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Volume 13
Issue 4
Online publication date 2012-12-15
Title Orthopedic aspects of surgical treatment of the patients with lumbar osteochondrosis
Author Khusniddin Nuraliev
Abstract
Based on the analysis of clinical, anatomical and functional results of operative treatment of osteochondrosis of the lumbosacral spine to develop optimal, pathogenic, orthopedic surgical treatment of these category patients. The study included 272 patients undergoing surgery for poor primary interventions 78 (28.6 %) (group A) and 194 (71.3 %) patients initially applied for surgical treatment in view of orthopedic factors (group B). 
The results of treatment were studied during period from 3 to 24 months. The dynamics of neurological status, pain intensity on visual analog scale and Oswestry index was studied. The most influence on the outcome of treatment had the following factors: the instability of the segment, spinal stenosis and a damage of the form of the lumbosacral spine. There were proved the advantages of the current methods of surgical correction taking into account the orthopedic factors compared to traditional methods of treatment. There was obtained 97.4 % of good and satisfactory results during the two-year follow-up. 
Leading pathomorphological changes in lumbar osteochondrosis is spinal canal stenosis and segmental instability. Therefore, the optimal methods of surgical treatment of osteochondrosis should be recognized those which provide simultaneous resolving of the dual task - to carry out the decompression of neurovascular formations of the spinal canal and to stabilize the affected vertebral segment. 

Citation
References
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Hu, R., Jaglal, S., Axcell, T. et al., 1997. “A population-based study of reoperations after back surgery,” Spine, Vol.22, pp.2265-270

Istrelov, A., 1998. “The analysis of the reasons of a relapse of pain syndrome after removal of lumbar intervertebral disk hernia,” The Second congress of neurosurgeons of the Russian Federation: Abstract Book [Vtoroy sezd neyrohirurgov Rossiyskoy Federacii: Tezis Dokladov], in Russian, St. Petersburg

Krylov, V., Lebedev, V., Grin, A. et al., 2001. “The state of neurosurgical care for the patients with traumas and diseases if spine and spinal cord in Moscow (The data of neurosurgical hospitals of the Committee of public health services for 1997-1999),”  Neurosurgery [Neurochirurgia], in Russian, No.1, pp.60-66

Perlmutter, O., 2000. “Compression of spinal cord and its roots (diagnosis, surgical strategy),” [Kompressiya spinnogo mozga i ego koreshkov (diagnostika, hirurgicheskaya taktika), in Russian, Synopsis of doctoral dissertation, Мoscow

Simonovich, A., Baykalov, A., 2004. “Surgical treatment of relapses of pain syndromes after removal of the lumbar intervertebral disk hernia,” Spinal surgery  [Chirurgiya pozvonochnika], in Russian, No.4, pp.87-92  

Keywords Cytokine, interleukin, hypoxic-ischemic CNS pathology
DOI http://dx.doi.org/10.15208/mhsj.2012.71
Pages 116-127
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