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Objective. To analyze the results of treatment of patients with implant-associated surgical site infection after decompression and stabilization surgery performed for lumbar spinal stenosis.Material and Methods. Results of treatment of 43 patients with early (up to 90 days after the operation) suppuration of the surgical wound after decompression and stabilization operations for lumbar spinal stenosis were analyzed.Results. A total of 4033 operations for lumbar spinal stenosis with implantation of stabilization systems were performed from 2015 to 2019. There were 43 (1.06 %) cases of early suppuration of the surgical wound with the installed instrumentation. Out of them seven (16.27 %) cases were superficial and 36 (83.78 %) – deep. In all cases, the wound revision, surgical debridement and installation of a vacuum assisted closure (VAC-dressing) were performed. The treatment of superficial suppuration was accompanied by a single installation of a VAC-dressing before wound closure, and in deep suppuration from 2 to 8 (on average 4.10 ± 1.73) VAC-dressings were changed. Wound healing was achieved in all patients within 14–55 (average 29.10 ± 10.06) days. Timely diagnosis of the complication and application of negative pressure therapy allowed arresting the inflammatory process and preserving the implants in all patients with a follow-up period of 12 months.Conclusion. In the case of development of early suppuration of the surgical wound, the patient needs an urgent sanitizing operation. Negative pressure treatment with VAC-dressings is an effective and safe way to relieve this complication. This method combined with etiotropic antibiotic therapy makes it possible to quickly cleanse and heal the wound while preserving the implanted instrumentation.

Objective. To analyze the significance of the influence of various risk factors on the development of proximal junctional kyphosis (PJK) and instability of instrumentation.Material and Methods. The results of surgical treatment of 382 patients with scoliotic deformities of the lumbar spine of type I and IIIb according to Aebi were analyzed. Patients were operated on through the posterior approach using the TLIF-PLIF technique with extended rigid transpedicular instrumentation. Potential risk factors influencing the development of proximal junctional kyphosis and instability of instrumentation were analyzed.Results. It was found that only three risk factors significantly affect the development of PJK: correction of lumbar lordosis more than 30° (p = 0.036) increases the likelihood of its development by 1.5 times, osteoporosis (p = 0.001) – by 2.5 times, and proximal junctionalangle ≥10° (p = 0.001) – by 3.5 times. Three factors showed a statistically significant effect on the incidence of instrumentation instability: correction of lumbar lordosis more than 30° (p = 0.034) increases the likelihood of its occurrence by 1.7 times, osteoporosis (p = 0.018) – by 1.8 times, and deviation of the sagittal vertical axis by more than 50 mm (p = 0.001) – by 3.3 times.Conclusion. The most significant risk factors for the occurrence of PJK and instability of instrumentation are osteoporosis, correction of lumbar lordosis more than 30°, an increase in the proximal junctional angle ≥10°, and an anterior deviation of sagittal vertical axis more than 50 mm. Consideration of these factors in the preoperative period, as well as during surgery, can decrease likelihood of the occurrence of PJK and instability of instrumentation.

Aim. To determine the clinical effectiveness of anterior stabilization in the surgical treatment of patients with traumatic injuries of the thoracic and lumbar spine with reduced bone mineral density. Materials and methods. The study included 238 patients with thoracic and lumbar vertebral fractures with reduced bone mineral density (BMD). The age of patients is from 48 to 85 years. There are following types of fractures according to F. Magerl (1992): A1.2, A1.3, B1.2, B2.3. BMD of the vertebrae was decreased (T-score from 1.5 to 3.5). Results. All patients underwent short segment transpedicular fixation (TPF) with four-screw systems. In group 1 were included 68 patients who underwent TPF without cemented augmentation of screws. Group 2 included 170 patients who underwent TPF reinforced with a cement. Both groups were divided into 2 subgroups. Subgroup 1.1 included patients, which were operated on in two stages. The first stage is TPF. The second stage is the anterior stabilization. Subgroup 1.2 included patients who underwent only TPF. Patients in group 2 were divided into two subgroups in a similar way. The results and complications according to clinical and spondylometric criteria were studied. Correlation analysis was performed between surgical technique, surgical tactics and the treatment results in the four selected subgroups. The observation period is at least 2 years. Conclusion. 1. When using TPF with cement augmentation for the treatment of patients with fractures of the thoracic and lumbar spine with reduced BMD, the anterior stabilization of injured spinal motion segment as a second stage of surgical treatment does not provide clinical advantages compared to the use of only TPF with cement augmentation. 2. In case of cementless TPF in patients with reduced BMD, anterior stabilization of the injured spinal motion segment is necessary. Only when anterior stabilization is performed, the stability of fixation is ensured. It is sufficient to preserve the anatomical relationships restored during the operation and functional adaptation of patients in the long-term period after surgery.

