Инновационная медицина Кубани (Apr 2019)
ISSUE OF NEUROLOGICAL COMPLICATIONS RISK AFTER SURGERY FOR POSTTRAUMATIC DEFORMITY OF LUMBAR AND THORACIC SPINE
Abstract
Background. Surgical correction and stabilization of post-traumatic spine deformations is connected with a neurologic complication development risk. However, at the moment there are no predictive scores for risk assessment of surgical neurologic complications in this category of patients.Aim. We offer an express system to estimate risk of neurologic complications after surgery in patients with posttraumatic thoracic and lumbar spine deformations.Material and methods. The analysis of treatment results of 124 patients with post-traumatic deformations of thoracic and lumbar spine during 2003–2017 was carried out. Among those there were 70 males and 54 females aged from 18 up to 54 years. Operations are executed in terms from 6 months up to 14 years from the moment of a trauma. In 61 cases deformation development was a result of diagnostic mistakes and/or not effective conservative treatment. Failed surgery was observed in 63 cases.Results. The analysis of clinical material has allowed to allocate 3 factors predetermining possibility of neurologic complications after surgical treatment. They are as follows: a functional condition of a spinal cord and roots in the late post-traumatic period, the spondylosis characteristics of the post-traumatic stenosis of the vertebral channel and localization of the spinal column deformation. For each of these factors there are several gradations according to their symptom intensity. All possible combinations of various gradation of above mentioned three specified factors sum up 46 estimated options for the risk of neurologic complication development following surgery for posttraumatic lumbar and thoracic spine deformations.Conclusion. This suggested score could be a basis for express estimation of the risk for post-surgical neurologic complications development.
