Restoration of the bone defects on the background of the purulent osteomyelitis process is one of most pressing problems in orthopedics. In the last few years the medical procedure was improved thanks to use of semi-synthetic or syntetic implantation biodegradable composite materials.

The object of the investigation is to study possibilities of use of fast-biodegradable implant LitAr (Russia) for filling infected bone defects in course of complex treating various osteomyelites forms.

The composite material LitAr (in plates) is a mixture of components: xenocollagen and hydroxoapatite. Material is intended for stimulating osteogenesis. In event of infection materials LitAr in 7-10 days is lysed by the wound and microbe ferments and cannot support purulent process. Composite material was introduced into osteomyelitis defect intraoperative through an open wound by introducing a dry substance through fistu-las as well as in form of a suspension in 0.9%-sodium chloride solution. For 13.6% of patients postoperative time period was complicated by suppuration of operative wound. It was stated in course of use of material LitAr that in spite of secondary wound suppuration active osteogenesis rate was little different from similar process for patients with wound healing by first intention. It made it possible to use material more active for patients of advanced years because it was impossible to use a radical sanitation of purulent bone cavity for these patients. Material LitAr was used for 13 patients with osteomyelitis cavities. In form of a suspension (injection-ally or through a fistular duct) in 0.9% NaCl solution material was introduced through fistulas for 8 patients with an affected shin bone. Roentgenological signs of consolidation emerged by 35-40 days. A complete ossi-fication set in by 95-120 days. Immobilization was performed by use of plaster. In far-off time periods (about 2 years) no pathologic fractures were noted. 2 patients had a relapse of fistulas formation (15.4%).

The use of implant LitAr for filling infected bone defects for stimulating osteogenesis and for restoring bone continuity in a complex treatment of various forms of osteomyelitis can be considered as an effective one including for patients because it was impossible to perform a radical sequestrectomy for these patients.

Aims: The purpose of this study is to estimate prospects of application Taurolin for treatment of the vertebral osteitis and purulent discitis. Methods: In the period from 1998 to 2001 16 patients with vertebral osteitis and purulent discitis were treated with the use of Taurolin-Gel 4%. The average age was 33,5. One-stage surgical procedure was always performed – careful surgical cleaning of a suppurative focus with total intravertebral disc and partial vertebral body resection, filling it with Taurolin-Gel 4% followed by drainage with obligatory transpedicular screw-rod fixation. In 9 cases Staph. Aureus was found, in 2 cases – Staph. Hemolyticus, in 1 case – Staph. Intermed and Klebs. Pneum were found. Adequate drainage of the wound and regular sampling of the effluent fluid were very important. When tests show the absence of bacteria, the drains can be removed, otherwise Taurolin may be used as a further instillation. The radioisotope scanning of a spine was applied to have additional control of inflammatory process. Results: In 13 of these cases local and general signs of infection disappeared after one implantation of Taurolin-Gel 4%. In 3 cases a second implantation was necessary. Neurological reactions to introduction of Taurolin-Gel 4% were not observed. In all patients a good medium-term result was obtained. After 1 year the X-ray control, CT-scan and radioisotope scanning showed good fusion in site of infection and absence of inflammatory reaction in all cases. Allergic or similar incompatibilities were not revealed. Conclusions: Taurollin-Gel 4% is a good local drug for treatment and prophylaxis of infections in spine surgery. The advantage is that it can be introduced into surgically cleaned cavities and does not require removal. If it is necessary to use bone graftings, Taurolin-Gel can be easily mixed with corticospongious bone chips or different artificial bone materials.