The use of intraoperative neurophysiological monitoring (IONM) increases the total duration (TD) of spinal fusions (SF). An increase in TD of SF is a risk factor for the development of early postoperative complications (EPOC).

AIM OF THE STUDY. Investigation of IONM influence on the TD of SF for degenerative diseases of the lumbar spine (DDLS) and, in particular, on the duration of screw placement (SP), as well as on the incidence of EPOC.

METHODS. The study included 358 patients who underwent SF for DDLS at the neurosurgical department of the Regional Clinical Hospital for the period 2019–2021. Patients were divided into 2 groups: group 1 — operated with IONM — 109 people (30.5 %), group 2 — without IONM — 249 people (69.6 %). There were no statistically significant differences between the groups in terms of age (p=0.061), gender (p=0.082), body mass index (p=0.130), nosological forms (p=0.788) and volume of surgery (p=0.515).

RESULTS. For the group 1 TD of 4-screw SF was 197.3±52.9 min, 6-screw SF — 261.9±47.1 min; for the group 2 TD of 4-screw SF was 178.4±43.7 min (p<0.01), 6-screw SF — 234.9±55.4 min (p<0.05). SP duration in group 1 for 4-screw SF was 60.0 ± 22.5 min, for 6-screw SF — 76.7 ± 28.6 min; in group 2 for 4-screw SF — 48.7 ± 22.0 min (p<0.001), for 6-screw SF — 58.1 ± 18.1 min (p<0.01). Reoperation needed EPOC were significantly more common in group 2 (3.21 %) than in group 1 (0 %) (p<0.05).

CONCLUSION. IONM using significantly increases TD of SF by 18.9–27.0 min and increases the SP duration by 11.3–18.6 min, depending on the length of the stabilizing system. Revision needed EPOC was significantly more common in the group without IONM.

THE AIM OF THE STUDY: to study the epidemiological indicators of cerebral strokes in the Chuvash Republic against the backdrop of the spread of a new coronavirus infection. A cross-sectional epidemiological analytical study was carried out. In our study we included of 11,898 patients aged 18 to 87 years 5,592 (47 %) male and 5,592 (53 %) female. The mean age of stroke development was 64.9 years for men and 70.7 years for women. The maximum increase in the number of cerebral strokes occurred in 2020 and reached to 3,466 patients in absolute terms, or 286.9 per 100,000 population, which is 6.8 % more than in 2018. The increase in the incidence of intracerebral and other intracranial hemorrhages (I61), (I62) in 2020 compared to 2018 was 22.8 %, and in 2021 it significantly decreased by 7.6 % compared to the previous year. Mortality in 2020 in this group of patients (I61), (I62) increased by 9.2 % compared to 2018. The increase in cerebral infarction rates (I63) in 2020 compared to 2018 was 4.99 %, and in 2021 it increased by another 2.9 %. Mortality in 2020 in this group of patients (I63) increased significantly by 18 %, and in 2021 the figure decreased by 12.5 %.

CONCLUSION:  the conducted study demonstrated that the incidence of stroke in the study region remained quite high (288.1 per 100 thousand of the population in 2021) comparing with the average incidence in the Russian Federation (190.9 per 100 thousand). Further, targeted research of the global spread of the disease in the region could be extremely promising for revealing the areas of concern that require targeted improvement.

Cognitive impairment is an actual problem of patients operated on for neurosurgical pathology of the brain.

THE AIM OF THE STUDY was a comparative assessment of the severity of disorders of higher cortical functions and the effectiveness of cognitive rehabilitation in patients with neuro-oncological and cerebrovascular pathology of the brain.

MATERIALS AND METHODS: Among the studied 23 patients (14 men and 9 women, average age 60.45±7.87 years) suffered an ischemic stroke, 27 were operated on for a brain tumor: in 12 cases, meningiomas, in 12 — vestibular schwannomas, in 3 — astrocytomas (18 women, 9 men, average age 50.47±12.35 years). 30 patients received neuropsychological correction procedures in isolation, 20 — in combination with transcranial electromagnetic stimulation.

RESULTS. The test results of stroke patients on the Roschina scale were 18.0 (13.0; 22.0) points at admission, 14.0 (13.0; 22.0) points at discharge, the dynamics index was 4.0 (0; 5.0) points. The indicators of the Roschina test score in neuro–oncological patients were 19.0 (15.0; 21.0) points at admission, 11.0 (9.0; 15.5) points at discharge, the dynamics indicator was 8.0 (1.0; 11.5) points.

