Additive technologies are now widely used in various fields of clinical medicine. In particular, 3D printing is widely used in neurosurgery, vertebrology and traumatology-orthopedics. The article describes in detail the basic principles of medical 3D printing. The modern classification of 3D printers is presented based on the following principles of printing: FDM, SLA, SLS and others. The main advantages and disadvantages of the above-mentioned 3D printers and the areas of clinical medicine in which they are used are described. Further in the review, the authors discuss the experience with 3D printing applications, based on the data of the modern scientific literature. A special attention is paid to the use of 3D printing in the manufacture of individual implants for cranioplasty. 3D printing technologies in reconstructive neurosurgery make it possible to create high-precision implants, reduce the time of surgical intervention and improve the aesthetic effect of the operation. The article also presents the data of the modern literature on the use of 3D printing in vertebrology, where a special role is given to the use of guides for the installation of transpedicular screws and the use of individual lordosing cages. The use of individual guides, especially for severe spinal deformities, reduces the risk of metal structure malposition and the duration of surgical intervention. This technique is also widely used in traumatology and orthopedics, where individual implants made of titanium, a bone-substituting material, are created using 3D printing, thanks to which it is possible to replace bone defects of any shape, complexity and size and create hybrid exoprostheses. The role of 3D modeling and 3D printing in the training of medical personnel at the present stage is described. In conclusion, the authors present their experience of using 3D modeling and 3D printing in reconstructive neurosurgery and vertebrology.

The overall incidence of symptomatic lumbar spinal stenosis is about 1015% among persons aged 5070 years. Due to the aging of the population, the incidence of this pathology is constantly growing. The desire of older patients to preserve their quality of life and their functional abilities, along with the improvement of surgical techniques, leads to an increase in the number of surgical interventions for lumbar stenosis. This publication describes the classification of spinal canal stenosis. The clinical picture of this disease has been studied in detail. A special attention is paid to such diagnostic methods as computed tomography (CT), radiography, CT-myelography, magnetic resonance imaging (MRI). Various methods of surgical treatment decompression and decompression-stabilization are described in detail.. The efficiency of various types of decompression operations are 7280%, the results of surgery not differing statistically between the types of decompression (hemilaminectomy, interlaminectomy). Decompression-stabilization operations are used for progressive degenerative spinal deformity, destabilization after the surgical treatment, and disruption of the vertebral-pelvic relations. Currently, the following types of stabilization are used in the lumbar stenosis surgery: ALIF, PLIF, PLF, TLIF, XLIF, OLIF, and transpedicular fixation. The rate of complications in the stabilizing interventions is 27.6%; after decompression operations 9.7%. The frequency of revision operations is also higher after stabilization 10.3%, while after decompression it is 6.5%, which makes us cautious about these types of interventions. Systems of interosseous fixation are also used in the treatment of lumbar stenosis. In the 14 years of followup after interosseous fixation and decompression in 142 patients, 30 (21.1%) patients underwent revision interventions, with chronic pain (38.5%) and disc herniation (42.3%) being the main indication for repeated surgery in 26 of them.

Relevance. Among the complications of traumatic spinal cord disease (SCD) pressure ulcers occupy a special place, with incidence reaching 68% and showing no tendency for decreasing. Literature reviews one of the main reasons for the formation of decubital ulcers is enteral insufficiency, the timely detection of which is still a common problem for many medical specialties, and laboratory indicators pointing to its manifestation remain in the zone of a controversial issue. New knowledge regarding laboratory predictors of pressure ulcer formation in the acute period of trauma will reduce the risk of decubital ulcerative defects.Purpose of the study. Based on the analysis of laboratory blood levels in the acute and early periods of hip joint injury, to identify predictors of the formation of pressure ulcers in patients with spinal trauma.Materials and methods. 68 case histories of adult patients with hip injury were retrospectively analyzed. The victims were treated in the City Clinical Hospital No. 39 of the Kanavinsky District of Nizhny Novgorod for the period from 2013 to 2020.Results and discussion. A comparative analysis of blood levels on the first day after injury showed that patients with subsequently developed bedsores at the early stages of treatment got hypoproteinemia and a decrease in serum creatinine levels more often than patients without bedsores. In addition, white blood cell count in patients with pressure ulcers was elevated, compared to normal values and patients without pressure ulcers white blood cell count. For a year creatinine and total protein values in patients of the main group tended to be or completely became normal, which is most likely associated with adequately administered enteral nutrition. The white blood cell count of the study group decreased to the normal range.Conclusion. Increased white blood cell, a decrease creatinine levels and total protein values in patients with HSC in the first hours after injury confirms the catabolic orientation of metabolism in the acute period of spinal cord injury, so it leads to conclusion that the early intensive therapy aimed at arresting protein losses and inflammation is needed, which in turn will prevent the formation of pressure ulcers in the early period of traumatic spinal cord disease.