Acta Biomedica Scientifica (Nov 2017)

ALGORITHM OF SURGICAL TREATMENT OF LUMBAR SPINAL AND DURAL SAC STENOSIS

  • V. A. Sorokovikov,
  • Z. V. Koshkaryova,
  • V. A. Byvaltsev,
  • A. A. Kalinin,
  • O. V. Sklyarenko,
  • A. P. Zhivotenko,
  • V. E. Potapov,
  • A. V. Gorbunov

DOI
https://doi.org/10.12737/article_5a0a850694d693.75349869
Journal volume & issue
Vol. 2, no. 6
pp. 44 – 51

Abstract

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A number of tasks were set: how to develop a morphometric method for diagnosing stenosing processes that would allow us to specify the localization of the pathological process, its volume and extent; to develop a classification of stenosing processes depending on the stenosis coefficient Zn; to develop a new method of latent instability of the vertebral-lumbar segment of the lumbar spine; to study the nature of multilevel lesions of intervertebral discs in osteochondrosis leading to stenosing processes of the spinal canal. Improvement of diagnostic methods in stenosing processes allowed the authors to develop new ways of diagnostics and surgical treatment of this pathology and to offer new medical technologies for practical health care. All of the above is the basis for the development of an algorithm for the surgical treatment of stenosing processes of the spinal canal and dural sac, which is the subject of this work. 416 patients underwent various surgical procedures depending on the severity of clinical and neurological disorders, the stenosis coefficient, the instability in the vertebral-motor segments, the magnitude of the extensional-flexion amplitude, the nature of the pathological process and the degree of its compensation. Of 416 patients, 179 patients underwent decompressive-stabilizing intervention with the installation of a dynamic system using a mini-invasive approach with a minimally invasive reconstruction of the spinal canal. Decompression-stabilizing intervention with rigid interspinous fixation, minimally invasive access to the vertebral canal with its minimally invasive reconstruction was performed in 96 patients. 141 patients underwent decompressive-stabilizing intervention with transpedicularfixation, with extended minimally invasive reconstruction of the spinal canal with its minimally invasive approach.

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