного и поясничного отделов позвоночника

Introduction. Surgical treatment of patients with spinal injuries with traumatic spinal canal stenosis is an important and widely discussed problem of contemporary vertebrology. Injuries to the spine in the incidence structure of isolated or combined injuries occupy a special place due to their high social and clinical significance. Long-term outcomes of traumatic disease in patients with combined trauma to the thoracic and lumbar spine are studied, as before, by ever larger groups of researchers in connection to the new generations of spinal fixation devices being introduced.Materials and methods. 111 patients with various thoracolumbar spine injuries treated surgically were included in the study. In 40 patients, the post-traumatic stenosis was treated with the use of ligamentotaxis and transpedicular osteosynthesis. Thll–Thl2, Th12–L1 and L1–L2 were the most frequent localisations of the level of injury in the study group.Results and discussion. The immediate treatment outcomes observed were as follows — good in 33 (82.5%) cases, satisfactory in 6 (15.0%), unsatisfactory — in 1 (2.5%). Long-term outcomes with follow-up longer than a year were recorded in 27 (67.5%) patients with good outcomes in 20 (74.1%) and satisfactory in 7 (25.9%).Conclusion. A correct stabilisation with metal systems makes it possible to verticalize the patient quickly and shorten the rehabilitation period in all patients including those of active working age, as well as minimize the risks in the long term.Введение. Хирургическое лечение пациентов с повреждениями позвоночника, сопровождающимися травматическим стенозом позвоночного канала, является актуальной и обсуждаемой проблемой современной вертебрологии. Повреждения позвоночника в структуре изолированной и множественной травмы занимают особое место по причине высокой социальной и клинической значимости. Отдаленный период травматической болезни при сочетанной травме грудного и поясничного отделов позвоночника по-прежнему изучается большими группами исследователей в связи с внедрением новых поколений фиксаторов.Материалы и методы. Проведено оперативное лечение 111 больных с различными повреждениями грудопоясничного отдела позвоночника. У 40 больных проведено устранение посттравматического стеноза методом лигаментотаксиса с применением транспедикулярного остеосинтеза. Наиболее частыми локализациями уровня повреждения среди пациентов с повреждениями грудопоясничного отдела в группе исследования были сегменты позвоночного столба на уровне Thll–Thl2,Тh12–L1 и L1–L2.Результаты и обсуждение. Ближайшие результаты лечения прослежены у всех пациентов: хорошие получены в  33  (82,5  %) случаях; удовлетворительные  — в 6 (15,0  %), неудовлетворительные  — в 1 (2,5  %). Отдаленные результаты со сроком наблюдения более 1 года прослежены у 27 (67,5 %) пациентов; у 20 (74,1 %) получены хорошие, у 7 (25,9 %) — удовлетворительные.Заключение. Корректная стабилизация металлоконструкцией позволяет в кратчайшие сроки вертикализировать пациента и сократить сроки реабилитации, в том числе у пациентов трудоспособного возраста, с наибольшей вероятностью минимального возникновения риска в отдаленном период

Особенности артропластики при двустороннем гонартрозе

Introduction. Hip and knee arthroplasty are the two of the most frequently used methods of surgical treatment. The techniques of drug support in the perioperative period, as well as the rehabilitation component, are of primary importance. However, due to the increase in number of operations the number of complications is also growing. At the same time, surgical approaches to the treatment of bilateral knee OA are still not sufficiently studied. The literature describes intervals between arthroplasty operations on knee joints from 3 months to 5 years. The epidemiological and pathogenetic aspects of functional recovery in bilateral knee OA patients are also in need of further research.Materials and methods. Authors analysed outcomes in 124 patients with gonarthrosis treated with arthroplasty. 32 patients underwent arthroplasty of the contralateral joint. The outcomes were evaluated with the KSS score and X-ray imaging at 1, 3 and 6 months postop.Results and discussions. In the first month after the operation functional recovery was noted due to the relief of pain, recovery of the muscle tone and regional hemodynamics in the area of the knee joint. It was also noted that the recovery of function in the period from month 1 to month 3 in patients with bilateral gonarthrosis occurs less intensively due to decompensation of the contralateral joint.Conclusion. The study demonstrates the recovery of function in patients in the postoperative period. There is, however, the issue of functional decompensation in the opposite limb, which in turn reduces the effectiveness of motor rehabilitation and leads to the need for endoprosthetic replacement of the second joint.Введение. Эндопротезирование крупных суставов — один из наиболее часто выполняемых методов хирургического лечения при дегенеративных процессах и последствиях травм. Важное значение имеют технологии медикаментозного обеспечения периоперационного периода, так же как и реабилитационная составляющая. Однако в связи с увеличением количества выполненных операций растет и количество осложнений. При этом недостаточно изученными остаются хирургические подходы в лечении двустороннего гонартроза. В литературе имеются данные о промежутках между артропластикой коленных суставов от 3 месяцев до 5 лет. Также нуждаются в дальнейшем изучении эпидемиологические и патогенетические аспекты восстановления функциональной активности при двустороннем гонартрозе.Материалы и методы. Были проанализированы результаты лечения 124 пациентов с гонартрозом по технологии артропластики. 32 пациента перенесли артропластику контрлатерального сустава. Результаты оценивались при помощи шкалы KSS, а также при помощи рентгенографии в промежутках 1, 3, 6 и месяцев после операции.Результаты и обсуждение. На протяжении первого месяца после операции отмечено восстановление функциональной активности за счет купирования болевого синдрома, восстановления тонуса мышц и регионарной гемодинамики в области коленного сустава. Также было отмечено, что восстановление функциональной активности в промежутке от первого до третьего месяца у пациентов с двусторонним гонартрозом происходит менее интенсивно за счет декомпенсации контрлатерального сустава.Заключение. Работа выявляет восстановление функциональной активности у пациентов в послеоперационном периоде, тем не менее есть декомпенсация функции противоположной конечности, что, в свою очередь, как снижает эффективность двигательной реабилитации, так и приводит к необходимости эндопротезирования второго сустава

