RESUMEN
BACKGROUND: The aim of this study was to develop optimal tactics of surgical treatment of complicated injuries of the cervical spine, in accordance with SLIC (subaxial injury classification) and to improve the results of intervention in the acute period. MATERIALS AND METHODS: We analyzed 97 patients with complicated subaxial injury of the cervical spine. All patients were operated via anterior approach. Contraindications for surgery included constant instability of systemic haemodynamics and impairment of breathing on the background of extremely severe condition of patient, purulent-inflammatory processes. Results were evaluated by dividing our series into groups: centromedullary injury, compression-burst fractures of vertebral bodies, facet subluxations and facet fractures-dislocations. RESULTS: Treatment by applied technique was effective in 88.7% of series, successful orthopaedic results was obtained in 99%. With incomplete consideration of possible limitations of the operations, early decompression and stabilization do not improve outcomes and quality of life of patients.
Asunto(s)
Fracturas por Compresión/diagnóstico , Fracturas por Compresión/cirugía , Traumatismos del Cuello/diagnóstico , Traumatismos del Cuello/cirugía , Traumatismos de la Médula Espinal/diagnóstico , Traumatismos de la Médula Espinal/cirugía , Femenino , Estudios de Seguimiento , Fracturas por Compresión/diagnóstico por imagen , Humanos , Masculino , Traumatismos del Cuello/diagnóstico por imagen , Radiografía , Traumatismos de la Médula Espinal/diagnóstico por imagenAsunto(s)
Tornillos Óseos , Descompresión Quirúrgica/métodos , Fijación Interna de Fracturas/métodos , Fracturas por Compresión/cirugía , Fijadores Internos , Fracturas de la Columna Vertebral/cirugía , Anciano , Descompresión Quirúrgica/instrumentación , Femenino , Fijación Interna de Fracturas/instrumentación , Fracturas por Compresión/diagnóstico por imagen , Fracturas por Compresión/patología , Humanos , Masculino , Persona de Mediana Edad , Osteoporosis/complicaciones , Osteoporosis/diagnóstico por imagen , Osteoporosis/patología , Radiografía , Fracturas de la Columna Vertebral/diagnóstico por imagen , Fracturas de la Columna Vertebral/patología , Resultado del TratamientoRESUMEN
The paper describes a case of successful treatment in a patient with third-grade fracture of the dens of the second cervical vertebra with transdental posterior subluxation. According to the treatment policy chosen, posterior upper cervical spine stabilization and anterior upper spinal cord decompression that was supplemented by anterior cervical spondylodesis were performed in the early period.
Asunto(s)
Vértebra Cervical Axis/lesiones , Vértebra Cervical Axis/cirugía , Luxaciones Articulares/cirugía , Fracturas de la Columna Vertebral/cirugía , Humanos , Luxaciones Articulares/complicaciones , Masculino , Persona de Mediana Edad , Fracturas de la Columna Vertebral/complicaciones , Resultado del TratamientoRESUMEN
The authors studied 54 patients with diskogenic compression of the cervical spine and nervous roots, who had undergone interventions including diskectomy, anterior cervical spondylodesis, and plate fixation. The purpose of the study was to provide rationale for choice of a surgical treatment for multileveled diskogenic compression of the cervical spine. Twenty-seven patients with multileveled lesion underwent diskectomy at 2-3 levels with and without vertebral body resection. Preference was given to the mini-invasive technique involving diskectomy, anterior cervical spondylodesis, by using osteoinductor blocks, and plate fixation. A control group consisted of 27 patients with one-leveled lesion who had undergone conventional surgical treatment. 0.5-3-year follow-ups showed positive results in 84% in the study group and in 89% in the control one. Fusion was successful in 89 and 96% in the study and control groups, respectively. The rate of complications and the level of successful professional and social rehabilitation were similar in both groups.