Objective: To assess the efficacy and use of vertebroplasty as a prophylactic measure to prevent stress fractures of vertebrae adjacent to transpedicular screw fixation with augmentation for osteoporosis. Methods: An experimental cadaveric study was performed to assess the overall strength of 10 cadaveric blocks of T10-L4 vertebral segments with simulation of L1 fracture and T12-L2 transpedicular 4-screw system with augmentation. T11 and L2 vertebroplasty cranial and caudal to the transpedicular system was performed in 5 blocks in the main group. Stress testing of the blocks was performed by placing them under a vertically directed load until destruction. Results: Vertically directed load on the blocks in the main group (0.84 ± 0.39831 kN) resulted in T11 vertebrae fractures. Vertebrae with augmentation were resistant to the load in the main group. T10 vertebrae fractures in the blocks of the main group occurred at a load of 1.91 ± 0.40566 kN. Conclusion: 1. The adjacent T11 vertebra is the weakest vertebra in the anatomical blocks of T10-L4 vertebral segments with simulation of L1 fracture (type A according to the AO/Magerl classification) and the T12-L2 4-screw transpedicular system with augmentation. 2. Bone cement injection into the T11 cranial vertebra adjacent to the level of fixation increases the overall strength of the blocks 3. Vertebroplasty of the overlying vertebra is an effective way to prevent its fracture and in case of osteoporosis. 4. Prophylactic vertebroplasty of the vertebra caudal to the level of fixation is unnecessary due to the insignificant risk of a fracture. Level of Evidence III; Experimental – Quasi experiments RESUMO Objetivo: Avaliar a eficácia e o uso da vertebroplastia como medida profilática para prevenir fraturas por estresse das vértebras adjacentes à fixação com parafuso transpedicular com o aumento da osteoporose. Métodos: Foi realizado um estudo cadavérico experimental para avaliar a resistência global de 10 blocos cadavéricos dos segmentos T10-L4 com simulação de fratura de L1 e sistema com 4 parafusos transpediculares em T12-L2 com aumento. A vertebroplastia de T11-L2 cranial e caudal ao sistema transpedicular foi realizada em 5 blocos no grupo principal. Os testes de estresse nos blocos foram realizados aplicando-se carga vertical até ocorrência de fratura. Resultados: A carga vertical sobre os blocos no grupo principal (0,84 ± 0,39831 kN) resultou em fratura da vértebra T11. As vértebras com aumento foram resistentes à carga no grupo principal. As fraturas da vértebra T10 nos blocos do grupo principal ocorreram com carga de 1,91 ± 0,40566 kN. Conclusão: 1. A vértebra adjacente à T11 é a mais fraca nos blocos anatômicos dos segmentos vertebrais T10-L4 com simulação de fratura de L1 (tipo A de acordo com a classificação AO/Magerl) e do sistema transpedicular com 4 parafusos T12-L2 com aumento. 2. A injeção de cimento ósseo na vértebra adjacente à T11 em sentido cranial ao nível de fixação aumenta a resistência global dos blocos. 3. A vertebroplastia da vértebra sobrejacente é uma forma eficaz de prevenir a fratura nos casos de osteoporose. 4. A vertebroplastia profilática da vértebra caudal ao nível de fixação é desnecessária devido ao risco insignificante de fratura. Nível de Evidência III; Experimental - Quase experimentos. RESUMEN Objetivo: Evaluar la eficacia y el uso de la vertebroplastia como medida profiláctica para prevenir fracturas por estrés de las vértebras adyacentes a la fijación con tornillo transpedicular con aumento de la osteoporosis. Métodos: Se realizó un estudio cadavérico experimental para evaluar la resistencia global de 10 bloques cadavéricos de los segmentos T10-L4 con simulación de fractura de L1 y sistema con 4 tornillos transpediculares en Th12-L2 con aumento. La vertebroplastia de T11-L2 craneal y caudal al sistema transpedicular se realizó en 5 bloques en el grupo principal. Los tests de estrés en los bloques fueron realizados aplicándose carga vertical hasta la ocurrencia de fractura. Resultados: La carga vertical sobre los bloques en el grupo principal (0,84 ± 0,39831 kN) resultó en fractura de la vértebra T11. Las vértebras con aumento fueron resistentes a la carga en el grupo principal. Las fracturas de la vértebra T10 en los bloques del grupo principal ocurrieron con carga de 1,91 ± 0,40566 kN. Conclusión: 1. La vértebra adyacente a T11 es la más débil en los bloques anatómicos de los segmentos vertebrales T10-L4 con simulación de fractura de L1 (tipo A según la clasificación AO/Magerl) y del sistema transpedicular con 4 tornillos T12-L2 con aumento. 2. La inyección de cemento óseo en la vértebra adyacente a la T11 em sentido craneal al nivel de fijación aumenta la resistencia global de los bloques 3. La vertebroplastia de la vértebra suprayacente es una forma efectiva de prevenir la fractura en los casos de osteoporosis. 4. La vertebroplastia profiláctica de la vértebra caudal al nivel de fijación es innecesaria debido al riesgo no significativo de fractura. Nivel de evidencia III; Experimental - Cuasi experimentos.

