Differentiated approach to the treatment of patients with fractures of lower thoracic and lumbar vertebral bodies and traumatic spinal stenosis

Abstract

Objective. To analyze clinical effectiveness of repositioning decompression of the dural sac and to justify a differentiated ap- proach to the decompression for traumatic spinal stenosis caused by damages of lower thoracic and lumbar vertebral bodies. Material and Methods. A total of 103 adult patients with injuries of the lower thoracic and lumbar spine accompanied by traumatic spinal canal stenosis were treated: 76 patients were included in the study group and 27 – in the control group. All patients underwent decompressive-stabilizing surgery with transpedicular fixation. In the study group, the priority was given to indirect repositioning decompression (more 50 %), in the control group – decompressive laminectomy (100 %). Results. In the study group, long-term results of treatment were assessed as good in 38 (79.2 %) cases, satisfactory – in 8 (16.7 %), and poor – in 2 (4.2 %). In the control group, good results were obtained in 13 (72.2 %) patients, satisfactory – in 4 (22.2 %), and poor – in 1 (5.6 %). Conclusion. Differentiated approach to decompression of the dural sac in patients treated for lower thoracic or lumbar spine injuries and traumatic spinal canal stenosis allowed avoiding laminectomy in 53.9 % of patients in the study group and per- forming anterior decompression consisting of subtotal corpectomy 1.9 times less often than in the control group.

Keywords

• spine
• injury
• decompression
• ligamentotaxis
• stenosis