V.B. Zavarukhin, D.N. Dzukaev, O.N. Dreval
(Faculty of Neurosurgery, Russian Medical Academy of Postgraduate Education, Municipal Clinical Hospital N 67, Moscow)
The Study Goal: To analyze outcomes, watched in surgical treatment of dislocation fracture of cervical spine, and to develop its optimum method.
Materials and Methods. There were 79 cases, operated for dislocation fractures of cervical spine in the First Neurosurgical Department of the Municipal Clinical Hospital N 67 in 2002-2005. Preoperative planning of surgical intervention was based on profound study of results of X-ray, CT and MRI examinations and their comparison with data of neurological examination. Taking into account anatomic and pathobiomechanical peculiarities of cervical spine, interventions were performed, using an anterior approach, Total removal of an injured disc and all fragments, located in a vertebral canal, was followed by applying an original device for dislocation reduction.
The last stage of an operation was stabilization of injured segments. Polysegmental fixation methods were preferable in case of dislocations, accompanied by injuries of articular processes.
Results and Discussion. The analysis of results has demonstrated such advantages of this method of surgical treatment, as its less traumatic character and smaller blood loss, a physiologic position of a patient on an operating table, rational removal of a pathologic factor, instrumental dislocation reduction under visual control of the vertebral canal contents, possibility of using modern technologies for creation of reliable spondylodesis.
Conclusion. The above method with application of the original device for dislocation reduction makes it possible to solve different problems, using one and the same surgical approach.