Medical Worker

26/06/2022

An analysis of key publications devoted to transpedicular fixation of the cervical spine has been carried out. The installation of transpedicular screws in the cervical spine is a technically challenging procedure, the frequency of screw deviation from the optimal trajectory remains high even with the use of modern intraoperative technologies, and there is a risk of serious life-threatening complications. The use of this technique allows achieving reliable three-column stabilization of the cervical spine through only posterior approach, which is the preferred or only possible option for a limited group of patients. According to literature data, screw displacement beyond the pedicle borders occurs, on average, in 15–20 % of cases, while clinically significant complications occur in 4–5 % of cases. Among 32 operated patients, one severe neurologic complication caused by vertebral artery compression by the screw was noted. Of the 79 installed screws, 18 (22.79 %) cases of lateral pedicle wall perforation were observed. There were no cases of the fixator instability, infection and radiculopathy due to compression by the screw.

26/06/2022

To analyze the results of surgical treatment of patients with injuries and diseases of the cervical spine operated on using transpedicular fixation with free-hand technique. Matherial and Methods. A total of 97 patients with unstable injuries, congenital and acquired deformities, as well as with tumorous lesions of the cervical spine were examined. All patients were evaluated for the stability and reliability of transpedicular fixation in the long-term period, with the analysis of mistakes and complications that arose during treatment. Results. Positive results were obtained in 94.8 % of cases, and signs of fixation instability were absent in all patients. Despite 125 cases of pedicle wall perforation, only four patients required revision surgeries. A low rate of complications was noted, including no damage to the vertebral artery. The pain syndrome in patients decreased. Conclusion. The obtained results prove high efficiency and sufficient safety of the free-hand technique for the cervical spine fixation. At the same time, the technique requires careful preoperative preparation and examination of patients, thorough knowledge of anatomy of the operated area, and experience and qualification of the surgeon.

26/06/2022

HElLo

26/06/2022