Surgical treatment of complicated spinal injury in the acute period

Objectives. To estimate macroscopically the strength, rigidity and limit of elasticity in the “spinal segments – transpedicular fixator” system. versus similar characteristics of the intact spine under dislocating rotational loads. Material and Methods. Еxperiments with anatomic specimens of Th12–L2 segments were performed. Unstable damages of L1 and transpedicular fixation with 4 screw transpedicular spinal system were imitated. All specimens were exposed to the testing rotational load in universal test machine Zwick 1464. Results. It is established that under rotational load general strength of the injured Th12–L1–L2 spinal segments fused with transpedicular fixator is 20 % lower than that in a corresponding intact spine segment. Rigidity parameters of fused segments are 17.5 % lower than those of intact segments. Destabilization of «spinal segments – transpedicular fixator» system under rotational loads is caused by the compression of a bone substance in Th12 and L2 bodies with screws and a turn of screws around longitudinal rods due to a rod slip in anchoring elements. Conclusion. The performed study may serve a basis for following data analysis from a viewpoint of metal resistance and for development of optimal rehabilitation loads to the injured spine during postoperative period.

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Comparative Study of Rotational Stability Parameters of Transpedicular Spinal Fusion in Experiment

Afaunov

Усиков

Afaunov

et al. 2005

Hir. pozvonoč.

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Retrospective analysis of restoration of the anatomy of the damaged thoracic and lumbar spinal motion segment using transpedicular repositioning device

Усиков¹,

Kuftov²,

Monashenko

2022

Hir. pozvonoč.

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Objective. To carry out a retrospective analysis of the restoration of the anterior and posterior vertebral body heights and the elimination of deformation of the anterior spinal canal wall caused by thoracic and lumbar spine injury, based on the data of spiral computed tomography (SCT).Material and Methods. The study analyzed SCT data and case histories of 50 patients with thoracolumbar spinal cord injury operated on at different times after injury: up to 10 days – Group 1 and 11–30 days – Group 2. All patients underwent spinal reposition using a transpedicular device. The preoperative and postoperative SCT parameters were compared with the initial ones, which were calculated. The restoration of vertebral body heights and the elimination of deformation of the anterior spinal canal wall were compared in two groups depending on the distraction of interbody spaces and changes in the angle of segmental deformity.Results. In Group 1, the anterior and posterior dimensions of the vertebral body were restored, on average, by 95.3 ± 1.9 and 96.9 ± 1.4 % of the initial height; in Group 2 – by 87.4 ± 4.2 and 96.6 ± 1.8 %, respectively. The maximum restoration of the anterior dimensions of the vertebral bodies was achieved with distraction of the anterior interbody spaces closer to 100 % of the original size in the first and second groups. The maximum recovery of the posterior dimensions of the vertebral bodies was obtained by distraction of the posterior interbody spaces by 97 % or more of the original dimensions. The maximum elimination of the displacement of bone fragments from the spinal canal was obtained by distraction of the interbody spaces to a distance close to 100 % of the initial one, and when the obtained angle of segmental deformity coincided with the initial one.Conclusion. In the first 10 days after the injury, a greater percentage of the restoration of the anterior and posterior vertebral body heights and a decrease in the deformation of the anterior wall of the spinal canal were obtained. It was possible to maximally eliminate the deformation of the anterior wall of the spinal canal and restore the height of the anterior and posterior walls of the damaged vertebra by approaching the obtained dimensions of interbody spaces and the angle of segmental deformity to the initial ones.

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Surgical treatment of complicated spinal injury in the acute period

Cited by 2 publications

References 4 publications

Comparative Study of Rotational Stability Parameters of Transpedicular Spinal Fusion in Experiment

Comparative Study of Rotational Stability Parameters of Transpedicular Spinal Fusion in Experiment

Retrospective analysis of restoration of the anatomy of the damaged thoracic and lumbar spinal motion segment using transpedicular repositioning device

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