Fedak V. Degenerative diseases of adjacent spine segments (experimental and clinical investigation)

Object: degenerative changes of adjacent vertebral segments after spondilodesis. Aim: to define the factors of risk and feature of degeneration of adjacent (to operated) segments of spine after spondilodesis for the improvement of prophylaxis of degenerative diseases of lumbar spine. Methods: clinical, rentgenologic, mathematical modeling with a use of finite element method, experimental, statistic. Results of researches tensely deformed state of the system of vertebral segment with an implant, the design of which was grounded on the basis of methods of mathematical modeling, and also the results of experimental researches, allowed to make optimal construction and material implants for spondilodesis of lumbar spine. Found out the negative factors of risk of development of degenerative changes of adjacent segments at presence of violations in the area of spondilodesis, and also age of patient, duration of disease, neurological deficit. The account of these factors allows to increase efficiency of diagnostics of diseases of adjacent segments and prevents development of complications. The problem of adjacent segments disease was heaved up by uns first in Ukraine. On the basis of retrospective analysis cross-correlation intercommunications are first set between state of area of spondilodesis (osteointegration of implants) and changes of intervertebral disks of adjacent vertebral segments and facet joints. Found out high probability of development of destructive changes in facet joints depending on violations of intervertebral disks. First the complex clinical-experimental research is performed, in which the analysis of the state of spine is united with a referred term after spondilodesis, developed design of implants on the basis of methods of mathematical modeling with experimental morphological and biomechanics researches of area of spondilodesis during using implants from different materials. First found out the features of the state of area of spondilodesis and its influence on adjacent segments in case of the using for spondilodesis implants from different biomaterials. New mathematical models are developed for the estimation of influence on tensely deformed state of vertebral segment of implants of different materials. First the methods of mathematical modeling and experemental researches are proved optimal material and biomechanics quality structural variants of implants for human spondilodesis, which provide the high level of osteointegration and stabilisation of implant in the area of spondilodesis. The results of researches are inculcated in clinical practice of practice Public Institution "Sytenko Institute of Spine and Joint Pathology, Ukrainian Academy of Medical Sciences"; Communal City Clinical Hospital of Medical Emergency, Lviv, Ivano-Frankivsk Regional Clinical Hospital, educational process of departments of traumatology and orthopaedy Kharkiv National Medical University, Kharkiv Medical Academy of Postgraduation Education, Lugansk State Medical University, department of human anatomy; histology, cytology and embryology of the Lugansk State Medical University. Traumatology and orthopaedy.