Cauzele nereuşitelor chirurgiei de stabilizare a coloanei vertebrale cervicale

Abstract

Pentru evaluarea cauzelor şi mecanismului de pierdere a corecţiei deformaţiei după intervenţiile de fuziune intervertebrală a coloanei vertebrale cervicale a fost efectuat un studiu în baza analizei spondilogramelor evolutive a 96 de pacienţi operaţi. La toţi pacienţii au fost depistate pierderi de corecţie, care diferă în dependenţă de tipul leziunii şi metodele de stabilizare. A fost elaborată o clasificare ipotetică a perioadelor de stare funcţională a coloanei vertebrale cervicale operate. A fost evidenţiată prioritatea întrebuinţării plăcilor înşurubate şi implantelor din ceramică în comparaţie cu spondilodeza osteoplastică.

In an effort to reveal the mechanism and the causes of loss of achieved deformation correction during postoperative period in case of interbody fusion of cervical spine there has been undertaken an investigation, based on detailed clinical and x-Ray analysis of 96 operated patients in dynamics, combined with experimental investigations at the interbody fusion model. In all patients there has been stated the loss of originally achieved correction, differing in value and direction is, for the most part, a single-stepped and intermittent event, that occurs, as a rule, in the near postoperative period. The system tendency to reach the state of stable equilibrium under the effect of arising external forces turned out to be the mechanism of losses and the main cause is inadequate primary stabilization of the created block. A hypothetic classification of the functional state periods of the operated cervical spine has been derived. The main advantages of ceramospondylodhesis and screwed anterior metallic plates as compared with osteoplastic one have been revealed. There have been determined the necessity of further improvement of implants and surgical intervention techniques, aimed at the primary stabilization level increase.