Isakov B.M (1)
Spinal injuries are a severe type of trauma, accompanied in most cases by disability of patients. Objective of the study: Improving the results of surgical treatment of spinal injuries and diseases using TPF systems. The analysis of the results of 154 patients with injuries of the thoracic and lumbar spine was carried out. The mechanism of injury: fall from a height - 111 patients, road traffic accident - 43 patients. Of the total number of examined patients, 53 patients underwent conservative treatment and 61 patients underwent surgical treatment. 1 Fixation of the damaged segment of the spine with various types of metal structures (TPF) - 42 patients. 2 Decompressive laminectomy with revision of the spinal canal and spinal cord at the level of injury - 37 patients. 3 Decompressive laminectomy at the level of injury + revision of the epi- and subdural spaces of the spinal cord and, as a final stage of the operation, fixation with metal structures - 12 patients. Results: During surgical interventions, during revision, a complete anatomical rupture of the spinal cord was detected in 9 patients, in 27 cases, a picture of hematomyelia and spinal cord contusion at the level of injury. Conclusions: 1 in the presence of symptoms of spinal cord injury, it is necessary to perform LE, revision of the spinal canal and spinal cord. 2 the most reliable fixation is achieved when using a structure for TPF, which allows for early activation of patients.
1.Akshulakov S.A., Usikov Yu.N., Mukhanov T.K., Kerimbaev T.T. Analysis of surgical treatment of patients with spinal cord injury // Proceedings of the Nth Congress of Neurosurgeons of the Russian Federation in Nizhny Novgorod.-SPb, 1998.-P.275-278.
2. Baskov A.V., Shevelev I.N., Yarikov D.E. New international classification of spinal injuries // Issues of Neurosurgery. 1999
3. Borshchenko I.A., A.G. Korshunov, F.S. Satanova, A.V. Baskov. Secondary spinal cord injury: apoptosis in experimental injury // Neurosurgery.-M,- 2002,- No. 4,- P. 23-27.
4. Valeev G.K., Safin Sh.M. On the Tactics of Treating Patients with Spinal Cord Injuries // 1st Congress of Neurosurgeons of the Russian Federation: Abstracts of Reports. Ekaterinburg, 1995. - 30.
5. Dulaev A.K., Orlov V.P. Efficiency of Using Various Methods of Surgical Stabilization in Victims with Acute Spinal Injuries // Proceedings of the 2nd Congress of Neurosurgeons of the Russian Federation in Nizhny Novgorod. M., 1998. P. 269.
6. Ermolov A.S., Krylov V.V., Grin' A.A., Ioffe Yu.S. Diagnostics and Tactics of Treating Victims with Spinal Cord Injuries // Methodical Recommendations. M. - 2003. - 27 p.
7. Zhadenov I.I. Surgical treatment of patients with traumatic injuries of the thoracic and lumbar vertebrae// Problems of spine and spinal cord surgery: Abstracts of the All-Russian scientific and practical conference. Novosibirsk, 1996. - P.26-28.
8. Nikitin G.D. et al. Bone and metal fixation of the spine in diseases, injuries and their consequences. - St. Petersburg: Russian graphics, 1998.
9. Musalatov Kh.A., Dzukaev D.N., Aganesov A.G. Transpedicular fixation in complicated spinal injury // VI Congress of traumatologists and orthopedists of Russia: abstracts of reports. N. Novgorod, 1997. - 744 p.
10. Denis F. The three-column spine its significance in the classification of acute thoracolumbar spinal injuries // Spine 1983: 8: P. 817-831.
11. Cammisa F.P., Eismont F.J. et al. Dural laceration occurring with burst fractures and associated laminar fractures // J. Bone J. Surg. Am. -- 1989. - Vol. 71. - P. 1044.
12. Carl A.L. et al. Pedicle screw instrumentation for thoracolumbar burst fractures and fracture-dislocations. // Spine. — 1992. - Vol. 17. - P. 317-323.
13. Ebara S., Kamimura M. et al. A new system for the anterior restoration and fixation of thoracic spinal deformities using an andoscopic approach // Spine. - - 2000. - Vol. 25. -P. 876-883.
14. Parker J.W., Lane J.R. et al. Successful short-segment instrumentation and fusion for thoracolumbar spine fractures // Spine. - 2000. - Vol. 25, No. 9. - P. 157-169.
15. Kaneda K., Taneichi H. et al. Anterior decompression and stabilization with the Kaneda device for thoracolumbar burst fractures associated with neurological deficits // J. Bone J. Surg. Am. - 1997. - Vol. 79. -- P. 69-89.
16. Liebeman I.H. et al. Transperitineal laparoscopic exposure for interbody fusion // Spine. - 2000. - Vol 25. - P. 509-514.
17. McAfee P. S., Bohlman H. H. et al. Anterior decompression of traumatic thoracolumbar fractures with incomplete neurological deficit using retroperitoneal approach // J. Bone J. Surg. Am. - 1985. - Vol. 67. - P. 89.
18. Thalgott J.S., Kabinus M.B. et al. Four year experience with the JSC thoracolumbar locking plate // Spinal Cord. -1997. - Vol. 3. - P. 286-291.