Objective To explore causes of proximal junctional kyphosis (PJK) following instrumented fixation of lumbar spine in patients with degenerative scoliosis due to mineral bone density deficiency. Material and methods A retrospective analysis was conducted on 308 patients with degenerative lumbar scoliosis surgically treated with decompression of neural elements, deformity correction and stabilization of FSU using rigid transpedicular fixation systems. The patients were followed up for 2 years of surgery and were subdivided into 2 groups, those who developed PJK (n=132) and those who did not (n=176). Variable risk factors for PJK described in the literature were analyzed. They could be categorized into patient related factors (age, gender, osteoporosis, body mass index (BMI), smoking habits), surgical factors (type of osteotomy performed, a magnitude of lordosis correction, long fixation to the sacrum) and radiographic parameters (PI, TK, LL, SVA, PI-LL, PJA). Results Osteoporosis (53–33 %, p = 0.032), BMI >25 (51–37 %, p = 0.042) and greater than 30° lordosis correction (51–34 %, p = 0.038) were found to be statistically significant for PJK. Lumbar lordosis restored in more than 30% increases the risk of PJK by 2.3 times. The proximal junctional angle (PJA) ≥ 11° is a statistically significant risk factor for PJK and associated with increased occurrence of PJK by 2.9 times (p = 0.022). An increase in PJA by 1° increases the risk of PJK by 11.8 % (making the risk 1.118 times higher). Osteoporosis coupled with PJA entails a statistically significant impact on PJK (p = 0.002) with PJA increased by 1° in osteoporosis scenario increasing the risk of PKJ by 66.4 % (making the risk 1.664 times higher). Conclusion Osteoporosis, body mass index > 25 and a surgical correction of lumbar lordosis by more than 30° have been shown to be significantly associated with PJK in patients with lumbar curves. PJA of 11° is the significant risk factor for PJK making the occurrence of PJK 2.9 times higher (p = 0.022). Osteoporosis coupled with PJA entails a statistically significant impact on PJK (p = 0.002) with PJA increased by 1° in osteoporosis cases increasing the risk of PKJ by 66.4 %.

Thematic justification Compression stress fractures of the vertebrae at the upper border with a metal structure are a serious problem, especially in extensive stabilization and in patients with osteoporosis. Nowadays, there is a lack of information on prevention of the fracture of the vertebrae adjacent to the metal structure. Purpose Compare experimentally the efficiency of cemented vertebroplasty and laminar band fixation of the cranial vertebra adjacent to the TPF level for prevention of fractures in osteoporosis. Study design Biomechanical cadaver study. Materials and methods We used the cadaver material obtained from females in the age from 66 to 81 years. The extension of the blocks withdrawn was from Th10 to L4 (7 vertebrae). L1 fracture was simulated in all the blocks by its mechanical destruction. A total of 15 blocks were studied divided into 3 groups of five units each: group 1 – controls (cemented TPF of Th12-L2); group 2 – cemented TPF of Th12-L2 + Th11laminar fixation with the «Universal Clamp»; group 3 – cemented TPF of Th12-L2 and preventive vertebroplasty of Th11 and L3. We used the axial load with a universal servo-hydraulic testing machine «Walter + bay ag» LFV-10-T50 (Switzerland). Compression was carried out until graphic signs of fracture were displayed. We took X-rays of blocks before and after the study. Results The control group revealed the appearance of vertebral fractures just above the metal structure (Th11). The first graphic signs of fracture were detected in the range of 0.78-0.94 kN (mean 0.86 ± 0.13784). The group with laminar fixation using the «Universal Clamp» revealed fractures of Th10 and Th11. The first graphic oscillations corresponding to a fracture were detected in the range of 1.12-1.48 kN (mean 1.21 ± 0.385227). The group with preventive vertebroplasty of Th11 and L3 revealed fractured vertebrae adjacent to the vertebroplasty (Th10). In this case, the first graphic oscillations corresponding to a fracture were detected in the range of 1.78-2.05 kN (mean 1.898 ± 0.222441). Conclusion The overlying vertebra is at increased risk of fracture when transpedicular fixation is used. The use of laminar fixation with the «Universal Clamp» does not prevent vertebral fracture over the pedicle system (Th11) but provides an increase of resistance to the vertebral fracture by 1.5 times. Preventive vertebroplasty of overlying vertebra is an effective way to prevent a pathological fracture (Th11), and also increases the resistance of the overlying (Th10) vertebra to fracture by 2–2.5 times.

