Neurosurgery and Neurology of Kazakhstan

7-9

Authors: B.M.Karibaev, Mukhametzhanov, O.S.Bekarissov.

The article presents results of treatment of 351 patients with thoracic and lumbar spine injuires. Postoperative complications due to surgical intervention occurred at 59 patients (16.8%), there were 30(8.5%) men and 29(8.2%) women. The most repeated complications are fractures and migration of rods and screws, brain tunic injuries, kyphotic deformation advance, failure of system due to bone resorption, thrombophlebitis of lower limb vessels, wound infection, decubitus, and sepsis. Transpedicular fixation is the most reliable stabilization in thoracic and lumbar spine and cerebrospinal injuries, use of this system can be accompanied with complications. These complications can be avoided if technique of construction fixation is strongly observed, and also orthopedic regime is observed by patients at postoperative period. Key words: thoracic and lumbar backbone fractures, spine injuries, transpaedicular fixation.

13-17

Authors: Kerimbayev Т.Т., Aleinikov V.G., Sypabekov S.Zh., Urunbayev Y.A., Kissayev Y.V., Yerezhepbekov B.S.

Objectives. To evaluate the effectiveness of tubular access technique of interbody PLIF- Cage fusion and percutaneous pedicle fixation. Methods. Radiological and clinical outcomes were evaluated, including the MRI, CT , X-ray with functional loads, electroneuromyography, Visual analog score (VAS) for lower back pain (VAS-BP) and leg pain (VASLP), and Oswestry Disability Index, before admission , at discharge and at 3, 6, 12 months after surgery. The average follow-up was 6 - 12 months. The tubular Access through (Quadrant ®, Medtronic) retractor with microscopic discectomy and PLIF - Cage (PEEK cage Capstone ®, Medtronic) and percutaneous pedicle screw fixation with the Sextant 2 , Medtronic and Viper 2 , De Puy system, was performed. Results. Clinical VAS-BP, VAS-LP and JOA scores were significantly improved at (P<0,05) between the preoperative period (average, 6/10) and on the day of discharge (on average, 2/10 ) , in ODI scale also noted improvement (P <0,07) compared to the pre-operation (average 43,5 %) after discharge (12,8 %). At the follow up period of 6 - 12 months the relief of clinical symptoms was observed in 38 patients, residual back pain in 6 patients, moderate radicular pain in 3 cases. Good consolidation according to CT observed in the majority of cases, insufficient in 2 – osteoporotic patients . The mean postoperative hospital stay was 7,5 days. Conclusion. The minimally invasive posterior lumbar interbody fusion through a unilateral approach and subsequent tubular percutaneous fixation is an effective method of surgery for vertebral-motion segment instability. Key words: spinal instability, spodylolistes, percutaneous transpedicular fixation, PLIF- cage.

23-26

Authors: Sh.T. Taylakov, L.V. Schischkina.

Most hemangiopericytomas are located in the musculo-skeletal system and the skin, while the intracranial location is rare. In a review paper, an analysis of publications in the world literature on the problem of diagnostic method and treatment of hemangiopericytomas. Radical surgery is the treatment of choice, but must be completed with postoperative radiotherapy, which has proved to be the therapy most strongly related to the final prognosis. Hemangiopericytomas have a relentless tendency for local recurrence and metastases outside the central nervous system which can appear even many years after diagnosis and adequate treatment of the primary tumour. Key words: hemangiopericytoma; meningeal; treatment; prognosis.

33-37

Authors: Mikhailova N.V., Savinov S.V., Akchurina I.E., Grebenyukova I.V., Utebekov Z.E., Sitnikov I.Y., Abedimova R.A., Esimova G.N., Sinitsina T.N.

Gemimegalentsefaly - serious malformation of the brain, which always combined with severe symptomatic forms of epilepsy. The latter, in turn, aggravate and worsen the prognosis for the child. Impossible to achieve a stable positive result against the background of selection of anticonvulsant therapy. In SVS Laboratory study of epilepsy, convulsions and family monitoring after V.M.Savinova observed a child with congenital malformation of the brain - gemimegalentsefaly. Parencephaly put at prenatal diagnosis by ultrasound, and then confirmed by CT scan of prenatal. After the birth repeatedly held video EEG monitoring with the registration period of sleep and wakefulness and including attack period, neurological examination, MRI diagnosis (1,5 Tsl). Prescribed anticonvulsants combination, with low effect results. Underwent surgery –functional vertical gemisferotomy in the left side. Postoperatively, seizures were not observed. As a result, our conclusions were drawn: Treatment of choice is surgical patients while taking AEDs. Surgical treatment is based on resection of the affected hemisphere to provide the best compensatory capacities of the brain due to a healthy hemisphere. Early diagnosis and a decision on operative treatment is great prognostic value. The sooner an operation will be made, the better the work of adaptation mechanisms of the body. The main indication for postponing surgery may serve as a small child’s weight due to an increased risk of breaking bcc intraoperative conditions. Key words: gemimegalentsefaly, prenatal diagnosis of congenital malformations of the brain, gemisferotomy, hemispherectomy.