E.K. VALEEV, S.V. OGURTSOV, I.E. VALEEV, I.A. SHULMAN

Republic Clinical Hospital of the MH of RT, 138 Orenburskiy Trakt, Kazan, Russian Federation, 420064 

Valeev E.K. — D. Med. Sc., Chief Researcher, tel. (843) 296-88-52, e-mail: ekv44@mail.ru

Ogurtsov S.V. ― neurosurgeon, tel. +7-917-853-95-86, e-mail: sergogurtsov@rambler.ru

Valeev I.E. ― Cand. Med. Sc., neurosurgeon, tel. (843) 296-88-52, e-mail: ekv44@mail.ru

Shulman I.A. ― neurosurgeon, tel. +7-927-400-14-28, e-mail: ilyashul@mail.ru

The article presents the analysis of various technical options of treatment of 107 patients with traumatic stenosis of spinal canal caused by injuries of the thoracolumbar spine. Planning of the technique of the dural sac decompression requires differentiated approach. Depending on location and degree of damage of the bone fragments and ligaments, as well as the severity of neurological disorders, the choice method for complex operations on the front and rear structures of the spinal column is the lateral out-of-cavernous access from one section, and for the two-stage operations or less traumatic operations — the introduction of osteochondral interpozites into the broken vertebral body and their fixation with various techniques.

Key words: spine injury and spinal cord trauma, stenosis, decompressive-stabilizing operations.

REFERENCES

1. Afaunov A.A., Kuz’menko A.V. Transpedicular fixation with injuries of thoracic and lumbar spine, accompanied by traumatic spinal canal stenosis. Khirurgiya pozvonochnika, 2011, no. 4, pp. 8-17 (in Russ.).
2. Tsiv’yan Ya.L. Povrezhdeniya pozvonochnika [Spine injuries]. Meditsina, 1971. 312 p.
3. Rerikh V.V., Borzykh K.O., Rakhmatillaev Sh.N. Surgical treatment of burst fractures of the thoracic and lumbar vertebrae, accompanied by a narrowing of the spinal canal. Khirurgiya pozvonochnika, 2007, no. 2, pp. 8-15 (in Russ.).
4. Wood K., Buttermann G., Mehbod A., et al. Operative compared with nonoperative treatment of a thoracolumbar burst fracture without neurological deficit. A prospective, randomized study. J. Bone Joint Surg. Am, vol. 85-A, pp. 773-781.
5. Wessberg P., Wang Y., Irstam L. et al. The effect of surgery and remodelling on spinal canal measurements after thoracolumbar burst fractures. Eur. Spine J, 2001, vol. 10, pp. 55-63
6. Vakkaro A.R., Baron I.M. Khirurgiya pozvonochnika. Operativnaya tekhnika [Spine Surgery. Operative technique]. Moscow: Progress, 2015. 440 p.
7. Dai L.Y., Jiang L.S., Jiang S.D. Conservative treatment of thoracolumbar burst fractures: A long-term follow-up results with special reference to the load sharing classification. Spine, 2008, vol. 33, no. 23, pp. 2536-2544.
8. Kassar-Pulichchino V.N., Khervig Imkhov Spinal’naya travma v svete diagnosticheskikh izobrazheniy [Spinal injury in the light of diagnostic images]. Moscow: MEDpress-inform, 2009. 264 p.
9. Magerl F., Aebi M., Gertzbein S.D., et al. A comprehensive classification of thoracic and lumbar injuries. Eur. Spine J, 1994, vol. 3, pp. 184-201.
10. Valeev E.K., Bizyaeva L.N., Valeev I.E., Shul’man I.A. Ustroystvo dlya impregnatsii kostnykh fragmentov pri travmaticheskom stenoze pozvonochnogo kanala [The device for impregnation of the bone fragments in traumatic spinal canal stenosis]. Patent RF na izobretenie no. 2568769; Zayavl. 2014141662; Opubl. 20.11.2014. Byul. no. 32.
11. Valeev E.K., Valeev E.K. Sposob diagnostiki sostoyaniya zadney prodol’noy svyazki sredney opornoy struktury pozvonochnika pri povrezhdeniyakh grudnogo i poyasnichnogo otdelov pozvonochnogo stolba [A method for diagnosing the state of the posterior longitudinal ligament of the spine secondary support structure with injuries of thoracic and lumbar vertebral column]. Patent RF na izobretenie no. 2508906; zayavl. 2013102744/14, 22.01.2013; Opubl. 10.03.2014. Byul. no. 7.
12. Jonillat S., Tete V., Frering V. et al. Evaluation of the effectiveness of two fibrin glues in dige experimental study in pigs. Lion Chir, 1990, 86, pp. 481-485.