Purpose Our goal is to demonstrate a typical clinical situation that promotes the development of PJF and PJK, as well as a variant of surgical treatment of these complications. Material and methods A case of a fracture of the overlying vertebra above the level of metal fixation of the vertebra and development of proximal junctional kyphosis (PJF and PJK) in a patient operated for degenerative scoliosis of the lumbar spine. Repeated extended stabilization of the spine without cranial level protection resulted in the re-development of this complication. Vertebroplasty of the bodies of two vertebrae cranial from the fixed vertebral motor segment was performed in order to prevent the development of PJF and PJK and a hybrid fixation with a polymeric band on the cranial vertebral motor segment (VMS) was performed. Result Observation for a year confirms a good result of treatment. Conclusion Using vertebroplasty of two vertebrae cranial from the fixed vertebral motor segment with 7-8 ml of bone cement per vertebra prevented the possible development of PJF and PJK in the presented clinical observation and achieved a good clinical outcome. Laminar band fixation of the cranial VMS ensured the transition of the rigid system into a semi-rigid system in its proximal part, which also contributed to prevention of PJF and PJK.

Objective: To analyze the structure of degenerative lumbar stenosis surgical treatment complications and to analyze their effect on the results and indications for revision operations. Methods: Between 2009 and 2013, 513 patients with lumbar stenosis of degenerative etiology were surgically treated. There were 205 men, 308 women, aged 23 to 74 years. The main clinical manifestations were persistent compression radiculopathy, chronic pain in the back and lower limbs, and difficulty walking. The intensity of the pain was assessed by the VAS. At the time of hospitalization, VAS was 55-90 points. Results: Of the 513 operated patients, 65 (12.67%) had complications in the early postoperative period (up to three months after the operation); intraoperative complications occurred in 26 (5.1%) patients; intraoperative dura mater injury occurred in 24 (4.67%); pulmonary embolism (PE) occurred in 2 (0.39%) patients; 39 patients had early postoperative complications; acute radiculopathy occurred in 22 patients (4.28%); and 17 patients (3.31%) had surgical wound complications. Conclusions: Liquorrhea, postoperative hematomas and acute radiculopathy had no negative effect on the results of treatment in any of the cases. In the early postoperative period, 4 (0.77%) deaths were recorded intraoperatively and in 2 (0.39%) cases, intraoperative PE occurred. Two cases (0.39%) resulted in sepsis and multiple organ failure. In eight (1.55%) patients, the results of the treatment were unsatisfactory: in 4 (0.77%) cases due to death, and in a further 4 (0.77%) due to elimination of the system by the spinal column as a result of suppuration. Level of Evidence IV; Therapeutic studies - Investing the results of treatment. RESUMO Objetivo: Analisar a estrutura das complicações do tratamento cirúrgico da estenose lombar degenerativa e analisar seu efeito nos resultados e indicações para operações de revisão. Métodos: Nos anos de 2009-2013, 513 pacientes com estenose lombar de etiologia degenerativa foram tratados cirurgicamente. Havia 205 homens, 308 mulheres com idades entre 23 e 74 anos. As principais manifestações clínicas foram radiculopatia por compressão persistente, dor crônica nas costas e membros inferiores, dificuldade para andar. A intensidade da dor foi avaliada pela EAV. No momento da hospitalização, a EVA foi de 55 a 90 pontos. Resultados: Entre os 513 pacientes operados, 65 (12,67%) tiveram complicações do pós-operatório imediato (até três meses após a operação ocorreram complicações intraoperatórias em 26 (5,1%) pacientes. A lesão intra operatória da dura-máter ocorreu em 24 (4,67%); embolia pulmonar (EP) ocorreu em dois (0,39%) pacientes, 39 pacientes com complicações pós-operatórias precoces, radiculopatia aguda em 22 pacientes (4,28%) e 17 pacientes (3,31%) com complicações da ferida. Os hematomas pós-operatórios e a radiculopatia aguda tiveram efeito negativo sobre os resultados do tratamento em nenhum caso. No período pós-operatório imediato, 4 (0,77%) dos óbitos foram registrados no período intra operatório e em dois (0,39%) casos o PE intra operatório. Em dois casos (0,39%) foram motivo de