CONCLUSION. Thus, an integrated approach, including, in addition to neuropsychological correction, transcranial electromagnetic stimulation, makes it possible to improve the results of cognitive rehabilitation of vascular and neurooncological patients.

THE PURPOSE OF STUDY is to analyze the main epidemiological indicators of spinal cord injury in the Republic of Tatarstan for 2017–2018.

MATERIALS AND METHODS: a continuous cohort retrospective study of completed cases of inpatient treatment of patients with acute spinal cord injury in hospitals of the Republic was carried out according to the data of the territorial fund of compulsory medical insurance.

RESULTS: The incidence of spinal cord injury in the Republic in 2017 was 76.65 patients per 100000 of the population, in 2018–74.95 patients per 100000 of the population. The highest incidence was observed in the group of 0–15 years, the second place in terms of incidence was in the age group of 60 years and older. In the most economically active population group (16–59 years old), the incidence was the lowest. The first place in terms of the number of cases was occupied by a group of injuries of the cervical spine, the second — by a group of injuries of the thoracic spine, the third place belonged to injuries of the lumbar spine. The distribution of spinal injury levels related to each age group were revealed.

CONCLUSION: Acute Spinal cord injury in the Republic of Tatarstan has a high morbidity rate, which leads to significant economic costs for providing care to this group of patients. The incidence of spinal cord injury exceeds the average for Russia and the world. The obtained data motivate to take measures for further optimization of medical and social care for this group of patients in complience with modern clinical guidelines.

Transforaminal lumbar interbody fusion with posterior instrumentation is widely used to treat patients with low-grade isthmic spondylolisthesis. Current evidence regarding factors that may affect functional outcomes is still controversial.

OBJECTIVE. To identify the factors that may affect the severity of functional adaptation disorders in patients with low-grade isthmic spondylolisthesis after surgery.

METHODS. Fourty-eight patients older than 18 years with isthmic spondylolisthesis who underwent transforaminal lumbar interbody fusion and posterior screw-rod instrumentation from 2018 to 2020, were retrospectively analyzed. The effect of gender, age, obesity, smoking, paravertebral muscle condition, the interbody height, degree of vertebral translation prior to surgery, amount of vertebral reduction performed, initial level of functional condition, approach to performing of interbody fusion and instrumentation on functional outcome measured by Oswestry scale was analyzed.

RESULTS. The degree of functional desadaptation after surgical treatment can be reliably affected by the patient’s excess body weight (BMI > 30) (p = 0.044). During the correlation analysis, a statistically significant association was observed between the degree of functional desadaptation of patients after surgery with initial functional status (rho = 0.418, p = 0.003) and the relative size of the psoas muscle (rho = –0.327, p = 0.023).

CONCLUSION. This study showed that adverse functional outcomes in patients with low-grade isthmic spondylolisthesis may be associated with obesity, functional status prior to surgery, the relative size of the psoas muscle. For this reason, it is necessary inform patients that some of the factors are modifiable, which means lifestyle correction, obesity treatment can significantly reduce the degree of functional desadaptation after surgery.

The problem of traumatic brain injury (TBI) remains relevant not only in the clinical aspect, but also in the definition of medical and social issues. The existing regional differences in craniocerebral injuries lead to the conduct of special studies aimed at identifying territorial features.

PURPOSE OFTHIS STUDY: to consider the socio-epidemiological features of traumatic brain injury in Kabardino-Balkaria.

MATERIALS AND METHODS: The study was conducted according to the state statistical reports for 2009–2018 in the CBD and in Russia as a whole. The levels of morbidity, including hospitalized patients, were evaluated. To study the social characteristics, we analyzed the data of patients hospitalized in Nalchik with a diagnosis of TBI.

RESULTS. A significant reduction in the incidence of TBI in the CBD in 2009–2018 led to a decrease in its level in 2018 to 1.3 %. Despite a twofold increase in 2009–2018, the CBD has low rates of hospitalization of the population with TBI. By studying the data of patients with TBI in hospitals in Nalchik, the medical and social features of TBI in the CBD were determined.

CONCLUSION. TBI in the CBD is a rarer type of injury than in Russia, and is mainly represented by a concussion of the brain. Based on the identified medical and social characteristics of persons hospitalized with mild TBI, a portrait of a patient with TBI in the CBD was compiled.

