IMMUNOLOGICAL MONITORING OF BONE BLOCK FORMATION DURING TREATMENT OF SPINE INJURIES

Abstract

Objective. To define the value of immunological monitoring for assessment of condition of patients with spine injuries. Material and Methods. Blood analysis was performed in 111 patients who underwent two-stage surgical treatment for spine injury. The assessment included general clinical blood test, phenotyping of lymphocytes, functional-metabolic activity of neutrophils, the level of circulating immune complexes, immunoglobulins, cytokine concentration (IL- 1α, IL1-β, IL-1ra, IL-8, and FNO-α), acute-phase proteins before operation and at different postoperative terms. Results. Specific dynamics of immunological parameters during surgical treatment of spine injuries allowed the development of criteria for prediction of delayed consolidation and incomplete fusion in the vertebral motion segment when treating spine injury with external fixation apparatus and anterior spinal fusion. A norm, diagnostic sensitivity, diagnostic specificity, and expected predictive value were calculated for each of the offered criteria. Their use in clinical practice helps to predict complications at different stages of treatment (before operation, at third or at tenth day after operation) and to correct the tactic of patient care. Conclusion. Immunological monitoring during treatment of spine injuries can be used for prediction of postoperative complications such as delayed consolidation and fusion failure in motor segment of the spine.