НЕВРОЛОГИЧЕСКИЕ НАРУШЕНИЯ У ДЕТЕЙ С ОСЛОЖНЕННЫМИ ПОВРЕЖДЕНИЯМИ ПОЗВОНОЧНИКА В ГРУДНОМ И ПОЯСНИЧНОМ ОТДЕЛАХ ДО И ПОСЛЕ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ

Abstract

Objective. To assess the dynamics of neurological disorders after surgical treatment in pediatric patients with complicated fractures of the thoracic and lumbar spine using ASIA scale. Material and Methods. Outcomes of surgical treatment in 32 children aged from 3 to 17 years with isolated injuries of the thoracic and lumbar spine accompanied by neurological disorders were analyzed. Type A3 fractures occurred in 50.0 %, type B in 6.3 %, and type C in 43.7 % of cases. Patients were divided into 2 groups: Group I included 12 patients with complete spinal cord injury, and Group II - 20 patients with incomplete injury. Results. In all patients, a vertebral-medullary conflict was eliminated and a rigid fixation of the damaged spinal motion segments was achieved. Voluntary movements in lower limbs of patients from Group I did not recover. Patients from Group II had significant decrease in paresis degree and sensitivity recovery in lower limbs: the ability of independent walking without aids and assistance was completely restored in 37.5 %, the ability to walk with one/two-sided assistive devices was achieved in 18.8 %, and significant improvement in lower limb support ability - in 6.3 % of cases. Conclusion. Surgical treatment of children with complicated spinal injury should include the elimination of vertebral-medullary conflict, complete reduction, and rigid stabilization with reconstruction of physiological profiles of injured spinal motion segments.