DIFFERENTIAL SURGICAL TREATMENT OF CERVICAL SPINE STENOSIS

Abstract

Objectives. To determine the efficacy of various procedures of precise differentiated surgical decompression for elimination of prevailing clinical manifestations of degenerative stenosis depending on a character and localization of morphological changes (degenerative or posttraumatic) in the cervical spine, the expediency and necessity of application of various fixation and stabilization techniques. Material and Methods. Eighteen patients included in the study were examined for degenerative stenosis in the cervical spine. All of them underwent decompressive surgery. International representative scales were used to estimate results depending on basic clinical syndrome. Results. The increase in latency and central sensory conduction time (according to somatosensory evoked potentials data) indicates that ischemic compression lesion is mainly caused by dorsal compression. In this case a laminectomy according to Hirabayashi was performed. The increase in central motor latency time (according to central transcranial magnetic stimulation) greater by 30 % than a norm indicates that ischemic lesion is caused by anterior vertebral artery compression. In this case a corporectomy was performed. Conclusion. Compression lesions in cervical spine stenosis have local ischemic character and correspond to blood supply basin of compromised spinal or segmental artery. There is a correlation of ischemic compression focus localization with a character of electrophysiological conduction and responses. Differential character of surgical decompression provides observation of minimal invasive principles and better neurological restoration of patients.