Dorsal correction of rigid posttraumatic deformities of thoracic spine in spinal cord injury
Year: 2018, volume 14 Issue: №3 Pages: 611-617
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shul'ga А.Е., Zaretskov V.V., Likhachev S.V., Smolkin A.A.
Organization:
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shul'ga А.Е., Zaretskov V.V., Likhachev S.V., Smolkin A.A.
Organization:
Summary:
Aim: the analysis of the outcomes of dorsal remedial operation in patients with rigid posttraumatic deformities in thoracic spine accompanied by spinal cord injury. Material and Methods. We analyzed surgical outcomes of transpe-dicular anchorage of 28 patients aged 34.5±19.5 with rigid posttraumatic deformities of thoracic spine: 12 patients with acute injury (1st group), 16 patients with long-term deformities (2nd group). The results were estimated by the severity of neurological deficit, pain intensity,the grade of deformity correction as well as by the LQ indexes. All interventions were performed from lateral medial approach with transpedicular anchorage. Results. There were no changes of neurological deficit in both patient groups, however we managed to obtain sufficient spine deformity correction. Pain intensity in patients of 1st group was 6 (5.3-7.8), function — 46.5 (42.5-49.8); 12 months postsurgically pain intensity corresponded to the score of 0 (0.0-0.1); function — 82 (79.0-86.0). The intensity of pain syndrome was significantly reduced in 2nd group patients (VAS reduced from 6 (4.0-7.0) to 1 (0.0-2.0), which in turn allowed for earliest rehabilitation of patients in sedentary position, thus increasing their mobility and functional independence (FIM increased from 70 (65.0-76.0) to 92 (89.0-95.0). Conclusion. Single-step dorsal surgical interventions in patients with rigid deformities of thoracic spine allow restoring normal spinal column axis, performing reconstruction of spinal cord column and safely stabilize injured locomotor segments both in acute and in late periods of spinal cord injury.
Keywords: thoracic spine, spine and spinal cord injury, spine, rigid posttraumatic deformities, dorsal correction
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. Spine surgery 2014; (3): 95-100
2 Shulga АЕ, 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): 811-9
3 Шульга A.E., Зарец-ков В.В., Коршунова ГА. и др. Хирургическая коррекция грубой посттравматической деформации грудного отдела позвоночника. Ортопедия, травматология и восстановительная хирургия детского возраста 2017; 5 (3): 80-6
4 Siebert JR, Eade AM, Osterhout DJ. Biomaterial approaches to enhancing neurorestoration after spinal cord injury: strategies for overcoming inherent biological obstacles. Biomed Res Int 2015; 2015: 752-5
5 Baindurashvili AG, Vissarionov SV, Aleksandrovich YuS, Pshenisnov KV. Spinal cord injury in children. St. Petersburg: Onli-press, 2016; 88 p.
6 Tomilov АВ, Kuznetsova NL. Orthopedic correction of posttraumatic spinal deformities. Genij Ortop 2012; (1): 60-3
7 Shulga АЕ, 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): 570-75
8 Zaretskov VV, Arsenievich VB, Likhachev SV, et al. A clinical case study of long-term injury of the thoracic and lumbar spine. Pediatric Traumatology, Orthopaedics, and Reconstructive Surgery 2016; 4 (2): 61-6
9 Shulga АЕ, Zaretskov VV, Bogomolova NV, et al. Differentiated approach to surgical treatment of patients with rigid posttraumatic deformities of thoracic and lumbar spine. Saratov Journal of Medical Scientific Research 2017; 13 (3): 772-9
10 Cecchinato R, Berjano Р, Damilano М, Lamartina С. Spinal osteotomies to treat post-traumatic thoracolumbar deformity. Eur J Orthop Surg Traumatol 2014; 24 (1): 31-7
11 Ryabykh SO, Khomchenkov MV, Savin DM. Vertebral column resection technique to treat sequelae of severe spine and spinal cord injury. Spine surgery 2013; (4): 13-6
12 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
13 Vissarionov SV, Drozdetsky AP, Kokushin DN, Belyanchikov SM. Surgical treatment of a patient with fracture-dislocation in the thoracic spine. Spine surgery 2011; (3): 21-5
14 Obeid I, Laouissat F, Vital JM. Asymmetric T5 Pedicle Subtraction Osteotomy (PSO) for complex posttraumatic deformity. Eur Spine J 2013; 22 (9): 2130-5
15 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
16 Aebi M. АО spine classification system for thoracolumbar fractures. Eur Spine J 2013; 22 (10): 2147-8
17 Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. AdvClin Rehabil 1987; 1:6-18
18 Zaretskov VV, Artemyeva IA. Comparative analysis of radiographic measuring methods for thoracic kyphosis. Vestnik travmatol. i ortoped. im. N.N. Priorova 1997; (3): 58-9
19 Rerikh VV, Borzykh КО, Rakhmatillaev ShN. Atypical segmental corrective vertebrectomy in the treatment of post-traumatic thoracic kyphosis. Spine surgery 2014; (4): 20-4.
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