Construction of geological model of a shallow super-viscous oil deposit based on core analyses and geophysical monitoring data

© Published under licence by IOP Publishing Ltd. Deficiency of fossil minerals, limited reserves of conventional hydrocarbon raw materials indicates the need to involve in the fuel and energy complex of other sources of hydrocarbons. Fields of super-viscous oil are one of the sources. Development of super-viscous oil deposits opens new challenges in the field of building geological models associated with the shallow occurrence of these deposits. This article is devoted to the study of sediments of the Permian sedimentary complex containing super-viscous oil deposits. Study object is Sheshmian sandstone pack of the Ufimian stage. The pack is composed of sands and sandstones with different degree of carbonate cementation with small interlayers of siltstones. Cementation is the main factor which affect reservoir quality. In the process of analysis and preparation of the initial data and, subsequently, the geological model construction, the main features of the super-viscous oil deposits were revealed

Construction of geological model of a shallow super-viscous oil deposit based on core analyses and geophysical monitoring data

© Published under licence by IOP Publishing Ltd. Deficiency of fossil minerals, limited reserves of conventional hydrocarbon raw materials indicates the need to involve in the fuel and energy complex of other sources of hydrocarbons. Fields of super-viscous oil are one of the sources. Development of super-viscous oil deposits opens new challenges in the field of building geological models associated with the shallow occurrence of these deposits. This article is devoted to the study of sediments of the Permian sedimentary complex containing super-viscous oil deposits. Study object is Sheshmian sandstone pack of the Ufimian stage. The pack is composed of sands and sandstones with different degree of carbonate cementation with small interlayers of siltstones. Cementation is the main factor which affect reservoir quality. In the process of analysis and preparation of the initial data and, subsequently, the geological model construction, the main features of the super-viscous oil deposits were revealed

Treatment of High-Impact Injuries of Thoracic and Lumbar Spine

Introduction. Surgical treatment of patients with spinal injuries with traumatic spinal canal stenosis is an important and widely discussed problem of contemporary vertebrology. Injuries to the spine in the incidence structure of isolated or combined injuries occupy a special place due to their high social and clinical significance. Long-term outcomes of traumatic disease in patients with combined trauma to the thoracic and lumbar spine are studied, as before, by ever larger groups of researchers in connection to the new generations of spinal fixation devices being introduced.Materials and methods. 111 patients with various thoracolumbar spine injuries treated surgically were included in the study. In 40 patients, the post-traumatic stenosis was treated with the use of ligamentotaxis and transpedicular osteosynthesis. Thll–Thl2, Th12–L1 and L1–L2 were the most frequent localisations of the level of injury in the study group.Results and discussion. The immediate treatment outcomes observed were as follows — good in 33 (82.5%) cases, satisfactory in 6 (15.0%), unsatisfactory — in 1 (2.5%). Long-term outcomes with follow-up longer than a year were recorded in 27 (67.5%) patients with good outcomes in 20 (74.1%) and satisfactory in 7 (25.9%).Conclusion. A correct stabilisation with metal systems makes it possible to verticalize the patient quickly and shorten the rehabilitation period in all patients including those of active working age, as well as minimize the risks in the long term

Features of Arthroplasty in Bilateral Knee Osteoarthritis

Introduction. Hip and knee arthroplasty are the two of the most frequently used methods of surgical treatment. The techniques of drug support in the perioperative period, as well as the rehabilitation component, are of primary importance. However, due to the increase in number of operations the number of complications is also growing. At the same time, surgical approaches to the treatment of bilateral knee OA are still not sufficiently studied. The literature describes intervals between arthroplasty operations on knee joints from 3 months to 5 years. The epidemiological and pathogenetic aspects of functional recovery in bilateral knee OA patients are also in need of further research.Materials and methods. Authors analysed outcomes in 124 patients with gonarthrosis treated with arthroplasty. 32 patients underwent arthroplasty of the contralateral joint. The outcomes were evaluated with the KSS score and X-ray imaging at 1, 3 and 6 months postop.Results and discussions. In the first month after the operation functional recovery was noted due to the relief of pain, recovery of the muscle tone and regional hemodynamics in the area of the knee joint. It was also noted that the recovery of function in the period from month 1 to month 3 in patients with bilateral gonarthrosis occurs less intensively due to decompensation of the contralateral joint.Conclusion. The study demonstrates the recovery of function in patients in the postoperative period. There is, however, the issue of functional decompensation in the opposite limb, which in turn reduces the effectiveness of motor rehabilitation and leads to the need for endoprosthetic replacement of the second joint