Dorsal correction of rigid posttraumatic deformities of thoracic spine in spinal cord injury

Aim: the analysis of the outcomes of dorsal remedial operation in patients with rigid posttraumatic deformities in thoracic spine accompanied by spinal cord injury. Material and Methods. We analyzed surgical outcomes of transpe-dicular anchorage of 28 patients aged 34.5±19.5 with rigid posttraumatic deformities of thoracic spine: 12 patients with acute injury (1st group), 16 patients with long-term deformities (2nd group). The results were estimated by the severity of neurological deficit, pain intensity,the grade of deformity correction as well as by the LQ indexes. All interventions were performed from&nbsp;lateral medial approach with transpedicular anchorage. Results. There were no changes of neurological&nbsp;deficit in both patient groups, however we managed to obtain sufficient spine deformity correction. Pain&nbsp;intensity in patients of 1st group was 6 (5.3-7.8), function — 46.5 (42.5-49.8); 12 months postsurgically&nbsp;pain intensity corresponded to the score of 0 (0.0-0.1); function — 82 (79.0-86.0). The intensity of&nbsp;pain syndrome was significantly reduced in 2nd group patients (VAS reduced from 6 (4.0-7.0) to 1&nbsp;(0.0-2.0), which in turn allowed for earliest rehabilitation of patients in sedentary position, thus&nbsp;increasing their mobility and functional independence (FIM increased from 70 (65.0-76.0) to 92&nbsp;(89.0-95.0). Conclusion. Single-step dorsal surgical interventions in patients with rigid deformities of&nbsp;thoracic spine allow restoring normal spinal column axis, performing reconstruction of spinal cord&nbsp;column and safely stabilize injured locomotor segments both in acute and in late periods of spinal cord&nbsp;injury.</p

Towards the causes of secondary post-traumatic deformations of thoracic and lumbar spine

The purpose of the study is to analyze and systematize main causes of secondary spine deformations forming in patients who had operations due to thoracic and lumbar spine damages. Material and Methods. The analysis of poor surgical results of 155 patients previously operated due to various thoracic and lumbar spine damages has been conducted. All patients had complications associated with secondary spinal column deformations at various time after the intervention. Standard investigation included the analysis of patients' complaints, their previous history, somatic, neurological and orthopedic status. Results. The intensity of spinal column deformation was defined due to the character and level of primary trauma structurally characterized predominantly by unstable damages. However as it has been found in this research the main cause of this complicated pathology lied in the number of tactical and technical pitfalls of primary surgical treatment. Conclusion. Surgical operations due to secondary post-traumatic deformations in most cases are laborious and are accompanied by significant surgical trauma therefore systematization and analysis of the main causes of poor results of primary spine surgery may contribute to the preventive treatment of this type of pathology