Barysh O. Current principles of stabilizing operations for surgical treatment of cervical spine diseases and injuries (experimental-clinical study)

The object: violations of structural-functional condition of spinal units in cases of diseases and injuries of the cervical spine. The purpose: to develop the system of stabilizing operations for surgical treatment of diseases and injuries for the cervical spine in accordance with principles proposed on the base of complex of experimental investigations. Methods: clinical, radiological, mathematical modeling by means of finite element analysis, graphoanalytical, biomechanical, morphological, statistical. For the first time comparative investigation of stressedly-deformed condition in functional spinal units, as well as known and developed implants for anterior interbody fusion has been investigated; dependence of dynamics in condition of adjacent to fixing unit from constructive peculiarities of implants and from changes in segmental sagittal contour of spinal units has been proved. For the first time while using graphoanalytical modeling of two-level fusion character and regularity of loading distribution in cervical spinal units in dependence from way of their stabilizations have been revealed; the ineffectiveness of interbody bearing restoration without additional anterior instrumentation has been proved and the optimal option for fusion has been defined. For the first time owing to investigation by means of multilevel physical model the ability of different options of one-level and two-level anterior and posterior fusion has been assessed for providing reconstruction of segmental cervical sagittal contour; its dependence in cases of different methods of fusion from change of internal stress in adjacent levels has been proved. For the first time by means of experimental investigation on laboratory animals (rabbits) the advantages of developed novel implants due to improvement of their integrative capacities have been proved. Procedure of radiological diagnostics of structural-functional condition in functional spinal units has been improved. Based on outcomes of experimental investigations principles of cervical spinal units' fixation have been formulated and a novel system of stabilizing operations taking into consideration proposed and improved procedures of anterior and posterior fusion has been developed and clinically approved in accordance with these principles providing an increasing of health service's quality for the patients. The results of investigation are used in the clinical practice of Public Institution “Sytenko Institute of Spine and Joints Pathology AMS of Ukraine”, Public Institution “Institute of Traumatology and Orthopedics AMS of Ukraine”, Scientific-Research Institute of Gorkiy Donetsk national medical university, Public Institution of health service “Kharkov regional traumatological hospital”, Military-medical clinical center of the North region of Ukrainian ministry of defense, they are also included in the course of lectures at the Chair of traumatology and orthopaedics of Kharkov medical academy of postgraduate education, Chair of traumatology and orthopedics and Chair of physical rehabilitation and sports medicine of Kharkov national medical university, Chair of traumatology and orthopedics of Gorkiy Donetsk national medical university. Traumatology and orthopaedics.