City Clinical Hospital №67 in Moscow it LA VorohobovaClinical Hospital №67 in Moscow it LA Vorohobova
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Advices


Degenerate disc lesions

Degenerate disc lesions

Disc protrusion (1-3 mm) is associated with a decrease in elasticity of pulpous nucleus, while the elasticity of fibrous ring is preserved. Treatment for disc protrusion is usually conservative – massage, gymnastics, physiotherapy. Treatment should be followed with lifestyle modifications, including daily physical exercises, walking, jogging, swimming, and most important – weight control to avoid excess loads on the spine.

Balloon kyphoplasty

Balloon kyphoplasty

The method of vertebral expanding was developed for the effective treatment of pathological fractures and reconstruction of anatomical relationship in pathological fractures and osteoporosis. In such procedure, a balloon is inserted into the vertebral body through the percutaneous needle and then inflated with fluid under pressure. It expands vertebral body – vertebra regains its height. It also eliminates the pathologic kyphosis at the injury site, and adjacent vertebrae regain correct position in relation to each other.

Balloon kyphoplasty and vertebral stenting

Balloon kyphoplasty and vertebral stenting

The idea of this method consists of using the balloon catheter connected with a titanium spring - stent. After expanding the broken vertebral body with pressure from the fluid, the stent expands together with a balloon. After achieving the necessary degree of reduction, the balloon can be removed, and the expanded stent supports the inner structure of the vertebrae. Then this cavity is filled with bone cement, and vertebral fracture is reliably fixed.

Vertebroplasty with high-viscosity cement (Confidence)

Vertebroplasty with high-viscosity cement (Confidence)

One of the possible ways of solving the problem of "diluting" the bone cement with blood flow, spreading beyond the vertebral body is increasing its viscosity. This approach helps to avoid such complications as cement migration through the cortical defects in back wall of vertebral body to the spinal canal, pulmonary embolism (cement leakage in the system of the azygos/hemizygous vein through the venous plexus, usually with treating more than three vertebrae at the same time and low viscosity of bone cement; asymptomatic, only X-ray signs).

Microdiscectomy procedure

Microdiscectomy procedure

Microdiscectomy is the minimally invasive procedure for the removal of disc herniation. It eliminates compression of the nerve root. This procedure requires only a small incision and takes 40 to 90 minutes. During the procedure, patient stays under the general anesthesia. The patient can walk on the next day after the operation. Hospital stay usually takes 7 to 9 days. In operation room patient is put into medical sleep (general anesthesia). Surgeons put the patient in a prone position with soft bolsters to widen natural spaces between the vertebrae. Special X-ray device (electronic image converter) helps to produce spine images in the real time. Surgeon treats the place of the incision with antiseptic, creating the sterile zone, which is bordered by sterile sheets and concealed by a surgical film for retaining the sterility for the entire operation. After this preparatory work the surgery begins. X-ray device helps to determine the level of the disc, and the surgeon uses a special pin to determine the length of the incision. The incision is usually 2-3 cm long. After gaining access to the spine, the surgeon makes another scan with the pin to check the disc level. Then surgeon uses retraction device, which separates soft tissues and muscles so that long and thin instruments could pass into the wound. After that begins the micro-surgical procedure with the microscope.


Spine surgery, part 2: Preparation for surgery

Spine surgery, part 2: Preparation for surgery

So, the decision is made: pain is so intense, that you are ready to get rid of it. You are ready for operation. What should you know about the operation?

Spine surgery, part 1 - First steps

Spine surgery, part 1 - First steps

Unfortunately, life is not always cheerful and enjoyable; sometimes people become ill. It is good, if the illness resolves rapidly as a common cold, and never comes back. But sometimes pain stays for a week, month, or more, and nothing seems to help. Painkillers, injections, all other medications seem to be worthless. Perhaps, that's the moment when you should think about MRI. Your doctor can advise you about getting an MRI. Or your neighbor, who had the same problem several years ago, will try to give you advice or tell you about his close friend N., who in turn had the same problem and ended up having surgery...

Spine examination before surgery

Spine examination before surgery

Back pain in any given situation — bad weather or incorrect loading on the spine, or diet violation and excessive weight — may happen in the life of each person. As a rule, realizing the cause of back pain in time, and removing it (warming up in the case of bad weather, spreading the load correctly when lifting weights, and healthy eating to eliminate excess weight) helps to avoid more serious problems with the spine.

Types of disc herniation

Types of disc herniation

Disc herniations are distinguished by the localization, the size, the time of onset, and the level of the spine.

Transpedicular fixation with cannulated screws combined with vertebroplasty

Transpedicular fixation with cannulated screws combined with vertebroplasty

Dmitry Dzukaev, head of Neurosurgical Department, offered the most elegant solution to this problem - to strengthen the screw position through the hole in it.

Spine dynamic fixation with DIAM system

Spine dynamic fixation with DIAM system

DIAM is the new concept in the treatment of back and lower limb pain. DIAM implant is the construction for the dynamic stabilization of the spine in treating the lower back pain and pain irradiating into lower limbs. The core of the implant is made from silicone, its outer shell - from the polyethylenterephthalat (polyester), and the locking device is made from titanium. The first DIAM implantation for dynamic spine fixation happened in 1996, at present already thousands of such operations have been done.

Vertebroplasty

Vertebroplasty

When conservative therapy fails (persistent pain) or in the case of pathological fracture, a patient can be treated with the minimally invasive procedure - vertebroplasty. In this procedure bone cement is injected in the affected vertebrae through a thin needle. After its hardening vertebra acquires sufficient strength to support the weight of the body.