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Introduction. Postoperatively, patients with lumbar osteochondrosis due to sagittal spinal-pelvic imbalance suffer from residual pain. Material and methods. The efficacy of the selective kinesotherapy program was studied in randomized study group (with selective kinesiotherapy program) and control group (standard program of stabilizing exercises) of 15 patients with lumbar osteochondrosis after posterior lumbar fusion in the late postoperative period. The parameters of sagittal spinal-pelvic balance and indicators of endurance of flexors and extensors of body and hip using the isometric tests were defined. Patients interviewed on the visual analogue scale (VAS), on the Oswestry Disability Questionnaire, version 2.0 (ODI), on the Tampa Scale for Kinesiophobia (TSK), on the Pain and Anxiety Symptoms Scale (PASS) – 20. Results. All patients defined the presence of sagittal spinal-pelvic imbalance with muscles imbalance. In the study group was significantly lower VAS and ODI, while decreasing TSK and PASS, as well as increasing muscle endurance was not statistically significant as compared with the control group. Discussion and Conclusion. The short-term results of using the selective kinesotherapy program for patients with lumbar osteochondrosis with uncompensated sagittal spinalpelvic imbalance and muscle imbalances in the late postoperative period after lumbar fusion have demonstrated its efficacy and applicability in specialized rehabilitation and orthopaedic centres.

Article

Zásady ošetření úrazů páteře
[Principles of treatment of spinal injuries]

This paper is meant for those colleagues who are faced with spinal injuries only sporadically or not ...

Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca. 1997 ; Roč. 64 (č. 4) : s. 227-231.

ISSN 0001-5415
Medvik
Source

Příspěvek je určen těm kolegům, kteří se s čerstvými úrazy páteře setkávají pouze sporadicky nebo vůbec ne, aby se se současnými principy ošetření těchto poranění seznámili. Léčení úrazů páteře má za cíl obnovit anatomické uspořádání páteře, stabilizovat ji vůči okolním silám, které na ni působí, a přitom zachovat její funkci. Jde tedy o stejné principy, jako je tomu při léčení iinvch zlomenin. Ošetření spočívá v repozici, uvolnění nervových struktur a stabilizaci, které je možno dosáhnout konzervativním postupem nebo operací. Indikací chirurgického výkonu jsou konzervativně nereponovatelné luxace a luxační zlomeniny, instabilní poranění, velké přední defekty, neklid raněného, nástup nebo zhoršování neurologického postižení po úrazu, nervové postižení se zúženým páteřním kanálem, v neposlední řadě pak i ekonomické důvody. Operační stabilizace musí být tak spolehlivá, aby nevyžadovala pooperační imobilizaci, fúze musí být co nejkratší, musí umožnit časnou mobilizaci a nesmí zvyšovat riziko sekundárního poškození. Samotný implantát pak musí umožnit repozici, zajistit požadovanou stabilitu, a umožnit tak časnou mobilizaci.

This paper is meant for those colleagues who are faced with spinal injuries only sporadically or not at all, to make them familiar with contemporary principles of treatment of these injuries. The treatment of spinal injuries has the objective to restore the anatomical set-up of the spine, stabilize it against surrounding forces which act on it and to preserve its function. Thus the same principles are involved as in the treatment of other fractures. Treatment involves reposition, releasing of nerve structures and stabilization which can be achieved by a conservative procedure or surgery. An indication for surgery are dislocations which cannot be treated conservatively and dislocated fractures, instable injuries, major anterior defects, unrest Of the patient, onset or deterioration of the neurological affection after injury, nervous affection with stenosis of the spinal canal, and last not least, also economic reasons. Surgical stabilization must be so reliable as to make postoperative immobilization unncessary, the fusion must be as short as possible, it must make earty mobilization possible and must not enhance the risk of secondary damage. The implant must make reposition possible and msure the required stability and make thus earty mobilization possible.

Article

Stem cells regenerative properties on new rat spinal fusion model

Spinal fusion represents common bone biology challenge. ...

Physiological research. 2015 ; 64 (1) : 119-128. [pub] 20140905

Physiol. Res. (Print)
ISSN 1802-9973
Medvik
Source

Stem cells biology is one of the most frequent topic of physiological research of today. Spinal fusion represents common bone biology challenge. It is the indicator of osteoinduction and new bone formation on ectopic model. The purpose of this study was to establish a simple model of spinal fusion based on a rat model including verification of the possible use of titanium microplates with hydroxyapatite scaffold combined with human bone marrow-derived mesenchymal stem cells (MSCs). Spinous processes of two adjacent vertebrae were fixed in 15 Wistar rats. The space between bony vertebral arches and spinous processes was either filled with augmentation material only and covered with a resorbable collagen membrane (Group 1), or filled with augmentation material loaded with 5 × 10⁶ MSCs and covered with a resorbable collagen membrane (Group 2). The rats were sacrificed 8 weeks after the surgery. Histology, histomorphometry and micro-CT were performed. The new model of interspinous fusion was safe, easy, inexpensive, with zero mortality. We did not detect any substantial pathological changes or tumor formation after graft implantation. We observed a nonsignificant effect on the formation of new bone tissue between Group 1 and Group 2. In the group with MSCs (Group 2) we described minor inflamatory response which indicates the imunomodulational and antiinflamatory role of MSCs. In conclusion, this new model proved to be easy to use in small animals like rats.

MeSH
Lumbar Vertebrae physiopathology radiography surgery MeSH
Time Factors MeSH
Spinal Fusion adverse effects instrumentation methods MeSH
Durapatite MeSH
Bone Plates MeSH
Cells, Cultured MeSH
Humans MeSH
Models, Animal MeSH
Osteogenesis MeSH
Osseointegration MeSH
Rats, Wistar MeSH
Prosthesis Design MeSH
Regeneration * MeSH
X-Ray Microtomography MeSH
Titanium MeSH
Tissue Scaffolds MeSH
Mesenchymal Stem Cell Transplantation adverse effects instrumentation methods MeSH
Animals MeSH
Check Tag
Humans MeSH
Male MeSH
Animals MeSH
Publication type
Journal Article MeSH
Evaluation Study MeSH
Research Support, Non-U.S. Gov't MeSH

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