Buznytskyi R. Anterior interbody cervical fusion using metal-ceramic implants in surgical treatment for diseases and injuries of the cervical spine (experimental-clinical research)

Object: the restoration of the load-bearing capacity of the front complex vertebral motion segments in diseases and injuries of the cervical spine. The goal: to justify and improve the methods of anterior interbody fusion vertical cylindrical mesh implants for improving the results of surgical treatment of patients with diseases and injuries of the cervical spine. Methods: the clinical, radiological, mathematical modelling using finite element method, statistical. For the first time with the help of developed X-ray technique laws of motion for the location omni-vertical cylindrical mesh implants in the gaps were determined after anterior interbody fusion, depending on the method of its implementation. For the first time with the help of mathematical modelling using finite element method features of the stress-strain state in the "cervical vertebral motion segment - fixing design" with the well-known and improved versions of anterior interbody fusion were studied. Significant differences mode of deformation in the contact area stabilized vertebral bodies with vertical cylindrical mesh implants determined by constructive features of the terminal part of the implant and method of their installation were proved. For the first time methods of anterior interbody fusion hybrid metal-ceramic implants with a larger bearing surface and adapted caudal terminal department providing prevention of prolapse in the vertebral body, the optimization of interbody fusion, correction and preservation of the cervical segmental sagittal contour were justified and improved. Mathematical multi segment model of the cervical spine that allow more realistic studying of stress-strain state in its elements in the modelling of various pathological conditions and surgical options was improved. The causes of faults, complications and unsatisfactory results of anterior interbody fusion vertical cylindrical mesh implants were identified and classified. The developed technique of X-ray diagnostics provides dynamic omni-objectification in the latched position of the implants vertebral motion segments that increases the information content of the results of this study. Use of improved methods of anterior interbody fusion can reduce the risk of prolapse implants into the vertebral body, ensures the formation of a reliable bone-ceramic block and the preservation of the cervical segmental sagittal contour and generally it will increase the efficiency of the stabilizing phase of surgery on the cervical spine. Results of the study introduced into clinical practice Sytenko Institute of Spine and Joints Pathology National Academy of Medical Sciences of Ukraine, HPU "Kharkiv Regional Clinical Hospital Trauma", HPU "Regional Hospital - Center for Emergency Medicine and Emergency Medicine" in Kharkov, and also used in the learning process of the Department of Traumatology and Orthopedics of Kharkiv Medical Academy of Postgraduate Education of Ukraine. Traumatology and orthopedics.