Contemporary Views on the Pathogenesis of Trauma to the Spinal Cord and Peripheral Nerve Trunks

Shulga, Anastasia; Норкин, И. А.; Нинель, В. Г.; Puchinyan, D M; Zaretskov, V. V.; Коршунова, Г. А.; Островский, В. В.; Смолькин, А. А.

doi:10.1007/s11055-015-0148-y

Cited by 6 publications

(5 citation statements)

References 103 publications

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“…Данный вид повреждений нередко сопровождается ана-томическим повреждением спинного мозга, по-этому лечение таких больных требует особенно-го внимания в этическом аспекте, учитывая тот факт, что зачастую единственным показанием для хирургического вмешательства является функцио-нальная несостоятельность позвоночника [18,19]. Следует также отметить, что тяжелый характер травмы может быть причиной различных патоло-гических состояний, которые не позволяют про-извести коррекцию деформации в остром перио-де.…”

Section: Discussionunclassified

Surgical treatment of gross posttraumatic deformations in thoracic spine

Shul'ga

Евгеньевич²,

Zaretskov

et al. 2017

Pediatr Traum Orthop Reconstr Surg

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Научно-исследовательский институт травматологии, ортопедии и нейрохирургии ФГБОУ ВО «СГМУ им. В.И. Разумовского» Минздрава России, Саратов Грубые посттравматические деформации грудного отдела позвоночного столба -это результат высокоэнерге-тической травмы, которая в последнее время в силу ряда причин все чаще встречается у детей. Данный вид повреждений нередко сопровождается анатомическим повреждением спинного мозга, поэтому лечение таких больных требует особенного внимания в этическом аспекте. Зачастую единственным показанием для хирур-гического вмешательства является функциональная несостоятельность позвоночника. Учитывая данный факт, а также нередко тяжелое соматическое состояние пациентов, травматичность операции должна быть сокраще-на до минимума. Наряду с этим необходимо достигнуть адекватной коррекции деформации, надежной стаби-лизации позвоночного столба и восстановления ликвородинамики. В литературных источниках последних лет все чаще встречаются публикации, посвященные успешному использованию различных вариантов дорзальных вмешательств (P/VCR) при нестабильных повреждениях у детей. В статье представлен клинический случай хирургического лечения грубой посттравматической деформации грудного отдела позвоночника с застарелым переломовывихом позвонка Th 7 у ребенка 15 лет.Ключевые слова: повреждение позвоночника у детей, травма спинного мозга, хирургическое лечение, спондилосинтез. Rigid severe post-traumatic thoracic spine deformities result from frequent, recent high-energy trauma in children with an increasing frequency due to a variety of reasons. These types of injuries are commonly followed by spinal cord anatomic injury; therefore, the treatment of these patients warrants special attention from the ethical viewpoint. Generally, the only indication for surgical intervention is spinal dysfunction. Considering this and the patients' ordinary severe somatic state, surgical trauma should be minimized as much as possible. However, for adequate deformity correction, effective spine stabilization and restoration of liquorodynamics is necessary. Recent studies have reported the successful use of different methods of dorsal interventions (P/VCR) in cases with unstable damages in children. Here, we present the case of a 15-year-old boy who underwent surgical treatment for coarse post-traumatic thoracic spine deformity with chronic fracture-dislocation of Th7 vertebra. SURGICAL TREATMENT OF GROSS POSTTRAUMATIC DEFORMATIONS IN THORACIC SPINE©

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Section: Discussionunclassified

Surgical treatment of gross posttraumatic deformations in thoracic spine

Shul'ga

Евгеньевич²,

Zaretskov

et al. 2017

Pediatr Traum Orthop Reconstr Surg

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“…Several primary and secondary pathophysiological events are precipitated after the t-SCI episode. The primary events are provoked spontaneously, including tissue injury, axonal breakdown, and vascular disruption [ 6 ]. Associated secondary aspects resulted from primary events are delayed, which include series of biochemical, molecular, and cellular alterations, leading to oxidative stress, inflammation, and pain that may extend from hours to weeks [ 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Euxanthone inhibits traumatic spinal cord injury via anti-oxidative stress and suppression of p38 and PI3K/Akt signaling pathway in a rat model

