Tactics of treatment of severe spinal injuries using modern technologies

The experience in treatment of 139 patients with cervical (71 patients) and thoracolumbar (68 patients) spine injuries is reviewed. The treatment of cervical spine injuries was performed with halo apparatus which was more effective in injuries of upper cervical zone. In 14 patients with lower cervical spine injuries the surgery with «Orion» system was carried out. All patients with fractures or posttraumatic deformities of the thoracic and lumbar spine underwent operative treatment. Eight patients had systemic osteoporosis. Reduction-stabilization operations with decompression and different spondylodesis were also performed. Steffee system was used in 33 cases, Cotrel-Dubousset in 22, Tenor in 7, and Luque in 6 cases. Operative stabilization allowed to achieve primary rigid fixation of the mobile injured lumbar segments for early activization of patients. For the achievement of good outcome the different choice of curative tactics is required. Concomitant osteoporosis significantly influences the long term results. Long term preservation of stability depends on the proper choice and the length of a fixation device as well as on the method of spondylodesis.