About Surgical Tactics in Damages of the Thoracic and Lumbar Parts of the Spine

Abstract

In the overall structure of spinal injuries in adults vertebro-spinal injury ranges from 2.2% to 20.6%. When fractures of the spine are complicated by neurological disorders, most commonly lower thoracic and lumbar vertebrae - 39.2% and 48.5% are injured respectively. 45 patients with damage to the thoracic and lumbar spine, admitted to the neurosurgical department of RCSUMA. The main method of preparation of the combined graft is performed in the following manner: Bone graft is taken from the iliac crest and wings of the fibula of the patient, depending on the size of the vertebra. Next, the graft is cleaned of soft tissues and placed in a glass, which contains 3% of hydrogen peroxide, then in a second glass with a solution of broad-spectrum antibiotic for 5-10 minutes. To improve and strengthen support ability of bone graft, a hole is formed in the middle of the graft with the drill, which is then filled with bone cement. Bone cement is dissolved before use with a special solvent and liquid form is introduced with a syringe through the hole formed in the bone graft. The bone cement hardens within the bone hole and thereby enhances support ability of the transplant. To increase the coupling properties of the graft a few teeth are formed at its ends. The resulting clinical and neurological findings in these patients showed that after a comprehensive operative and conservative treatment 31 (68.9%) patients had positive neurological symptoms, increased sensitivity below the level of damage, and also the growth of the movement in the distal extremities was noted improvement of function of the pelvic organs in the form of urination. But despite undertaken complex therapeutic measures in 14 (31.1%) patients is not a marked improvement in neurological performance was not noted during treatment. The dynamics of neurological disorders after surgical treatment showed that in complicated injuries of the body of thoracic and lumbar vertebrae combined graft provides sufficient support ability of the spine and thus creates the conditions necessary to restore the function of damaged spinal cord and its elements