sepse e falência múltipla de órgãos, sendo que em oito (1,55%) pacientes foram encontrados resultados insatisfatórios: em quatro (0,77%) devido à morte - e em quatro devido à remoção dos sistemas da coluna por causa de supuração. Nível de Evidência IV; Estudos terapêuticos - investigação dos resultados do tratamento. RESUMEN Objetivo: Analizar la estructura de las complicaciones del tratamiento quirúrgico de la estenosis lumbar degenerativa y analizar su efecto sobre los resultados y las indicaciones para las operaciones de revisión. Métodos: En 2009-2013 513 pacientes con estenosis lumbar de etiología degenerativa fueron tratados quirúrgicamente. Hubo 205 hombres, 308 mujeres, de 23 a 74 años. Las principales manifestaciones clínicas fueron radiculopatía por compresión persistente, dolor crónico en la espalda y las extremidades inferiores, y dificultades para caminar. La intensidad del dolor fue evaluada por EVA. En el momento de la hospitalización, la EVA tenía 55-90 puntos. Resultados: Entre los 513 pacientes operados, 65 (12,67%) tuvieron complicaciones en el período postoperatorio temprano (hasta tres meses después de la operación); hubo complicaciones intraoperatorias en 26 (5,1%) pacientes; lesión duramadre intraoperatoria ocurrió en 24 (4,67%); embolia pulmonar (EP) se presentó en dos pacientes (0,39%); hubo 39 pacientes con complicaciones postoperatorias tempranas; en 22 (4,28%) radiculopatía aguda y en 17 (3,31%) complicaciones en la herida. Conclusiones: Liquorrea, hematomas postoperatorios y la radiculopatía aguda no tuvieron efecto negativo en los resultados del tratamiento en ninguno dos casos. En el período postoperatorio temprano se registraron cuatro (0,77%) muertes intraoperatorias y en dos (0,39%) casos se trató de una PE intraoperatoria. Dos casos (0,39%) resultaron en sepsis y falla orgánica múltiple. Se observaron resultados de tratamiento insatisfactorios en ocho (1,55%) pacientes: en 4 (0,77%) - debido a la muerte, y en cuatro (0,77%) - debido a eliminación del sistema por la espina dorsal debido a supuración. Nivel de evidencia IV; Estudios terapéuticos - Investigación de los resultados del tratamiento.

Objective. To study the structure of complications after surgical treatment of degenerative lumbar stenosis and to analyze their influence on outcomes and indications for revision. Material and Methods . A total of 513 patients with degenerative lumbar stenosis underwent decompression and stabilization of stenotic spinal motion segments including transpedicular fixation and fusion (TLIF or PLIF). All complications both during operations and in the early and late periods of follow-up were systematized. Results . The total rate of complications was 26.51 %. The rate of early complications, including intraoperative ones was 12.67 %, and of late complications - 13.84 %. Conclusion . Unsatisfactory outcome in the early postoperative period was associated with pulmonary embolism and suppuration of postoperative wound with generalization of the infection process. Unsatisfactory long-term results of treatment were most often caused by loosening of instrumentation and late suppuration.

Objective. To substantiate experimentally a method for preventing adjacent vertebra fractures during cement transpedicular fixation of vertebral fractures in osteoporotic patients. Material and Methods. An experimental study included the assessment of overall strength of 10 cadaver blocks of T10–L4 vertebral segments with simulated Magerl’s type A fracture at the L1 level and transpedicular fixation at the T12–L2 levels with four-screw system and cement augmentation. In five control blocks, only cement augmented transpedicular fixation was per- formed after the L1 fracture simulation. In five blocks of the study group it was supplemented by vertebroplasty at T11 and L3 levels cranial and caudal to the level of fixation. Load testing of the blocks was carried out by destruction under the influence of a vertically directed force. Results. Vertical loading of anatomical specimens in the control group (average of 0.84 kN) caused Th11 vertebral body fractures. In the study group, the vertebrae augmented by vertebroplasty were resistant to loading. Fractures occurred in the T10 vertebral bodies (over the vertebra with vertebroplasty) under the average load of 1.91 kN. Conclusion. Vertebroplasty of the vertebra overlying the level of transpedicular fixation is an effective way to prevent its fracture.

