Etiopathogenetic substantiation of surgical treatment of neurogenic pain syndromes.

The purpose of the study was to improve classification of neurogenic (neuropathic) pain syndromes. This will make it possible to define the indications for appropriate analgesic surgery for each type of drug-resistant neurogenic pain syndrome. Incorrect management of neurogenic pain syndromes is usually associated with underestimation of pathogenetic prerequisites for its occurrence.

Clinical diagnostic features of surgical treatment for thoracic outlet syndrome.

The thoracic outlet syndrome is characterized by a variety of clinical signs due to multiple causes resulting in compression of a neurovascular bundle in a relatively narrow anatomical space. Despite the frequently encountered clinical symptoms, inadequate attention is paid to their analysis, and their diagnostic and surgical aspects require a modern approach. The study included 46 patients.

[Myelopathies in impairment of extravertebral venous blood circulation].

Development of myelopathies of venous genesis is based on venous hypertension inside vertebral canal which was initially described by J. Aboulker. According to anatomical and functional features of epidural venous system, two factors contribute in development of venous congestion: decreased outflow and increased inflow.

[Angular approach in the surgical treatment of the axillary neurovascular bundle pathologies].

Different surgical approaches have been developed in the surgical treatment of various isolated and combined lesions of the axillary neurovascular bundle. The angular approach favorably differs from others and has a number of advantages. The angular approach was used to operate on 16 patients with varying abnormalities at this site, including 6 patients with traumatic lesion of the secondary trunks of the brachial plexus and 6 with space-occupying lesion, and 1 patient with the superior thoracic aperture; the remaining 6 patients with significant neurovascular compression syndrome, who had been operated on for various causes.

[The specific features of clinical manifestations and surgical treatment of spastic and pain syndromes after injury to the vertebral column and spinal cord].

The purpose of the investigation was to study the clinical manifestations of spastic syndrome after injury to the vertebral column and spinal cord and to devise its surgical treatment policy. The investigation included 21 patients with significant spasticity or pain syndrome after severe injury to the vertebral column and spinal cord without any potential of motor recovery. All the patients were observed to have severe inferior paraplegia, cacesthesia following the radicular and conduction with total hypo- or anesthesia.

[Modified posterior subscapular approach to the trunks of the brachial plexus].

In 1993 A. Dubuisson et al. describe a posterior subscapular approach to treating different forms of lesions of the trunks of the brachial plexus in detail.

[Hematoma of the cerebral peduncle].

The paper presents a rare case of surgical treatment for hematoma of the cerebral peduncle in a 30-year-old woman found to have progressive neurological focal disorders due to mesaticephalic and thalamic lesions. Computed tomography and magnetic resonance imaging (MRI) revealed a round mass (26 x 3 x 25 mm) in the left cerebral peduncle and thalamus without surrounding edema. The focus showed characteristic signs of subacute parenchymatous hematoma.

[The selective phlebography of the large tributaries of the vena cava system in the diagnosis of venous circulatory disorders in the spinal complex].

As any other organ, the spinal cord also suffers in chronic congestion. Since the epidural venous system drains into the vena cava system and participates in collateral circulation, there is increased inflow with impaired blood flow along its large tributaries in the vertebral canal along with poor outflow, resulting in intracanal hypertension and chronic congestion. Venous hemodynamic disorders are found beyond the vertebral canal and detected by selective phlebography of the large tributaries of the vena cava system.

[Diagnosis of venous circulation disorders in the cervical portion of the spine and spinal cord using selective phlebography].

Selective phlebography of the major branches of the vena cava superior, supplemented, if necessary, by selective catheterization of the spinal vein, was employed to study the disorders in the cervical section of the spine and cord. Twenty-five patients with myelopathies of obscure origin were examined. The main symptoms were stenoses and atresias of the orifices of the internal jugular veins and compression and stenoses of the brachiocephalic trunks.

[Selective epidural phlebography in the diagnosis of tumors of the cervical spinal cord and of the cauda equina roots].

The method of selective epidural phlebography (SEP) was applied in the diagnosis of tumors of the cervical segment of the spinal cord and the roots of cauda equina in 45 patients. The diagnosis was confirmed in 32 of the 37 patients who were operated on. The SEP method does not produce serious complications and allows circulatory disorders in the vertebral venous plexuses to be revealed.

[Transfemoral lumbar epidural phlebography in the diagnosis of intervertebral disk hernia].

The diagnosis of herniated disks with the use of lumbar epidural phlebography is discussed. Fifty patients were examined. The diagnosis was verified during the operation in 38 of 44 patients.

[Microsurgery of the vertebral arteries in vertebrobasilar insufficiency].

The low efficacy of nonoperative management of patients with vertebrobasilar insufficiency (VBI) made the development of a surgical method necessary. Twenty-eight patients with VBI were examined and operated on. Transient circulatory disorders in the vertebrobasilar channel were the main indications for the operation.