PURPOSE OF THE STUDY: to evaluate the results of surgical treatment in adult patients with drug resistant epilepsy associated with mesial temporal sclerosis.

MATERIALS AND METHODS. Fifty-one patients with mesial temporal sclerosis and drug resistant epilepsy were examined and surgically treated at Federal State Budgetary Institution “Scientific Center of Neurology” during the period from March 2018 to May 2022.

RESULTS. Mean patient age was 33,5±9,3 years, mean epilepsy duration was 21,4±11,3лет; there were 32 cases of dominant and 19 cases of subdominant mesial temporal sclerosis. The percentage of seizure free outcomes (Engel class IA) was 76, 67, 52 and 35 % at 6 months, 1 year, 2 years and 3 years after surgery. We observed no significant neurological impairment in our patients postsurgically.

CONCLUSION. The results of this study show high efficacy and safety profile of surgical treatment in adult patients with drug resistant epilepsy associated with mesial temporal sclerosis.

Surgical approach selection is one of the main questions in skull base surgery that mostly determines the successful outcome of the surgery.

THE OBJECTIVES OF THIS STUDY are the decision-making tactics for approach selection and the results of the surgical treatment of patients with anterior and middle skull base meningiomas.

MATERIALS AND METHODS: There were performed 245 surgeries of removal anterior and middle skull base meningiomas in the department of neurosurgery of the “Interregional Clinical and Diagnostic Center” (ICDC) with a mortality rate of 2,8 % in the period from 2010 to 2020 years.

RESULTS: The decision-making algorithm includes such criteria as the size and location of the tumor, involvement of neural and vascular structures in the tumor’s stroma and safety and efficacy properties of the surgical approach. The common approaches that are used in the department of neurosurgery of ICDC are unilateral subfrontal, transbasal bifrontal, pterional, modified orbitozygomatic, supraorbital eyebrow, and endoscopic transnasal approaches. Thus, the tumor can be attacked by multiple angles with the most effective and safe trajectory. In some cases, it is advisable to stage the tumor removal using approaches with different trajectories or combine transcranial and endoscopic approaches to facilitate the radicalism and safety of the surgery.

Paraganglioma of the lateral base of the skull (PLOC) (glomus tumor of the jugular vein bulb) is a predominantly benign neoplasm developing from paraganglia cells associated with sympathetic and parasympathetic ganglia associated with anatomical formations such as auricular branch of the vagus nerve (Arnold nerve), tympanic nerve (branch of the lingual nerve, Jacobson nerve), jugular bulb veins. Currently, the term paraganglioma of the lateral base of the skull is considered the most adequate. These paragangliomas account for 0.6 % of all neoplasms of the head and, as a rule, are sporadic, however, the probability of genetic predisposition of paragangliomas reaches 30 % in family members of the patient. The incidence of glomus tumor of the lateral base of the skull is 1:300000. Women get sick more often than men — 3:1, and the onset of the disease usually falls on the fifth and sixth decades of life.

THE AIM OF THE STUDY: to improve the results of treatment of patients with hypervascular volumetric formation of PLOC based on the development and introduction into clinical practice of a new method of diagnosis and treatment, namely, endovascular superselective emobolization of tumor tissue.

MATERIALS AND METHODS: to solve this problem, 12 cases of paraganglioma of the lateral base of the skull were studied. These patients underwent endovascular superselective embolization of tumor vessels with non-adhesive compositions and hypospheres.

RESULTS: The authors have introduced into medical practice a personalized method of endovascular superselective vascular emobolization PLOCH. Endovascular superselective embolization was performed in 12 patients with PLOC. Patients with type A and B paragangliomas were embolized with tumor vasculature with microparticles of HepaSphere 200–300 microns. a with type C and D non-adhesive composition and microparticles of HepaSphere 200–300mkm. A direct indicator of the effectiveness of endovascular superselective embolization of paragangliomas of the lateral base of the skull was the progressive death of tumor tissue and, as a consequence, a significant decrease in the size of the tumor itself. After superselective ebolization on day 6–7, patients were discharged and sent to an oncological dispensary at their place of residence. A positive relapse-free effect of treatment was achieved in 8 patients, and in 4 patients, a tumor recurrence was detected after two years. Timely re-hospitalization and newly performed endovascular superselective ebolization turned off the pathological newly grown arterial network of neoplasms from the bloodstream. After superselective ebolization on day 6, these patients were discharged in a satisfactory condition and sent to an oncological dispensary at their place of residence.

