Saratov JOURNAL of Medical and Scientific Research

Differentiated approach to surgical treatment of patients with rigid posttraumatic deformities of thoracic and lumbar spine

Year: 2017, volume 13 Issue: №3 Pages: 772-779
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shul'ga А.Е., Zaretskov V.V., Bogomolova N.V., Korshunova G.A., Smol'kin A.A.
Organization:
Summary:

The aim: to investigate the outcomes of surgical treatment of patients with rigid posttraumatic deformities in thoracic and lumbar spine on the basis of the comparative analysis of different approaches to the planning of operative intervention management. Material and Methods. A comparative analysis of the results of surgical treatment of 138 patients (main group) with old injuries of thoracic and lumbar spine was carried out with the help of the proposed surgery managing algorithm and 86 patients (comparison group) — without taking the given algorithm into account. The choice of surgery managing in the main group of patients was based on the study of the spinal deformity degree, pain syndrome intensity and life quality indices of patients before and after surgery. Results. In the main group in 122 (88,4%) patients after the surgery spinal deformity correction exceeding 80% was achieved, pain syndrome regressed in accordance with the visual analog scale up to 3 points and less, life quality indices improved up to the level of 0-25%. Conclusion. The application of the proposed algorithm approach enables surgeons to get persistent positive outcomes in the majority of cases.

Bibliography:
1. Norkin IA, Baratov AV, Fedonnikov AS, et al. The significance of medical and social parameters of spinal damages in the specialized health care organization. Hir Pozvonoc 2014; (3): 95-100
2. Stoltze D, Harms J, Boyaci В. Correction of post-traumatic and congenital kyphosis: indications, techniques, results. Orthopade 2008; 37 (4): 321-338
3. Norkin IA, Zaretskov VV, Arsenievich VB, et al. High-tech solutions in surgical treatment of spine injuries and disease. In: Papers of Russian research and practice conference and exhibition «High Medical Technologies». Moscow, 2007; p. 217-218
4. Wilson J, Buchowski JM. Post-traumatic deformity: prevention and management. Handb Clin Neurol 2012; 109: 369-384
5. Shul'ga AE, Norkin IA, Ninel' VG, et al. Modern aspects of pathogenesis of the trauma of the spinal cord and trunks of peripheral nerves. Rossiiskii fiziologicheskii zhurnal im. I.M. Sechenova 2014; 100 (2): 145-160
6. Shchanitsyn IN, Ivanov AN, Bajanov SP, et al. Methods for studying changes in the spinal cord after traumatic injuries of peripheral nerves. Regionarnoe krovoobrashcheniye i mikrotsirkuliatsiya2014; 13/1 (49): 13-22
7. Wilson JR, Tetreault LA, Kim J, et al. State of the Art in Degenerative Cervical Myelopathy: An Update on Current Clinical Evidence. Neurosurgery 2017; 80 (3): 33-45
8. Shulga AE, Zaretskov VV, Ostrovsky VV, et al. Towards the causes of secondary post-traumatic deformations of thoracic and lumbar spine. Saratov Journal of Medical Scientific Research 2015; 11 (4): 570-575
9. Schmidt S, Thomann KD, Rauschmann M. Deformities following spinal injury at the thoracolumbar junction. Orthopade 2010; 39(3): 256-263
10. Zaretskov VV, Arsenievich VB, Likhachev SV, Shul'ga AE, Titova Ju.l. Transpedicular fixation in comminuted fractures of bodies of thoracic and lumbar vertebrae. Saratov Journal of Medical Scientific Research 2014; 10 (3): 441-446
11. Hempfing A, Zenner J, et al. Restoration of sagittal balance in treatment of thoracic and lumbar vertebral fractures. Orthopade 2011; 40 (8): 690-702
12. Obeid I, Laouissat F, Vital JM. Asymmetric T5 Pedicle Subtraction Osteotomy (PSO) for complex posttraumatic deformity. Eur Spine J 2013; 22 (9): 2130-2135
13. Gum JL, Carreon LY, Buchowski JM, et al. Utilization trends of pedicle subtraction osteotomies compared to posterior spinal fusion for deformity: a national data base analysis between 2008-2011. Scoliosis Spinal Disord 2016; 11 (1): 25
14. Arsenievich VB, Zaretskov VV, Shul'gaAE,Pomoshchnikov SN. The application of ventricular multisegmental systems in the interjacent thoracolumbar spine. Hir Pozvonoc 2007; (3): 16-19
15. Rerikh VV, Borzykh КО. Staged surgical treatment of posttraumatic deformities in the thoracic and lumbar spine. Hir Pozvonoc 2016; 13 (4): 21-27
16. Mayer М, Ortmaier R, Koller Н, et al. Impact of sagittal balance on clinical outcomes in surgically treated T12 and L1 burst fractures: analysis of long-term outcomes after posterior-only and combined posteroanterior treatment. Biomed Res Int 2017; 2017: 1568258
17. Shul'ga AE, Norkin IA, Ninel' VG, et al. Contemporary views on the pathogenesis of trauma to the spinal cord and peripheral nerve trunks. Neuroscience and Behavioral Physiology 2015; 45 (7): 811-819
18. Auerbach JD, Lenke LG, Bridwell KH, et al. Major complications and comparison between 3-column osteotomy techniques in 105 consecutive spinal deformity procedures. Spine 2012; 37 (14): 1198-1210
19. Zaretskov VV, Artem'yeva |A. Comparative analysis of radiographic measuring methods for thoracic kyphosis. Vestnik travmatologii i ortopedii im. N.N. Prizorova 1997; (3): 58-59.

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