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congenital malformations of the spine, 3d design and prototyping, surgery for spinal deformities., Surgery, and RD1-811

The experience of using the method of 3D design and prototyping is examplified in a clinical case of surgical treatment of a six-year-old patient with kyphoscoliotic deformity of the spine due to congenital malformation of the L1 vertebra. At the stage of diagnostics and preoperative preparation, a created model of the deformed spine was used in the form of a breadboard variant made according to the data of spiral X-ray CT on a 3D printer from a plastic polymer material. The use of the created model of the deformed spine made it possible to additionally visualize and touch the pathological object in full size, to really assess the anatomical features and parameters of the interested vertebral segments and the altered spinal canal, which provided significant constructive assistance in planning surgical intervention and its immediate technical implementation.

vertebral fractures, anterior fusion, titanium mesh implant, rate and grade of implant penetration, Surgery, and RD1-811

Objective. To assess radiological results of anterior spinal fusion using cylindrical titanium mesh implant for lumbar spine fracture. Material and Мethods. A total of 74 adult patients with unstable fractures of the L1–L5 vertebral bodies were selected. They underwent posterior instrumental fixation, anterior decompression of the spinal cord and its roots, and anterior interbody fusion with placement of titanium mesh implant. Radiological and CT control was performed immediately and 0.5–2 years after surgery. Results. The phenomenon of implant penetration into the body/bodies of the cranial and/or caudal fused vertebrae has been revealed. De- pending on the nature of penetration, single-level (into one vertebra) and two-level (into two vertebrae) variants of the implant edge pen- etration were identified. A method for calculating the penetration rate was developed, which value determines three grades of the implant penetration: grade 1 with a rate less than 0.1; grade 2 – 0.1–0.29; and grade 3 – more than 0.3. On this basis, the results of anterior spinal fusion are evaluated as good, satisfactory or unsatisfactory, respectively. If the implant did not penetrate, the result is considered excellent. Conclusion. The proposed rate of implant penetration allows for objective evaluation of the interbody fusion results, both immediate and long-term.