Email this article Anterior stabilization of spine column in the staged surgical treatment of patients with fractures of thoracic and lumbar vertebrae with low bone mineral density
- Authors: Afaunov A.A.1, Basankin I.V.2, Takhmazyan K.K.2, Giulzatyan A.A.2, Mukhanov M.L.1, Chaikin N.S.3
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Affiliations:
- Federal State Budgetary Institution of Higher Education “Kuban State Medical University” of the Ministry of Health of the Russian Federation
- State Budgetary Healthcare Institution “Research Institute — Regional Clinical Hospital No. 1 named after Professor S.V. Ochapovsky”
- State Budgetary Healthcare Institution “Stavropol Regional Clinical Hospital”
- Issue: Vol 27, No 3 (2020)
- Pages: 5-15
- Section: Original study articles
- URL: https://journals.rcsi.science/0869-8678/article/view/39493
- DOI: https://doi.org/10.17816/vto20202735-15
- ID: 39493
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Abstract
Aim. To determine the clinical effectiveness of anterior stabilization in the surgical treatment of patients with traumatic injuries of the thoracic and lumbar spine with reduced bone mineral density.
Materials and methods. The study included 238 patients with thoracic and lumbar vertebral fractures with reduced bone mineral density (BMD). The age of patients is from 48 to 85 years. There are following types of fractures according to F. Magerl (1992): A1.2, A1.3, B1.2, B2.3. BMD of the vertebrae was decreased (T-score from –1.5 to –3.5).
Results. All patients underwent short segment transpedicular fixation (TPF) with four-screw systems. In group 1 were included 68 patients who underwent TPF without cemented augmentation of screws. Group 2 included 170 patients who underwent TPF reinforced with a cement. Both groups were divided into 2 subgroups. Subgroup 1.1 included patients, which were operated on in two stages. The first stage is TPF. The second stage is the anterior stabilization. Subgroup 1.2 included patients who underwent only TPF. Patients in group 2 were divided into two subgroups in a similar way. The results and complications according to clinical and spondylometric criteria were studied. Correlation analysis was performed between surgical technique, surgical tactics and the treatment results in the four selected subgroups. The observation period is at least 2 years.
Conclusion. 1. When using TPF with cement augmentation for the treatment of patients with fractures of the thoracic and lumbar spine with reduced BMD, the anterior stabilization of injured spinal motion segment as a second stage of surgical treatment does not provide clinical advantages compared to the use of only TPF with cement augmentation. 2. In case of cementless TPF in patients with reduced BMD, anterior stabilization of the injured spinal motion segment is necessary. Only when anterior stabilization is performed, the stability of fixation is ensured. It is sufficient to preserve the anatomical relationships restored during the operation and functional adaptation of patients in the long-term period after surgery.
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##article.viewOnOriginalSite##About the authors
Asker A. Afaunov
Federal State Budgetary Institution of Higher Education “Kuban State Medical University” of the Ministry of Health of the Russian Federation
Author for correspondence.
Email: afaunovkr@mail.ru
ORCID iD: 0000-0001-7976-860X
professor, MD, PhD
Russian Federation, KrasnodarIgor V. Basankin
State Budgetary Healthcare Institution “Research Institute — Regional Clinical Hospital No. 1 named after Professor S.V. Ochapovsky”
Email: basankin@rambler.ru
ORCID iD: 0000-0003-3549-0794
MD, PhD
Russian Federation, KrasnodarKarapet K. Takhmazyan
State Budgetary Healthcare Institution “Research Institute — Regional Clinical Hospital No. 1 named after Professor S.V. Ochapovsky”
Email: dr.karpo@gmail.com
ORCID iD: 0000-0002-4496-2709
Traumatologist-orthopedist, neurosurgeon. Physician of Neurosurgery department No. 3
Russian Federation, KrasnodarAbram A. Giulzatyan
State Budgetary Healthcare Institution “Research Institute — Regional Clinical Hospital No. 1 named after Professor S.V. Ochapovsky”
Email: abramgulz@gmail.com
ORCID iD: 0000-0003-1260-4007
MD
Russian Federation, KrasnodarMikhail L. Mukhanov
Federal State Budgetary Institution of Higher Education “Kuban State Medical University” of the Ministry of Health of the Russian Federation
Email: pputinn@yandex.ru
ORCID iD: 0000-0002-9061-6014
MD
Russian Federation, KrasnodarNikita S. Chaikin
State Budgetary Healthcare Institution “Stavropol Regional Clinical Hospital”
Email: ch.nik92@yandex.ru
ORCID iD: 0000-0003-4297-6653
Neurosurgeon
Russian Federation, StavropolReferences
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