SURGICAL TREATMENT OF CERVICAL SPINE INJURIES BY PRIMARY STABLE FIXATION WITH METAL CONSTRUCTIONS

Objective. To study efficiency of primary stable metal constructions and halo-vest for lower cervical spine injuries.

Material and Methods. Experience in surgical treatment of 62 patients with various injuries of lower cervical spine has been analyzed and summarized. The patients were grouped according to two main factors causing the injured spine dysfunction: dislocation damages (dislocations, fracture-dislocations), in which compression of neurovascular structures and disturbance of spine support ability are caused by vertebra dislocation; and vertebral body fractures (compression, compression-splintered) in which the compression and disturbance are arising from vertebral body destruction. In the first case a reduction of dislocated vertebra by various methods depending on the duration and rigidity of the injury was performed. In the second case a destroyed vertebral body was resected with subsequent stabilization.

Results. The choice of surgical tactics with use of modern metal fixation devices was substantiated for treatment of lower cervical spine injuries. Indications for the application of anterior and posterior stabilizing constructions were determined considering a compression direction of neurovascular structures and a degree of destruction of the spine support columns. An algorithm of surgical treatment was suggested basing on a principle of damage reposition irrespective of injury duration. High efficiency of Halo-traction for treatment of lower cervical spine injuries was proved and its most effective application (combination with various methods of internal fixation) was determined.

Conclusion. The application of primary stable metal devices in combination with halo fixation is a method of choice for treatment of lower cervical spine injuries.

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