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Применение малоинвазивных методов хирургического лечения переломов нижних грудных и поясничных позвонков

Применение малоинвазивных методов хирургического лечения переломов нижних грудных и поясничных позвонков

Abstract

Цель исследования. Анализ результатов лечения переломов нижних грудных и поясничных позвонков с помощью малоинвазивных вмешательств. Материал и методы. Разработана и успешно применена в 56 случаях методика малоинвазивного вентрального спондилодеза и перкутанной погружной транспедикулярной фиксации при лечении неосложненных повреждений нижних грудных и поясничных позвонков. В 19 случаях вентральная стабилизация позвоночника осуществлялась в комбинации с малоинвазивной методикой транспедикулярной фиксации при повреждениях типа BI (11 пациентов) и ВП (8 пациентов) по AO/ASIF. При повреждениях АН и АШ вентральный спондилодез имплантатом из пористого NiTi сочетали с накостной фиксацией (11 случаев). Проведен сравнительный анализ предлагаемых малоинвазивных и традиционных методик вентрального спондилодеза и транспедикулярной фиксации. Результаты. Отдаленные результаты лечения малоинвазивными методами прослежены у 31 пациента. Хорошие результаты достигнуты в 93,5 % (п = 29) случаев, удовлетворительные в 6,5 % (п = 2), неудовлетворительных результатов лечения не зафиксировано. Заключение. Малоинвазивный вентральный спондилодез и перкутанная погружная транспедикулярная фиксация по сравнению с аналогичными операциями, выполненными традиционными методами, позволили осуществить адекватную стабилизацию поврежденного позвоночно-двигательного сегмента, снизить травматичность операции и уменьшить косметический дефект.

Objective. To analyze results of minimally invasive surgery for lower thoracic and lumbar spine fractures. Material and Methods. The method of minimally invasive anterior fusion and percutaneous pedicle screw fixation for treatment of non-complicated fractures of the lower thoracic and lumbar vertebrae was developed and successfully used in 56 cases. In 19 patients with type BI (n = 11) and BII (n = 8) fractures according to AO/ASIF classification the anterior stabilization of the spine was performed in combination with minimally invasive transpedicular fixation. Type All and AIII fractures were treated by anterior fusion with porous NiTi implant combined with internal fixation (n = 11). A comparative analysis of suggested minimally invasive and conventional methods of anterior fusion and transpedicular fixation was performed. Results. The long-term outcomes of minimally invasive treatment were followed in 31 patients. Good results were achieved in 93.5 % of cases (n = 29), satisfactory in 6.5 % (n = 2), unsatisfactory results were not registered. Conclusion. Minimally invasive anterior fusion and percutaneous internal transpedicular fixation as compared with conventional methods provided adequate stabilization of fractured spinal motor segment, decrease in surgery invasiveness, and elimination of cosmetic defect.

Keywords

МАЛОИНВАЗИВНЫЙ ВЕНТРАЛЬНЫЙ СПОНДИЛОДЕЗ, МАЛОИНВАЗИВНЫЙ ТРАНСПЕДИКУЛЯРНЫЙ ОСТЕОСИНТЕЗ, ПЕРЕЛОМ НИЖНИХ ГРУДНЫХ И ПОЯСНИЧНЫХ ПОЗВОНКОВ

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold