Krylov V.V., Lebedev V.V., Grin A.A., Ioffe Yu.S.
(Sklifosovsky Research Institute of Emergency Care, Moscow, Russia)
The report deals with information on neurosurgical care, rendered to patients with spinal pathology in hospitals of the Moscow Committee on Public Health. A number of patients, admitted to these hospitals in 1998 and 1999, was equal to 2894 and 3285 men respectively. Today patients with spinal pathology account for 15-18% of all cases, treated in neurosurgical departments. More than a half of patients with spinal pathology (61.6-62.5%) was cases with degenerative diseases of the spine. Despite considerable growth of an absolute number of patients during the last three years, surgical activity reduced from 62% up to 50%.
In 1997-1999 there were 1415 casualties with acute trauma of the spine. One should pay attention to decrease of surgical activity in spinal trauma. It reduced from 65.4% (1997) up to 56.5% (1999) in acute trauma. As for cases with sequelae of trauma of the spine and spinal cord, surgical activity in 1997 and 1999 was 63.3% and 54.0% respectively. There was a twofold increase of surgical activity in uncomplicated trauma of the spine in 1999 (24%) against 1997. During the last years it reduced from 79% up to 68% in complicated trauma of the spine.
In 1999 patients with associated trauma of the spine accounted for 7% of all cases with spinal trauma. Surgical activity in associated spinal trauma was 55%. Postoperative mortality in isolated trauma of the spine and spinal cord was 23.1%. A number of patients with degenerative diseases of the spine, treated in neurosurgical establishment of the Moscow Committee on Public Health in 1997, was 5273 men. There were 2024 patients in 1999; 1651 (81%) of them had osteochondrosis and discal hernias of the lumbar spine; 264 (13%) and 122 (6%) patients suffered from degenerative diseases of the cervical and thoracic spine respectively.