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Моносегментарный транспедикулярный остеосинтез при повреждениях грудного и поясничного отделов позвоночника

Моносегментарный транспедикулярный остеосинтез при повреждениях грудного и поясничного отделов позвоночника

Abstract

Цель исследования. Анализ клинической эффективности моносегментарного транспедикулярного остеосинтеза (ТПО) при лечении повреждений грудного и поясничного отделов позвоночника. Материал и методы. Проведено хирургическое лечение 46 пациентов с повреждениями грудного или поясничного отделов позвоночника. Пациенты оперированы в сроки от 2 дней до 7,5 мес. с момента травмы. Применяли двухэтапное хирургическое лечение. Первый этап моносегментарный ТПО внутренней спинальной системой, второй передний корпородез травмированных позвоночно-двигательных сегментов (ПДС). В случаях поздних обращений за хирургической помощью применяли авторский способ интраоперационной репозиции позвоночника или предварительную репозицию внешним транспедикулярным устройством. Результаты. Применяемая тактика лечения позволила получить 82,6 % хороших и 15,2 % удовлетворительных результатов. Неудовлетворительный результат (2,2 %) связан с дестабилизацией остеосинтеза у одной пациентки при остеопорозе и необходимостью реостеосинтеза. Заключение. Моносегментарный ТПО имеет высокую клиническую эффективность и может применяться в случаях повреждений, сопровождающихся дестабилизацией одного ПДС при условии сохранения в фиксируемых позвонках костного массива, достаточного для корректной имплантации винтов.

Objective. To analyze clinical efficiency of transpedicular single-segment osteosynthesis for treatment of thoracic and lumbar spine injuries. Material and Methods. Surgical treatment of 46 patients with thoracic or lumbar spine injuries was performed. Patients were operated on within 2 days to 7.5 months after trauma. Two-stage surgical treatment was applied. The first stage included transpedicular osteosynthesis at one level with internal spinal fixation system. The second stage included anterior fusion of the injured motion segments of the spine. Cases of delayed seeking for medical assistance required application of original authors' technique of intraoperative spine reposition or preliminary reposition with external transpedicular fixation device. Results. The applied treatment approach allowed achieving good (82.6 %) and satisfactory (15.2 %) Unsatisfactory result in one patient (2.2 %) was caused by osteosynthesis destabilization due to osteoporosis, and required reosteosynthesis. Conclusion. Transpedicular single-segment osteosynthesis has a high clinical efficiency and may be applied for the treatment of spinal injury with one destabilized motion segment, when preserved vertebral bone mass is sufficient for proper screw insertion

Keywords

ПОЗВОНОЧНИК, ТРАВМА, ТРАНСПЕДИКУЛЯРНЫЙ ОСТЕОСИНТЕЗ

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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