Objective. To analyze clinical effectiveness of repositioning decompression of the dural sac and to justify a differentiated ap- proach to the decompression for traumatic spinal stenosis caused by damages of lower thoracic and lumbar vertebral bodies. Material and Methods. A total of 103 adult patients with injuries of the lower thoracic and lumbar spine accompanied by traumatic spinal canal stenosis were treated: 76 patients were included in the study group and 27 – in the control group. All patients underwent decompressive-stabilizing surgery with transpedicular fixation. In the study group, the priority was given to indirect repositioning decompression (more 50 %), in the control group – decompressive laminectomy (100 %). Results. In the study group, long-term results of treatment were assessed as good in 38 (79.2 %) cases, satisfactory – in 8 (16.7 %), and poor – in 2 (4.2 %). In the control group, good results were obtained in 13 (72.2 %) patients, satisfactory – in 4 (22.2 %), and poor – in 1 (5.6 %). Conclusion. Differentiated approach to decompression of the dural sac in patients treated for lower thoracic or lumbar spine injuries and traumatic spinal canal stenosis allowed avoiding laminectomy in 53.9 % of patients in the study group and per- forming anterior decompression consisting of subtotal corpectomy 1.9 times less often than in the control group.

Introduction Compression stress fractures of the vertebrae adjacent to the fixed steel structure is a serious problem. Especially, it is observed in patients with osteoporosis. The biomechanical studies proving any method of preventing such complications are not found in the literature. The objective was the recognition of the possible ways of preventing adjacent vertebral fractures in the conditions of the cement transpedicular osteosynthesis while having osteoporotic. Materials and Methods The postmortem graft of women aged 66 to 81 years was used. The length of the blocks withdrawn from Th10 to L4. A total of 10 blocks were removed and then they were equally divided into two groups. In both the groups, the fracture of L1 vertebra was simulated by its mechanical destruction. We implanted transpedicular system Th12 to L2 with augmentation. Besides the described interventions nothing more was done in the control group. In the exploring group, the bone cement was injected to the vertebrae adjacent to the transpedicular system (Th11 and L3) in a volume 20 to 25% of the vertebra (7–8 mL). Tests were held with the help of compressive load along the longitudinal axis of the spine on the universal servohydraulic testing machine “Walter + bay ag” LFV-10to T50 (Switzerland). The strength of the vertical mechanical impact on the unit the graphical display of the fracture was investigated. After performing a mechanical test, all blocks were exposed to X-ray examination to visualize the fracture. Results Destabilization of the system and vertebral fractures in which screws were implanted with cement (Th12 and L2) was not observed in any case in both the groups. In the control group of the experimental units (without prophylactic vertebroplasty), fractures of the overlying vertebra over the pedicle system (Th11) were diagnosed. The first graphic indications of fracture were defined in the range 0.78 to 0.94 (average, 0.84 ± 0.39831) kN. Further strengthening of the load led to the formation of deformation and obvious destruction of Th11 vertebra. These changes were recorded within 1.24 to 1.6 (average, 1.47 ± 0.39831) kN. In the exploring group of blocks (with a prophylactic vertebroplasty up and underlying vertebrae), fractures of these vertebrae (Th11 and L3) were not found. In this case, the first graphical oscillations corresponding to the fracture were detected in the range of 1.78 to 2.05 (average, 1.91 ± 0.40566) kN. The more marked graphic changes were detected within 2.12 to 2.88 (average, 2.51 ± 0.40566) kN. After the testing X-ray examination, the fracture of the proximal end of the block vertebra (Th10) was revealed. Adjacent caudal vertebrae (L3 and L4) were not destroyed in any case, in both the groups. Conclusion Although using the PSF with augmentation at increased risk of fracture there is the overlying vertebra. Prophylactic vertebroplasty of the overlying vertebra is an effective way to prevent its pathological fracture. Vertebral fracture of the cranial level of preventive vertebroplasty occurs when the average load is 2 to 2.5 times higher than the fracture of adjacent vertebrae TPV without prophylactic vertebroplasty. Prophylactic vertebroplasty of the underlying vertebra is impractical because of its low risk of fracture.