Tactics of surgical treatment for thoracic and lumbar spinal injuries

Cover Page


Cite item

Abstract

The analysis of results of surgical treatment of 154 patients with a vertebral and spinal trauma of chest and lumbar departments of a backbone aged from 16 till 75 years is carried out. All patients were operated in Bryansk city hospital N 1. The volume and sequence of surgeries, and existence were defined with the combined damages, character of an injury of a backbone and a spinal cord or absence free part bone bodies of the injured vertebra compressing a spinal cord defined different accesses on a backbone. So, surgeries at 125 (81,2 %) patients were carried out from one back access, at 23 (14,9 %) patients - to the combined back and lobbies and at 6 (3,9 %) patients - front and back access. In all cases for fixing of a spine implants “Sintez” firm (St. Petersburg) were used. Results of treatment were estimated on neurologic dynamics, restoration of an axis of a backbone, a gleam of the vertebral channel and restoration possibility of a support of a backbone. Good results of treatment are received at 87 (56,5 %), satisfactory - at 55 (35,7 %) and unsatisfactory - at 12 (7,8 %) patients.

About the authors

V. D. Usikov

Vreden Russian Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: sintez@rambler.ru
Russian Federation

V. S. Kuftov

Bryansk City Hospital No. 1

Email: kuftov@mail.ru
Russian Federation

N. I. Ershov

Bryansk City Hospital No. 1

Email: nick.ershov@yandex.ru
Russian Federation

References

  1. Гранди Д., Суэйн Э. Травма спинного мозга. М.: БИНОМ; 2008. 124 с
  2. Гринь А.А., Жестков К.Г., Николаев Н.Н., Самарин М.С., Кайков А.К., Крылов В.В. Торакоскопические операции при травме грудного отдела позвоночника: реферат. Журнал Вопросы нейрохирургии. 2009;(1): 48-53
  3. Корнилов Н.В., Усиков В.Д. Повреждения позвоночника (тактика хирургического лечения). СПб: МОРСАР АВ; 2000. 231с
  4. Макаревич С.В. Спондилодез универсальным фиксатором грудного и поясничного отделов позвоночника. Минск: Юнипак; 2001. 80 с
  5. Осипов Ю.В. Мониторинг первичной инвалидности при травмах позвоночника и позвоночно-спинальной травме в Республике Беларусь. Журнал Гродненского государственного медицинского университета. 2012;(4):61-65
  6. Полищук Н.Е., Корж Н.А., Фищенко В.Я. Повреждения позвоночника и спинного мозга. Киев: Книга плюс; 2001. 388 с
  7. Усиков В.Д. Руководство по транспедикулярному остеосинтезу. СПб: Гиппократ; 2006. 176 с
  8. Щедренок В.В., Орлов С.В., Могучая О.В. Нестабильность при застарелых повреждениях позвоночника и спинного мозга. Травматология и ортопедия России. 2010; (2):79-81
  9. American Spinal Injury Association and International Medical Society of Paraplegia, eds. Reference manual of the international standards for neurological classification of spinal cord injury. Chicago, IL: American Spinal Injury Association; 2003.
  10. Bellabarba C., Fisher C., Chapman J.R., Dettori J.R., Norvell D.C. Does early fracture fixation of thoracolumbar spine fractures decrease morbidity or mortality? Spine. 2010; 35 (9):138-145.
  11. Carreon L.Y., Dimar J.R. Early versus late stabilization of spine injuries: a systematic review. Spine. 2011; 36(11):727-733.
  12. Denis F. Spinal stability as defined by the three-column spine concept in acute spinal trauma. Clin. Orthop. 1984; 189:65-68.
  13. Dimar J.R., Carreon L.Y., Riina J., Schwartz D.G., Harris M.B. Early versus late stabilization of the spine in the polytrauma patient. Spine. 2010; 35 (21):187-192.
  14. Frangen T.M, Ruppert S., Muhr G., Schinkel C. The beneficial effects of early stabilization of thoracic spine fractures depend on trauma severity. J. Trauma. 2010; 68(5):1208-1212.
  15. Kirshblum S., Millis S., McKinley W., Tulsky D. Late neurologic recovery after traumatic spinal cord injury. Arch. Phys. Med. Rehabil. 2004; 85(11):1811-1818.
  16. Knop C., Bastian L., Lange U., Oeser M., Zdichavsky M., Blauth M. Complications in surgical treatment of thoracolumbar injuries. Eur. Spine J. 2002; 11(3):214-226.
  17. Lenehan B., Fisher C.G., Vaccaro A., Fehlings M., Aarabi B., Dvorak M.F. The urgency of surgical decompression in acute central cord injuries with spondylosis and without instability. Spine. 2010;35(21):180-186.
  18. Reinhold M., Knop C., Beisse R., Audig L., Kandziora F., Pizanis A. et al. Mid-term results of PLIF/TLIF in trauma. Eur. Spine J. 2011; 20(3): 395-402.
  19. Schinkel C., Anastasiadis A.P. The timing of spinal stabilization in polytrauma and in patients with spinal cord injury. Curr. Opin. Crit. Care. 2008; 14 (6):685-689.
  20. Shamim M.S., Ali S.F., Enam S.A. Non-operative management is superior to surgical stabilization in spine injury patients with complete neurological deficits: A perspective study from a developing world country, Pakistan Surg. Neurol. Int. 2011; 2:166.
  21. van Middendorp J.J., Hosman A., Doi S.A. The effects of the timing of spinal surgery after traumatic spinal cord injury: A Systematic Review and Meta-Analysis. J. Neurotrauma. 2013; Jul 1.
  22. Vikas V.P., Evalina B., Courtney W.B. Spine trauma: surgical techniques. Heidelberg: Springer-Verlag; 2010. 413 p
  23. Wyndaele J.J. The impact of early versus late surgical decompression in neurological recovery after traumatic spinal cord injury (SCI). Spinal Cord. 2012; 50 (11):789

Copyright (c)



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies