A method for determining the optimal technique of surgical intervention in patients with post-traumatic kyphotic deformity of the thoracolumbar spine in the late period of spinal injury.
- Autores: Ptashnikov D.A.1,2, Magomedov S.S.1,3, Rominsky S.P.1,3, Mytyga P.G.4
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Afiliações:
- “National Medical Research Center of Traumatology and Orthopedics named after R.R. Vreden” of the Ministry of Health of the Russian Federation
- «North-Western State Medical University named after I.I. Mechnikov».
- FGBU "National Medical Research Center of Traumatology and Orthopedics. R.R. Vredena" Ministry of Health of Russia
- Edição: Volume 15, Nº 3 (2022)
- Páginas: 198-205
- Seção: Original articles
- URL: https://journal-vniispk.ru/2070-478X/article/view/233336
- DOI: https://doi.org/10.18499/2070-478X-2022-15-3-198-205
- ID: 233336
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Resumo
Introduction. Spinal fractures account for 63.6 cases per 100,000 populations. Of these, the largest number falls on the Th10-L2 zone. Regardless of the choice of treatment tactics in the early period of spinal injury, a vast number of patients continue to complain of local pain and deformity. In these patients, surgical treatment may be indicated. At the preoperative stage, the operating surgeon faces the problem of choosing an intervention of sufficient volume.
The aim of the study was to determine the optimal amount of corrective surgical interventions in patients with kyphotic deformity that has developed as a result of a vertebral fracture.
Methods. Patients with a medical history of vertebral compression fracture and local kyphotic deformity greater than 11 degrees were enrolled in a single-centre, prospective, experimental study. All patients were divided into three groups according to the studied algorithm. Patients in group A underwent two-stage surgical treatment with corporectomy, implantation of a mesh interbody implant, and posterior transpedicular fixation from two approaches. Group B patients underwent one-stage surgical treatment with corporectomy and implantation of a mesh interbody implant from a single approach. Patients of group C underwent corrective vertebrotomy without the use of a mesh implant. The degree of deformity correction, the traumatism of surgical intervention, the stability of the metal structure, the formation of a bone block, and changes in the functional status of the patient were assessed. Patients were followed up for 24 months after surgical treatment.
Results. The study was completed by 114 patients. Surgical treatment options used allowed achieving good results in the correction of deformity in all groups, in groups B and C the traumatism of the operation was significantly (p=0.05) lower than in group A. A bone block was formed in all study groups. It is important to note that patients in group B had transient radicular pain in the early postoperative period, which probably associated with the traction of neural structures during the installation of an interbody mesh implant.
Conclusion. Application of the presented algorithm allowed us to achieve comparable beneficial results in patients of all study groups, however, a small sample and the absence of control subgroups do not allow us to extrapolate the study results to the entire population.
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##article.viewOnOriginalSite##Sobre autores
Dmitriy Ptashnikov
“National Medical Research Center of Traumatology and Orthopedics named after R.R. Vreden” of the Ministry of Health of the Russian Federation;«North-Western State Medical University named after I.I. Mechnikov».
Email: drptashnikov@yandex.ru
ORCID ID: 0000-0001-5765-3158
Código SPIN: 7678-6542
Doctor of Medical Sciences, Professor, Head of the Department No. 18 NMRC TO R.R. Vredena
Head of the Department of Traumatology and Orthopedics, Military Clinical Hospital with a course in dentistry, State Budget Educational Institution of Higher Professional Education of the Ministry of Health and Social Development of the Russian Federation and North-Western State Medical University named after I.I. Mechnikov.
Rússia, 195427, Russia, St. Petersburg, Ak. Baikova, 8,
191015, Russia, St. Petersburg, st. Kirochnaya, 41,
Shamil Magomedov
“National Medical Research Center of Traumatology and Orthopedics named after R.R. Vreden” of the Ministry of Health of the Russian Federation;
Email: dr.shamil@mail.ru
ORCID ID: 0000-0001-5706-6228
Código SPIN: 3481-1899
Ph.D. head of department No. 12 NMRC TO R.R. Vredena
Rússia, 195427, Russia,St. Petersburg, Ak. Baikova, 8,Sergey Rominsky
“National Medical Research Center of Traumatology and Orthopedics named after R.R. Vreden” of the Ministry of Health of the Russian Federation;
Email: rominskiy@mail.ru
ORCID ID: 0000-0002-7771-3274
Código SPIN: 5920-1552
doctor dep. No. 12 NMRC TO R.R. Vredena
Rússia, 195427, Russia,St. Petersburg, Ak. Baikova, 8,Pavel Mytyga
FGBU "National Medical Research Center of Traumatology and Orthopedics. R.R. Vredena" Ministry of Health of Russia
Autor responsável pela correspondência
Email: paveji.official@gmail.com
ORCID ID: 0000-0002-4386-9780
Código SPIN: 6853-3113
doctor dep. No. 12 NMRC TO R.R. Vredena
Rússia, 195427, Russia,St. Petersburg, Ak. Baikova, 8,Bibliografia
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