EVALUATION OF PECULIARITIES OF SPINAL BLOOD CIRCULATION, SPINAL ARACHNOID MICROCIRCULATION AND NEUROVEGETATIVE REGULATIONS IN SCOLIOSIS

Abstract

Objective. To study aorta topography, spinal cord blood circulation, and spinal arachnoid microcirculation, as well as to evaluate thermographically microcirculation in soft tissues of the back and peculiarities of its neurovegetative regulation in scoliotic spine deformity. Material and Methods. Seventy four angiographies have been performed in 69 patients with scoliosis. In 21 patients laser doppler flowmetry was used intraoperatively to study spinal arachnoid microcirculation in red and infrared spectra before and after deformity correction. In 26 patients microcirculation and trophism of soft tissues of the back was studied in pre- and postoperative period. Results. Angiographic data show that in severe and extremely severe scoliosis the shape of aorta, but not its diameter, is changed. Examination of patients with secondary kyphoscoliosis showed a system of posterior arteries that was not visualized in patients with dysplastic scoliosis. Study of microcirculation in spinal arachnoid revealed that correction of relatively light scoliosis with CDI system improved the indices of microcirculation. In extremely severe scoliosis there is a tendency towards blood circulation disturbance in deeper layers of the arachnoid. Normalization of vegetative segmental regulation takes place in 2/3 of patients within a postoperative period. Conclusion. Spinal blood supply system in patients with scoliosis is a self-regulating mechanism of hemodynamic interactions, the compensation degree of which depends on localization of afferent spinal arteries, deformation of vertebral canal and permeability of anterior spinal artery system.