Cheverda A. Diagnosis and treatment of spina bifida cystica orthopedic manifestations

The thesis is dedicated to the actual problem: optimization of the locomotor apparatus function and amelioration of the treatment results of orthopedic manifestations in patients with spina bifida cystica by the way of study of clinical and roentgenologic course of the disease, development of the orthopedic system of complex early conservative and operative treatment. In the result of the performed examination of 99 patients with orthopedic manifestations of spina bifida cystica, the development of orthopedic pathology depending on the form of spina bifida cystica and the level of spinal cord lesion, special features of clinical and roentgenologic picture of the disease have been determined. On the basis of study of special features of the course of orthopedic manifestations of spina bifida cystica, the system of score estimation of functional state of lower extremities has been developed, patients have been distributed into clinical groups (I, II, IIIA, IIIB clinical groups and groups of children up to one year of age). The system of orthopedic treatment of patients with spina bifida cystica has been elaborated that is based on the evaluation of functional state of lower extremities, condition of orthopedic pathology, depth of paresis of lower extremities that includes preventive, conservative and operative methods of treatment. On the basis of dopplerrography, the estimation of the efficacy of conservative and operative treatment of patients with the orthopedic manifestations of spina bifida cystica has been performed, the necessity and expediency of the orthopedic treatment have been proved.