Risk factors for damage to the dura mater in thoracic and lumbar spine injury

Author:

Martikyan A. G.1ORCID,Grin A. A.2ORCID,Talypov A. E.3ORCID,Arakelyan S. L.4ORCID

Affiliation:

1. N.V. Sklifosovsky Research Institute of Emergency Medicine Hospital for War Veterans No. 2, 3 Bolshaya Sukharevskaya Sq., Moscow, 129090, Russia; 168 Volgogradskiy prospect, Moscow, 109472, Russia

2. N.V. Sklifosovsky Research Institute of Emergency Medicine; A.I. Yevdokimov Moscow State University of Medicine and Dentistry 3 Bolshaya Sukharevskaya Sq., Moscow, 129090, Russia; 1a, build. 4 Kuskovskaya str., Moscow, 111398, Russia

3. N.V. Sklifosovsky Research Institute of Emergency Medicine 3 Bolshaya Sukharevskaya Sq., Moscow, 129090, Russia

4. City Clinical Hospital No. 13 1/1 Velozavodskaya Str., Moscow, 115280, Russia

Abstract

Objective. To clarify a significance of the risk factors for damage to the dura mater (DM) in fractures of the thoracic and lumbar spine.Material and Methods. The study is based on the analysis of examination data and surgical treatment results of 350 patients with spinal cord injury (SCI). Fractures of the thoracic spine were observed in 124 patients, and those of the lumbar spine in 226. The study included 167 operated patients who underwent posterior decompression at the fracture level using laminectomy and transpedicular fixation of the injured spinal motion segment. There were two groups of patients: study group included 55 patients with DM rupture and control one – 112 patients without damage to the DM.Results. Damage to the DM was found in 32.9 % of patients, the rupture was localized on the posterior surface of the dural sac. In patients with rupture of the dura mater, ASIA type A and B neurological disorders were significantly more common (p = 0.00065). The DM damage occurs significantly more often in patients with  type C fracture according to the AOSpine classification, with multilevel spinal injuries and combined SCI (Injury Severity Score more than 27.58 ± 9.46 points). The most significant risk factors for the development of DM ruptures are narrowing of the spinal canal at the fracture level by more than 50 %, a fracture of the vertebral arch, an increase in the relative interpedicular distance of more than 20 %, and diastasis between the fragments of the arches by more than 2.5 mm.Conclusion. The damage to the dura mater is a common complication of vertebral fracture. The prediction of dura mater rupture will allow optimizing surgical approach and improving the treatment outcome.

Publisher

Association of Spine Surgeons

Subject

Anesthesiology and Pain Medicine,Orthopedics and Sports Medicine,Surgery

Reference28 articles.

1. Afaunov A.A., Kuz'menko A.V., Basankin I.V. Differentsirovannyi podkhod k lecheniyu bol'nykh s travmaticheskimi stenozami pozvonochnogo kanala na nizhnegrudnom i poyasnichnom urovne // Innovatsionnaya meditsina Kubani. 2016. № 2. S. 5–16. [Afaunov AA, Kuzmenko AV, Basankin IV. Differentiated treatment in patients with traumatic vertebral canal stenosis at lower thoracic and lumbar levels. Innovatsionnaya meditsina Kubani = Innovative Medicine of Kuban 2016;(2):5–16].

2. Grin' A.A., Kordonskii A.Yu., L'vov I.S., Kaikov A.K., Sytnik A.V., Bogdanova O.Yu. Faktor vremeni v khirurgii pozvonochno-spinal'noi travmy (obzor literatury) // Neirokhirurgiya. 2018. T. 20. № 3. S. 81–90. [Grin’ AA, Kordonskiy AYu, Lvov IS, Kaikov AK, Sytnik AV, Bogdanova OYu. The timing in surgery of spinal trauma (a review). Russian journal of neurosurgery. 2018;20(3):81–90]. DOI 10.17650/1683-3295-2018-20-3-81-90.

3. Krylov V.V., Grin' A.A, Timerbaev V.Kh., Genov P.G., Efremenko S.V., Grigor'eva E.V., Nikitin S.S., Kurenkov A.L., Khit' M.A. Travma pozvonochnika i spinnogo mozga. M., 2014. [Krylov VV, Grin’AA, Timerbaev VKh, Genov PG, Efremenko SV, Grigor’eva EV, Nikitin SS, Kurenkov AL, Khit’ MA. Trauma of the Spine and Spinal Cord. Moscow, 2014].

4. Aydinli U, Karaeminogullari O, Tiskaya K, Ozturk C. Dural tears in lumbar burst fractures with greenstick lamina fractures. Spine. 2001;26:E410–E415. DOI 10.1097/00007632-200109150-00012.

5. Cammisa FP Jr, Eismont FJ, Green BA. Dural laceration occurring with burst fractures and associated laminar fractures. J Bone Joint Surg Am. 1989;7:1044–1052. DOI: 10.2106/00004623-198971070-00011.

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3