In anesthesiology practice, an actual problem is the perioperative modulation of the surgical stress response through a multimodal effect on the nociceptive system. The severity of the patient’s stress response to any surgical intervention to the greatest extent depends on the invasiveness of the operation and the adequacy of the performed perioperative anesthesia. Surgical stress response, a complex of neuroendocrine, metabolic and inflammatory changes that develops as a result of surgical trauma, is considered as the main cause of postoperative complications.

AIM OFTHE STUDY: To assess the formation and severity of the surgical stress response, the effectiveness of anesthesia and hemodynamic parameters during surgical correction of spinal deformities, depending on the type of anesthesia.

MATERIALS AND METHODS. After approval by the local ethics committee and taking written informed consent, a prospective randomized single-center study included 70 patients aged 18 to 39 years who underwent elective surgical interventions for the correction of spinal deformities of congenital or idiopathic (kyphoscoliotic deformities) genesis.

RESULTS. The response to surgical stress reflects the combination of endocrine, immunological, and hematological changes that occur after injury and injury. By modulating mediators of neurohumoral stress, anesthesia can indirectly influence the inflammatory response of surgical patients by suppressing or releasing various cytokines and neurotransmitters. In addition, anesthetics can directly affect the functions of immunocompetent cells, such as phagocytosis, proliferation, and cell number through apoptosis. Inhalation anesthetics cause apoptosis of lymphocytes by increasing mitochondrial permeability. Opioid receptors are located at varying densities throughout the body, central, peripheral, and autonomic nervous systems, as well as in endocrine tissues and cells of the immune system. In our study, we have shown that, as a rule, the maximum immunosuppression and stress response in almost all parameters of the immune system are observed on the 2nd and 3rd day after surgery. Thus, we found a statistically significant difference in the level of lymphocytes in patients. A proper inflammatory response is essential for tissue healing and infection control after surgery. However, an imbalance between pro- and anti-inflammatory mediators increases the risk of postoperative infection. In addition to a weaker preoperative physical condition, a strong inflammatory response is one of the reasons for slower functional recovery.

CONCLUSION. Combined anesthesia provided the best pain relief. Adequate analgesia and hemodynamic stability in the CA+PEA group led to a reduction in fentanyl doses. The results of the present study confirm that blockade of afferent nerves with spinal and epidural analgesia can reduce the postoperative neuroendocrine stress response and optimize hemodynamics in patients undergoing spinal deformity surgery through effective pain control and consumption of fentanyl, promedol, and morphine.

Malignant ischemic infarction in the territory supplied by the middle cerebral artery (MCA) is manifested by development of a massive postischemic edema of the affected cerebral hemisphere, resulting in dislocation syndrome.

OBJECTIVE. The aim is to study the specific clinical presentation of malignant ischemic infarction.

MATERIALS AND METHODS: Case histories of 34 patients presented with malignant ischemic infarction in the middle cerebral artery territory were analyzed.

RESULTS. A dominant clinical feature of the disease in this category of patients presented with malignant ischemic infarction is development of the general cerebral syndrome manifested as depressed level of consciousness, which is decisive for the choice of the surgical technique. Another characteristic is development of marked focal symptoms, predominantly function loss symptoms. Irritation symptoms such as Jacksonian march are not typical. Postischemic edema of a cerebral hemisphere was progressing in 8.8 % starting from the first day of admission to hospital, and in 91.2 % of patients starting from the second day from the onset of infarction. The maximum aggravation of postinschemic edema was observed at Day 7. Stabilization of the status of postischemic edema of the cerebral hemisphere occurred in the period from Day 7 through Day 15 after the onset of infarction; regression of the postischemic cerebral edema in the patients was noted starting from Day 15.

CONCLUSION. Malignant ischemic infarction in the MCA territory is the most severe form of ischemic infarction resulting in constant disability of patients; the clinical presentation is dominated by general cerebral syndrome manifested as depression of consciousness.

The study of the etiopathogenesis of epilepsy is one of the most important tasks of modern neurology. Hippocampal sclerosis (HS) is a common morphological substrate in drug resistant epilepsy (DRE).

PURPOSE. To evaluate changes in the cellular composition in the hippocampus in patients operated on for drug-resistant epilepsy, to compare with the comparison group.

