N.N. Priorov Journal of Traumatology and OrthopedicsN.N. Priorov Journal of Traumatology and OrthopedicsВестник травматологии и ортопедии им. Н.Н. Приорова0869-86782658-6738Eco-Vector63374310.17816/vto633743Clinical case reportsКлинические случаиResearch ArticleSurgical treatment of spinal deformities associated with neurological deficits using 3D modeling technologiesХирургическое лечение деформаций позвоночника, ассоциированных с неврологическим дефицитом, с применением технологий 3D-моделированияhttps://orcid.org/0000-0002-9526-82747052-0220KuleshovAlexander A.КулешовАлександр Алексеевич
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук

cito-spine@mail.ruhttps://orcid.org/0000-0003-1314-28871402-5186NazarenkoAnton G.НазаренкоАнтон Герасимович
Russian Federation

MD, Dr. Sci. (Medicine), professor of RAS

д-р мед. наук, профессор РАН

nazarenkoag@cito-priorov.ruhttps://orcid.org/0000-0001-6689-52209690-5117VetrileMarchel S.ВетрилэМарчел Степанович
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

vetrilams@cito-priorov.ruhttps://orcid.org/0000-0003-0406-19972767-2429MakarovSergey N.МакаровСергей Николаевич
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

moscow.makarov@gmail.comhttps://orcid.org/0009-0005-9832-316X4015-8113MilitsaIgor M.МилицаИгорь Михайлович
Russian Federation

MD

igor.milica@mail.ruhttps://orcid.org/0000-0002-2479-43819845-1251LisyanskyIgor N.ЛисянскийИгорь Николаевич
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

lisigornik@list.ruPriorov National Medical Research Center of Traumatology and OrthopedicsНациональный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Приорова15032025150220253211611722406202402092024Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-Вектор2025Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://journals.eco-vector.com/0869-8678/article/view/633743

BACKGROUND: Progressive spinal cord compression in spinal deformities leads to neurological deficit, creating a high risk of patient disability. Modern 3D modeling technologies allow for the production of individual implants and the creation of full-size models of the spine and spinal cord, which radically improves the approach to treating patients with severe spinal deformities. These technologies are especially effective in congenital anomalies, tumors, and post-traumatic defects, providing a better spatial representation of the pathology and the possibility of personalized surgical treatment of neurologically complicated spinal deformities.

CLINICAL CASES DESCRIPTION: The results of two patients with kyphoscoliotic deformities of the spine combined with spinal cord compression using custom metal structures and 3D modelling capabilities are presented. Clinical examples show the choice of surgical tactics in the treatment of progressive kyphoscoliotic deformities leading to spinal cord compression. Methods of spinal cord decompression and surgical planning using individual full-size 3D models of the spine and spinal cord are presented, as well as the possibility and effectiveness of using individual plates to fix spinal deformities.

CONCLUSION: Surgical treatment resulted in stable fixation of the deformity and regression of the neurological deficit, helping to prevent disability and restore functional activity.

Обоснование. Прогрессирование компрессии спинного мозга при деформациях позвоночника приводит к неврологическому дефициту, создавая высокий риск инвалидизации пациентов. Современные технологии 3D-моделирования позволяют изготавливать индивидуальные имплантаты и создавать полноразмерные модели позвоночника и спинного мозга, что радикально улучшает подход к лечению пациентов с тяжёлыми деформациями позвоночника. Эти технологии особенно эффективны при врождённых аномалиях, опухолях и посттравматических дефектах, обеспечивая лучшее пространственное представление патологии и возможность персонализированного хирургического лечения неврологически осложнённых деформаций позвоночника.

Описание клинических случаев. Представлены результаты хирургического лечения двоих пациентов с кифосколиотическими деформациями позвоночника в сочетании с компрессией спинного мозга с применением индивидуальных металлоконструкций и возможностей 3D-моделирования. На клинических примерах показан выбор хирургической тактики при лечении прогрессирующих кифосколиотических деформаций, которые привели к компрессии спинного мозга. Представлены методы декомпрессии спинного мозга и планирования хода операции с использованием индивидуальных полноразмерных 3D-моделей позвоночника и спинного мозга, а также возможность и эффективность применения индивидуальных пластин для фиксации деформации позвоночника.

Заключение. В результате хирургического лечения достигнуты стабильная фиксация деформации и регресс неврологического дефицита, что способствовало предотвращению инвалидизации пациентов и восстановлению их функциональной активности.

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