Guided correction of posttraumatic deformities of the vertebral column

Abstract

Aim. To improve the results of treatment of patients with post-traumatic deformity of the vertebral column. Methods. Analyzed were the results of treatment of 400 patients with fractures of the thoracic and lumbar vertebrae. Lesions of types A2, A3 and B according to the classification of the Association of osteosynthesis were seen in 70% of cases, lesions of type C - in 30%. The external transpedicular «Crab» construction was used in 100 patients. An internal transpedicular construction of the Scientific Research Institute «Syntez» was used in 300 cases. Transpedicular spondylosynthesis with intraoperative correction of the deformity with an original repositioning device was performed in all patients. Explosion fractures with the destruction of the vertebral body and stenosis of the spinal canal demanded the implementation of decompressive-stabilizing interventions in 25% of the cases. Conducted were clinical and radiological (spondylography, computed tomography, magnetic resonance imaging) studies. Results. Proposed was a technique of guided correction of posttraumatic deformities of the vertebral column. Unstable fractures and dislocation-fractures, lesions of intervertebral discs in the thoracic and lumbar segments of the vertebral column, inveterate lesions, posttraumatic deformities of the thoracic and lumbar segments of the vertebral column served as indications for using guided correction. Kyphotic deformity at the level of the damaged segment was corrected in 98% of observed cases with hypercorrection in the range of 2°. The vertical size of the vertebral body was restored up to 100% in the early posttraumatic period and up to 82.3% in the remote posttraumatic period. Subluxation was corrected in 86.9%, while dislocation of the fractured vertebra was corrected in 96.7% of cases. Conclusion. The proposed method of correction of posttraumatic deformities of the vertebral column makes it possible to provide similar treatment results of patients operated both with using the external fixation device of the vertebral column «Crab» and using the submersible transpedicular construction of the Scientific Research Institute «Syntez».