MATERIALS AND METHODS. The biopsy material of fragments of the temporal lobe and hippocampus of Polenov Russian Scientific Research Institute of Neurosurgery — branch of Almazov National Medical Research Centre, obtained intraoperatively from 26 patients with locally caused DRE aged 22 to 56 years. Histological sections stained with hematoxylin and eosin were, as well as the results of immunohistochemical (IHC) reactions. The IHC method was used to determine glial fibrillar acidic protein (GFAP), NeuN (antibodies from Dako, Denmark). Histological analysis and morphometry were performed using a Carl Zeiss Axio Lab microscope (Germany) and ImageJ software in 5 fields of view at x400 magnification. Statistical analysis was carried out using the software packages Statistica v.10 and Matlab 2013.

RESULTS. Histological examination of fragments of the hippocampus in the zone of epileptic activity revealed focal cortical dysplasia of various types (in 88,5 % of patients). The surgical material of the hippocampus was fragmented, which made it difficult to interpret according to the ILAE classification. Histological examination of the structures of the hippocampal formation in all the studied samples showed a sharp neuronal devastation of the hippocampal nuclei, dispersion and bifurcation (in 2 cases) of the granular layer of the dentate gyrus, the phenomena of satellitosis and neuronophagy, glial reactions with areas of cell accumulation. In 5 cases, the material was presented as a single block, which made it possible to reliably identify hippocampal sclerosis of various types according to ILAE (2013). Immunohistochemical study revealed a pronounced expression of GFAP in the nuclei of the hippocampus and dentate gyrus, confirming the development of astrocytic gliosis. Statistical data processing revealed significant differences between the median numbers of neurons in the dentate gyrus in patients with drug-resistant epilepsy and in the comparison group. We studied the possibility of distinguishing two groups (study and control) by the totality of the values of neuronal density and glia density. According to the results obtained, it is impossible to distinguish more than 2 clusters: the study group and the control group. The distributions of the values of the studied indicators of female patients and male patients also do not differ significantly.

We also checked the difference in the average values of vectors in the groups of neuron and glia density using the T2 Hotelling criterion, as a result of which it was found that the averages in the groups (study and control) differ significantly and very significantly. Based on the full probability and Bayesian formulas for solving the functional optimization problem, the probability of correct identification of the patient (that is, his correct assignment either to the group of locally determined mediobasal DRE or to the control group) was estimated according to the same criteria, as a result of which the probability value (taking into account random error) amounted to (91±8)%.

CONCLUSION. Structural changes in the resected hippocampi in patients with DRE are characterized by elective neuronal death with a predominant lesion of the dentate gyrus. A comparative statistical analysis of cell density calculation data using Bayes formulas revealed a high probability of classifying the studied hippocampal fragment as a group of patients with epilepsy, regardless of the representativeness of the material and the severity of pathomorphological changes. Thus, the cellular imbalance in the hippocampus has typical homogeneity, which makes it possible to identify characteristic changes in its structures during DRE.

Epilepsy is a major public health problem worldwide. In more than 30 % of patients, the disease progresses to drug-resistant epilepsy (DRE) and requires surgical treatment. A large number of works are devoted to the development of pathogenetic treatment taking into account the molecular genetic status, in particular, the expression of various neuroprotective proteins, including the distribution of vimentin in brain tissues, which belongs to the proteins of intermediate filaments of tissues of mesodermal origin, is of great interest.

PURPOSE OFTHIS STUDY. To study the immunoreactivity of vimentin in the structures of the hippocampus in patients with DRE.

MATERIALS AND METHODS. The biopsy material of hippocampal fragments of 15 patients (6 women, 9 men) with DRE, mean age 32.6 years, was studied. Autopsy material from 7 patients with an average age of 51 years was used as a comparison group. Histological sections stained with hematoxylin and eosin were studied, as well as the results of immunohistochemical reactions with antibodies to vimentin. The result of the reaction was evaluated by calculating the densitometric density of stained cells in 5 fields of view of the dentate gyrus zones, fields CA1 and CA4. Statistical analysis was carried out using the program Statistica v.10.

