SURGICAL TREATMENT OF POSTTRAUMATIC DEFORMITIES IN THE THORACIC AND LUMBAR SPINE

Abstract

Objective. To analyze clinical efficiency of some variants of staged surgical treatment of posttraumatic deformities in the thoracic and lumbar spine by transpedicular instrumentation osteosynthesis (ТО). Material and Methods. Presented information includes the experience of surgical treatment of 35 patients (19 male and 16 female patients at the age of 18 to 54 years) with posttraumatic deformities of the thoracic and lumbar spine who were operated on within 6 months to 7 years after trauma. Three variants of staged surgical technique were used. The first variant included TO with internal instrumentation, and anterior interbody fusion of injured vertebral motion segments (VMS). The second variant comprised of TO with external device for gradual restoration of anatomical relations in the injured spinal segments, TO with internal transpedicular system, and interbody fusion. The third variant included TO with external apparatus, anterior interbody fusion after reposition, and spine osteosynthesis with ventral spinal system. Results. Used tactics resulted in 77.1 % of good and 20.0 % of satisfactory treatment outcomes. One patient (2.8 %) presented an unsatisfactory result due to late suppuration and removal of hardware. Conclusion. An additional stage of transpedicular osteosynthesis with the device for external fixation enables favorable conditions for reposition. Spine osteosynthesis with ventral systems performed at the conditions of full-scale reposition and stabilization of the injured VMS has the tactical advantages and is to be preferred.