Главная Тезисы Лечение заболеваний и повреждений позвоночника Surgical treatment of injuries and disorders of the upper cervical spine

Surgical treatment of injuries and disorders of the upper cervical spine

Introduction: Anatomical and biomechanical peculiarities of the upper cervical spine as well as relations' specific of its vessel and nervous structures are main reason's factors which provoke the biggest doubts in choosing of treatment's tactics in cases of injuries and disorders of this region. Despite on fact that in present time there are quite large amount of fixators for stabilization of the upper cervical spine and subjacent functional spinal units, all of them have got some shortcomings, and using of some of them needs some multiple special devices and is quite complicated technically.

Purpose: to assess outcomes of using of novel technologies for occiput-cervical fusion and atlanto-axial fusion and devices for their realization in cases of treatment of the patients with injuries and disorders of the upper cervical spine.

Material & Methods: There were 9 patients with injuries (7 patients) and disorders (2 patients) of the upper cervical spine which underwent surgical treatment. In spite of this there was done posterior occiput-cervical instrumentation for 6 patients with fixing system developed at SISJP, and there was done posterior cross-segmental С1/3 tension instrumentation for 3 patients according to method created by us. Clinical and radiological evaluation of outcomes after surgical treatment of this patients' group we perfomi in accordance with criteria proposed by us. Maximal follow-up endpoint was 36 months. Due to their insistence removal of fixateurs was done for two patients after occiput-cervical fusion in terms of more than 24 months, and this allowed obtaining intra OP confirmation of fusion on the level of surgery.

Results: Positive dynamics took place in all cases after clinical assessment of outcomes. According to radiological evaluation, there was noted fusion also in all cases. One of the components of the fixateur was broken in one case, but there was no any negative influence for final outcome because of it. None cases of screw migration or loosing of fixators capacities was noted.

Conclusion: Therefore, we conclude that developed at SISJP technologies for posterior occiput-cervical fusion and fusion of the upper cervical spine with devices proposed by us are effective for reliable stabilization by minimal risk of rise of some kind of complications in cases of surgical treatment of injuries and disorders for cranio- vertebral region and the upper cervical spine.

Barysh A.E.
Sytenko Institute for Spine and Joints Pathology of the Ukrainian Academy of Medical Sciences, Kharkiv, Ukraine

 

Информация на данном сайте не является руководством к самолечению!
Консультация с лечащим врачом - обязательна!