RESULTS. When studying the histological material of the hippocampus, atrophic changes in its structures were revealed up to the development of sclerosis of various types. When conducting immunohistochemical reactions with vimentin, bright immunopositivity was revealed in the cytoplasm of ischemic neurons, neurons of the granular layer of the dentate gyrus, astrocytes, and microglia. The study of the densitometric density of vimentin-stained cells revealed: in the CA1 nucleus 0,12–0,56 (μ = 0,028±0,008); in the CA4 nucleus 0,014–0,044 (μ = 0,029±0,008); in the dentate gyrus 0,01–0,045 (μ = 0,027±0,009). Statistical data processing resulted in a significant difference according to the Mann-Whitney, Kolmogorov-Smirnov criteria (p <0,05) in all the studied areas.

CONCLUSION. Thus, in the structures of the hippocampus in patients with DRE, there is a significant increase in the immunoreactivity of vimentin in the neurons of the nuclei and dispersed neurons of the dentate gyrus, associated with the activation of neurogenesis. On the other hand, vimentin-associated remodeling of astrocytes with the formation of a glial scar prevents the repair of nervous tissue in the area of the epileptic focus and is a pathogenetic link in the formation of hippocampal sclerosis.

TBI is a major multidisciplinary problem due to high incidence, disability and mortality rates. Thorough understanding of various morbidity aspects is essential to optimize prevention and treatment of that trauma type.

STUDY GOAL: to analyze morbidity, outcomes and structure of TBI cases involving adult population of Tyumen during 2016–2020 period.

MATERIALS AND METHODS: We studied 3558 cases of TBI which met inclusion criteria. Those were: cases coded S06 (MKB‑10), patients who are 18 y. o. or older, and trauma occurrence during studied period (2016–2020). We also had exclusion criteria: head trauma without confirmed TBI and patients younger than 18 years.

RESULTS. Most cases of TBI occurred during 2016–855 cases, 24 % — while lowest incidence occurred in 2020–552 cases, 15,5 %. Most common trauma type was concussion (1500 cases, 42,2 %). Men were 2,1 times more prone to TBI — 2409 (67,7 %) cases as opposed to 1149 (32,3 %) cases involving females (p <0,05). Young patients (18–44 y. o.) were most prone to TBI — 1890 cases (53,1 %). Average annual incidence was 9,4±1,8 cases (for 10 thousand people), we discovered statistically significant decrease in incidence during studied period (p<0,05).

CONCLUSION. Based on our study we established that average incidence in adults of Tyumen is lower that that of many other Russian regions; mortality and morbidity decreased during studied period, which was statistically significant, and is probably due to favorable social and economic environment in Tyumen.

among all injuries of the musculoskeletal system, injuries to the posterior pelvic ring are the most severe. U-shaped sacral fractures are especially dangerous. The issues associated with the final treatment tactics and the specific aspects of its implementation still remain unresolved.

STUDY PURPOSE: to assess the efficacy of the delayed isolated local decompression in patients with U-shaped fractures of the posterior pelvic ring, without final lumbosacral fixation.

MATERIALS AND METHODS: we have reviewed outcomes of treatment of three patients with severe polytrauma and complicated U-shaped sacral fractures who admitted to the hospital over the period since 2019 to 2021. All patients underwent local decompression of the sacral vertebrae, without subsequent stabilization by metal fixators in the late postinjury period.

RESULTS: one month after discharge, against the background of rehabilitation treatment, 2 patients (1 male and 1 female) had excellent functional outcomes according to the Majeed score, 1 patient had sexual disorders (discomfort during sexual intercourse). According to the Gibbons scale, all patients showed positive changes in the form of regression of motor and sensory disorders in the lower limbs; one patient had persisting numbness in the perianal area (2 points according to the Gibbons scale) after decompressive sacral laminectomy. The mean VAS score of the pain syndrome in all patients at the time of admission was 8–9 points vs. 1–2 points at discharge.

CONCLUSION: delayed isolated sacral laminectomy in patients with polytrauma and complicated U-shaped sacral fractures, after the formed spinal fusion and callus at the site of the sacral fracture allows to obtain favorable anatomical and functional outcomes.

Decompression and stabilization on the lumbar spine is one of the most common surgery for degenerative pathology. The fusion formation plays a key role. The number of postoperative complications can reach up to 30 %. In order to determine the predictors of adverse outcomes, we analyzed data from 236 patients who underwent single level lumbar interbody fusion. Outcomes were assessed using the modified Macnab scale 2–7 years after surgery.

RESULTS: excellent and good results according to the Macnab criteria were obtained in 168/236 (71,2 %) patients, and 29/236 (12,3 %) respectively, fair in 9/236 (3,8 %), poor in 30/236 (12.7 %) patients.

