Основні типи ушкоджень хребців при пухлинах хребта (ретроспективне дослідження)

Abstract

Damage to the vertebrae as a result of neoplastic processes leads to serious health consequences for people of all ages and genders. Unsuccessfully constructed tactics for the treatment of primary and metastatic spinal lesions are the result of severe orthopedic and neurological complications, which can lead to fatal consequences. To decide what type of surgery to perform, you need to have more information than the type of tumor. To create a rational algorithm for the treatment of patients with loss of spinal support due to neoplastic lesions of the thoracic and lumbar vertebrae should consider the features of damage to the anatomical structures of the spinal motor segment and identify the main types of vertebral injuries. The purpose of the study was based on a prospective analysis of patients with spinal cord injuries, and description of the types of vertebral injuries. Material and methods. In the Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine. In the period from 2008 to 2017, 264 patients with pathological changes in the spine were diagnosed. The age of patients was from 18 to 81 years. There were 137 men and 131 women. 39 (14.8%) patients did not have vertebral body deformity accompanied by bone edema, 168 (63.6%) patients had vertebral body damage without destruction of other anatomical structures, 52 (19.7%) patients were diagnosed with deformation of the vertebral body with damage to the arches and joints, and 5 (1.9%) patients had damage to the posterior support complex. Results and discussion. As a result of a prospective analysis of patients with spinal tumors, 5 types of vertebral lesions were identified by cancer: 1 – without deformation, accompanied by bone edema and visualized on MRI; 2 – deformation of the vertebral body up to 30% without damage to the posterior wall or with a small defect; 3 – deformation of the vertebral body > 30%, but < 60% with damage to the posterior vertebral wall; 4 – deformation of the vertebral body> 60% with damage to the posterior vertebral wall; 5 – deformation of the vertebral body with damage to the arches and joints. Conclusion. As a result of damage to the anatomical structures of the vertebrae by the tumor process, important morphological features were identified: the degree of damage to the vertebral body; the magnitude of local kyphosis; deformation of the posterior wall of the vertebral body, on the basis of which the types of vertebral injuries are determined