Nizhny Novgorod Research Institute of Traumatology and Orthopaedics

Nizhniy Novgorod, Russia

Nizhny Novgorod Research Institute of Traumatology and Orthopaedics

Nizhniy Novgorod, Russia
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Mlyavykh S.,Nizhny Novgorod Research Institute of Traumatology and Orthopaedics | Ludwig S.C.,University of Maryland Baltimore County | Mobasser J.-P.,Goodman Campbell Brain and Spine | Kepler C.K.,Thomas Jefferson University | Anderson D.G.,Thomas Jefferson University
Journal of Neurosurgery: Spine | Year: 2013

Object. Lumbar spinal stenosis (LSS) is a common condition that leads to significant disability, particularly in the elderly. Current therapeutic modalities for LSS have certain drawbacks when applied to this patient population. The object of this study was to define the 12-month postoperative outcomes and complications of pedicle-lengthening osteotomies for symptomatic LSS. Methods. A prospective, single-treatment clinical pilot study was conducted. A cohort of 19 patients (mean age 60.9 years) with symptomatic LSS was treated by pedicle-lengthening osteotomy procedures at 1 or 2 levels. All patients had symptoms of neurogenic claudication or radiculopathy secondary to LSS and had not improved after a minimum 6-month course of nonoperative treatment. Eleven patients had a Meyerding Grade I degenerative spondylolisthesis in addition to LSS. Clinical outcomes were measured using the Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ), 12-Item Short-Form Health Survey (SF-12), and a visual analog scale (VAS). Procedural variables, neurological outcomes, adverse events, and radiological imaging (plain radiographs and CT scans) were collected at the 1.5-, 3-, 6-, 9-, and 12-month time points. Results. The pedicle-lengthening osteotomies were performed through percutaneous approaches with minimal blood loss in all cases. There were no operative complications. Four adverse events occurred during the follow-up period. Clinically, significant improvement was observed in the mean values of each of the outcome scales (comparing preoperative and 12-month values): ODI scores improved from 52.3 to 28.1 (p < 0.0001); the ZCQ physical function domain improved from 2.7 to 1.8 (p = 0.0021); the SF-12 physical component scale improved from 27.0 to 37.9 (p = 0.0024); and the VAS score for leg pain while standing improved from 7.2 to 2.7 (p < 0.0001). Imaging studies, reviewed by an independent radiologist, showed no evidence of device subsidence, migration, breakage, or heterotopic ossification. Thin-slice CT documented healing of the osteotomy site in all patients at the 6-month time point and an increase in the mean cross-sectional area of the spinal canal of 115%. Conclusions. Treatment of patients with symptomatic LSS with a pedicle-lengthening osteotomy procedure provided substantial enlargement of the area of the spinal canal and favorable clinical results for both disease-specific and non-disease-specific outcome measures at the 12-month time point. Future studies are needed to compare this technique to alternative therapies for lumbar stenosis. Copyright © 1944-2012 American Association of Neurological Surgeons.


Soloveva A.G.,Nizhny Novgorod Research Institute of Traumatology and Orthopaedics | Martusevich A.K.,Nizhny Novgorod Research Institute of Traumatology and Orthopaedics | Peretyagin S.P.,Nizhny Novgorod Research Institute of Traumatology and Orthopaedics | Didenko N.V.,Nizhny Novgorod Research Institute of Traumatology and Orthopaedics
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk | Year: 2014

Aim: to make multiparametric analysis of blood metabolic profile in early period of burn disease. Materials and methods: we tested blood samples of 15 healthy adults (control group) and 60 patients with thermal trauma (main group - II-IIIA, B degree of burn, more then 15 bsp). Parameters of lipid metabolism, level of glucose, lactate, malonic dialdehyde and some enzymes in blood plasma and erythrocytes were estimated. Results: in early period of burn disease we fixed the clear metabolic disorders, including tissues hypoxia, activation of plasma transaminases and oxidoreductases, inhibition of detoxication system, induction of oxidative stress. Connection of metabolic changes, associated with burn disease, was registered. It supported by numerous correlations between studied parameters, formed from first day after trauma. Conclusions: our data expand the knowledge about mating metabolic changes of catalytic activity of blood enzymes, forming in early period of burn disease (system metabolic disadaptation), and diagnostic value of some blood biochemical parameters in estimation of burned patient metabolism.


Presnyakova M.,Nizhny Novgorod Research Institute of Traumatology and Orthopaedics
Human Ecology | Year: 2012

Pneumonia is not only the most frequent complication of burn patients, but also one of the leading causes of deaths as a result of this pathology. We have studied the system of hemocoagulation, endogenous anticoagulants and fibrinolysis in 136 patients with severe burns; in 69 patients, the burn disease was complicated by pneumonia and in 67 patients, it was not observed. Based on the totality of the laboratory tests results, it has been shown that pneumonia progress in the acute period of the burn disease was accompanied by high procoagulant activity, reduced levels of endogenous anticoagulants, fibrinolysis depression and moderate thrombocytopenia, severe hepatorenal failure indicating progress of the disseminated intravascular coagulation syndrome (DIC). Progress of acute DIC syndrome from 2 to 6 days after a burn can be not only an indirect evidence of pneumonia, but also can precede its clinical picture.


Martusevich A.K.,Nizhny Novgorod Research Institute of Traumatology and Orthopaedics | Martusevich A.A.,Nizhny Novgorod Research Institute of Traumatology and Orthopaedics | Solov'eva A.G.,Nizhny Novgorod Research Institute of Traumatology and Orthopaedics | Peretyagin S.P.,Nizhny Novgorod Research Institute of Traumatology and Orthopaedics
Biophysics (Russian Federation) | Year: 2014

The aim of this work was to estimate the dynamics of blood physical and chemical parameters when blood specimens were processed by singlet oxygen in vitro. Our experiments were executed with whole blood specimens of healthy people (n = 10). Each specimen was divided into five separate portions of 5 mL. The first portion was a control (without any exposures). The second one was processed by an oxygen-ozone mixture (at ozone concentration of 500 μg/L, the third portion by oxygen, and the fourth and fifth ones were processed by a gas mixture with singlet oxygen (50 and 100% of generator power). In blood samples after processing we studied the activity of lactate dehydrogenase, aldehyde dehydrogenase and superoxide dismutase, erythrocyte and plasma levels of glucose and lactate, acid-base balance and the partial pressure of gases in blood. It was found out, that blood processing by singlet oxygen leads to optimization of energy, detoxication and antioxidant enzymes functioning with changes in plasma and erythrocyte level of glucose and lactate, normalization of blood gases level and acid-base balance. Our results show, that the effect of singlet oxygen on enzyme activity is more pronounced than exposure to an oxygen-ozone gas mixture. © 2014 Pleiades Publishing, Inc.

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