CONCLUSION: Statistically significant predictors of adverse outcomes were identified: age over 65 years (p30), diabetes mellitus (HbA1c>7), osteoporosis (T-score < –2.5) and their combination (p<0.0001) ); the duration of the exacerbation period, the threshold value is a period of more than 5 months. (p<0.0001).

Increasing interest to a role of epiphysis (pineal gland) is explained both by its participation in regulation of human biorhythms, which is connected with production of melatonin, a hormone being one of factors of biorhythms regulation, and by close neuroendocrine mediation with hormonal and neurotransmitter activity of the brain.

With the advent of MRI, pineal cysts, the genesis of which is still largely unclear, as well as approaches to the frequency of examination, prognosis, etc., began to attract attention. This work considers aspects of the structure of the epiphysis and the involvement of the melatonin it produces in the pathogenesis of psychiatric disorders.

The study included 149 healthy volunteers aged 18 to 70 years divided into two groups: without morphological changes of the epiphysis according to MRI and with different types of cystic transformation. The results of the Spielberg questionnaire (personality anxiety) and the Stroop test (interference coefficient) revealed a correlation in patients with different types of cystic transformation, which reflects the presence of increased personality anxiety in patients with different variants of cystic transformation of the epiphysis compared to the group of persons without morphological changes.

Inflammatory complications after planned neurosurgical interventions are a rare but formidable complication. The incidence of this pathology is 0.5–7.7 %. The vast majority of purulent-inflammatory complications are observed within the first month after craniotomy. A case of subdural and intracerebral abscesses of the brain that developed 6 years after the planned removal of convexital meningioma of the frontal region was demonstrated.

Giant cell tumor of the vertebra is a rare clinical observation, especially in the mobile segment of the spine. The tactics of treatment may vary, but surgical treatment such as total resection is the method of choice. This paper describes the experience of treating a case of a 40-year-old patient with a giant cell tumor of the Th11 vertebra with a long preoperative history and severe neurological deficit. Despite the large size of the neoplasm, the chosen tactic of surgical treatment made it possible to completely remove the tumor with the stabilization of the spine, as well as to stabilize the patient’s condition with a gradual regression of neurological symptoms.

Injury to peripheral nerves of the extremities leads to a deterioration in the quality of life and disability, and creates a heavy social burden. In the last 10–15 years, ultrasonography has become a widespread method for diagnosing peripheral nerve damage. Studies have shown its high sensitivity for traumatic nerve injury, and even certain advantages over electroneuromyography and magnetic resonance imaging. This review presents the progress history of ultrasound diagnostics of peripheral nerves, analyzes all published studies on the use of the studied techniques for peripheral nerve traumas (Web of Science, Google Scholar, PubMed and Elibrary databases up to 2022), and describes the prospects of this method.

Currently, there is a widespread introduction into clinical practice of innovative techniques using nanotechnology. One of the promising materials of scientific and practical interest for medical science is graphene, an allotropic modification of carbon with a number of specific physical properties. We have analyzed the results of research on this problem. The information available in the literature indicates high prospects for its use in neuroscience. The main directions of graphene introduction into neurology and neurosurgery have been established. The development of technological techniques using graphene will contribute to the emergence of new effective methods of diagnosis and therapy, qualitatively increasing the level of management of patients with diseases and injuries of the nervous system.

Chronic pelvic pain (CPP) is an actual problem for various specialties, including neurosurgeons. One of the main difficulties in the diagnosis and treatment of this pain syndrome is the absence of an anatomical substrate of pain in about half of patients suffering from CPP. That is why such patients undergo multiple diagnostic manipulations that not only do not reveal any pathology, but also increase the intensity and prevalence of existing pain. In this way it is extremely important to establish the nature of pain initially when examining these patients. The presented literature review summarizes the features of clinical manifestations of the neurogenic type of CPP, taking into account the anatomy and innervation of nerve structures which mostly cause this type of CPP.

The article introduces the medical, educational, and scientific activities of the Chair of Neurology and Neurosurgery of the Faculty of Advanced Training and Professional Retraining of Kazan State Medical University for twenty years.

The article provides a list of educational programs for the training of residents in neurology and neurosurgery, advanced training courses, including those within the scope of continuing medical education, and statistics on trainees. It shows the main directions and results of the scientific activities of the Chair. Finally, the paper presents information about regional, all-Russian and international conferences, symposiums, and congresses held with the participation of the Chair staff.