Yao

Ren

Wang

et al. 2021

Translational Neuroscience

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Background Owing to neurite promoting, antioxidant and anti-inflammatory effects of Euxanthone (Eux), the investigation was aimed to probe the neuroprotective efficacy of Eux against traumatic spinal cord injury (t-SCI) in rats and whether Eux can improve neuropathic function in t-SCI. Method Sprague-Dawley (SD) rats were randomized in – Sham, t-SCI, Eux30, and Eux60 (t-SCI + 30 and 60 mg/kg respectively). Animals with compression force-induced t-SCI were subjected to estimation of locomotor functions. Spinal cord water content and Evans blue (EB) effusion were determined for quantifying edema and intactness of the spinal cord. Oxidative stress and immunochemical markers were quantified by ELISA and western blotting. Results Findings revealed that Eux60 group animals had greater Basso, Beattie, and Bresnahan (BBB) and (incline plane test) IPT score indicating improved locomotor functions. There was a reduction in the spinal edema and water content after Eux treatment, together with lowering of oxidative stress markers. The expression of IL-6, IL-12, IL-1β, caspase-3, RANKL, TLR4, NF-κB, p-38, PI3K, and Akt in spinal cord tissues of t-SCI-induced rats was lowered after Eux treatment. Conclusion Overall, the investigation advocates that Eux attenuates t-SCI and associated inflammation, oxidative damage, and resulting apoptosis via modulation of TLR4/NF-κB/p38 and PI3K/Akt signaling cascade.

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“…Fractures of the thoracolumbar transitional vertebra (Th 11 –L 2 ) account for nearly 90% of vertebral column injuries [ 1 – 3 ]. Of these, nearly 20% are burst fractures [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Optimization of Spondylosynthesis for Certain Thoracolumbar Burst Fractures

Likhachev¹,

Арсениевич

Ostrovskiy

et al. 2020

Sovrem Tehnol Med

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Intermediate transpedicular fixation, i.e. additional insertion of transpedicular screws into the injured vertebrae, is an improvement to the most popular surgical intervention for spinal injuries, currently gaining widespread use in clinical practice. Unilateral insertion of transpedicular screws into the injured vertebrae allows combining the advantages of intermediate transpedicular fixation with the possibility to perform anterior column support without remounting the transpedicular system. The aim of the study was to use biomechanical computer modeling for evaluating the stability of intermediate transpedicular fixation components, which allow performing anterior column support if necessary. Materials and Methods. DICOM files obtained during CT scan of a patient with intermediate thoracolumbar spine injury and the ANSYS software were used. Stability of the transpedicular system and supportability of the complementary Mesh implant installed with unilateral intermediate transpedicular screws were evaluated using computer modeling based on the finite element method. Results. The values of stress and displacement fields for spine-hardware systems with various arrangements have been obtained. The maximum loads exceeding bone tissue strength (153-161 MPa) were registered for standard 4-screw system (190 MPa) when modeling the load equivalent for walking and falling from a standing position. The use of the proposed fixation system arrangement supplemented with intermediate screws allows obtaining loads in the spine-hardware system not exceeding these thresholds. Complementary eccentric Mesh implant enhances fixation stability of the transpedicular system with intermediate screws. Conclusion. The results show the high degree of mechanical stability of the proposed hardware arrangement and its potential efficacy for thoracolumbar transitional vertebra stabilization.

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Contemporary Views on the Pathogenesis of Trauma to the Spinal Cord and Peripheral Nerve Trunks

Cited by 6 publications

References 103 publications

Surgical treatment of gross posttraumatic deformations in thoracic spine

Surgical treatment of gross posttraumatic deformations in thoracic spine

Euxanthone inhibits traumatic spinal cord injury via anti-oxidative stress and suppression of p38 and PI3K/Akt signaling pathway in a rat model

Optimization of Spondylosynthesis for Certain Thoracolumbar Burst Fractures

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