RU149172U1 - METHOD FOR TREATING SPIN INJURIES IN THE BREAST AND LUMBAR DEPARTMENT IN DOGS AND CATS - Google Patents

Abstract

1. A method of treating injuries of the spinal column in the thoracic and lumbar spine in dogs and cats, comprising closed osteosynthesis of the damaged spine with knitting and an external fixation apparatus, characterized in that the external fixation apparatus is assembled from structural blocks for external transosseous osteosynthesis, which are installed before the fracture zone and after the fracture zone and are interconnected after correction of the spinal column. 2. The method according to claim 1, characterized in that the blocks of structures for external transosseous osteosynthesis are made up of sector and semicircular arrangements in combination with a universal monoblock from the veterinary orthopedic set VOSYS-OPTIMA.

Description

The utility model relates to veterinary medicine, and more specifically to veterinary surgery, and is intended to restore the integrity of the spinal column in dogs and cats with fractures in the chest and lumbar spine.

To date, questions about methods of fixing the spinal column for various injuries and the possibilities of optimal preservation of the spinal cord are very relevant in both veterinary and humanitarian medicine. The multiplicity of injuries with mechanical action on different parts of the spine and spinal cord requires a constant search for technical solutions to stabilize fractures and dislocations of the spine, and restore conduction of the spinal cord. In humanitarian medicine, various authors use immersion osteosynthesis methods to stabilize the spinal column using transpedicular fixation, stabilizing plates, cercular linkage of the spinous vertebrae, etc. These methods allow you to restore deformations of individual vertebrae during fractures, and part of the spine as a whole, but there is a risk of early and late complications.

Known works associated with the use of external fixation devices, most often in the treatment of natural deformations (distortions) of the spinal column, for example, A method for the treatment of post-traumatic instability of the spinal column in small pets (see P. No. 2428946, RU, IPC А61В17 / 56). In the method, the stabilized spine is fixed using a compression-distraction apparatus. From the opposing surfaces of the articular processes of the vertebrae forming the arched joints, cartilage removal is performed, they are compared with each other. Through spliced surfaces, conduct spokes with a threaded thread of the working end. In the process of fixing the stabilized spinal column, the axial rotational displacement of the spokes is carried out to full

extraction. The disadvantage of this method is that it is designed to eliminate post-traumatic consequences.

Closest to the claimed method is the Method of osteosynthesis of the cervical spine in small pets (Pat. No. 2328245, RU, IPC A01D 1/00). In the method, closed osteosynthesis of the damaged cervical vertebra is performed. Fixing spokes are carried through the front and / or rear structures of the vertebrae lying above and below the damaged one with their subsequent reposition using an external fixation device. The disadvantage of this method is that in the postoperative period, displacement of the vertebrae is possible due to the insignificant fixation area, because the proposed fixation scheme does not tolerate large loads.

The utility model is based on A method for treating injuries of the spinal column in the thoracic and lumbar spine in dogs and cats has been tasked with simplifying transosseous osteosynthesis and increasing stability, to improve clinical results.

The problem is solved in that in a method that includes the fixation of the vertebrae using an external fixation device, a closed surgical intervention is performed with the fixation of the fracture zone by hardware structures for external transosseous osteosynthesis, and the blocks of structures that fix the vertebrae are installed in front of the fracture zone and after the fracture zone, and after correction of the spine, they are interconnected.

It is known that the sooner the restoration of the integrity of the spinal column, decompression of the spinal cord and treatment is started, the more favorable the clinical outcome of the disease and the obvious cases of complete rupture of the spinal cord with a significant discrepancy between spinal fragments. Therefore, there is a need for primary correction of the integrity of the spinal column in the early stages after an injury with the restoration of hemocirculatory functions of the spinal cord. Stable osteosynthesis using external fixation devices for injuries of the spinal column in the thoracic and lumbar regions allows for emergency surgery regardless of the patient's condition, can be combined with the treatment of polytrauma and revision events associated with it. For

osteosynthesis of fractures and dislocations of the thoracic and lumbar spine requires a number of requirements:

- early surgical intervention;

- accurate and optimal stabilization of the area of spinal injury (fracture, dislocation);

- rigid fixation of the near-fracture sector, which protects the broken segment from muscle action;

- low invasiveness;

- careful attitude to the injured spinal cord;

- lack of postoperative consequences.

The hardware structures for external osteosynthesis from the VOSYS-OPTIMA veterinary orthopedic kit (see 3. No. u201301454 of 02/07/2013, Ukraine) are capable of meeting these requirements, which provide the opportunity for tactical remodeling of structures during operations on the thoracic and lumbar spine.

The method is illustrated by photographs. In FIG. 1 - fractures of the thoracolumbar spine; FIG. 2 - stable fixation of the thoracic spine by the external fixation apparatus in cats; FIG. 3 - stable fixation of the lumbar spine with an external fixation apparatus in a dog; FIG. 4 - x-ray correction of the spinal column by an external fixation device in a cat; FIG. 5 is a radiograph of the correction of the spinal column by an external fixation apparatus in a dog.

The method is implemented as follows. In the shortest possible time after an injury in an animal under the conditions of the natural anatomical position of the vertebrae below and above the fracture zone, they are fixed with hardware blocks. For fixation, sector and semicircular arrangements are used (see Fig. 4.5) in combination with a universal monoblock from the veterinary orthopedic set VOSYS-OPTIMA. Then, the spinal column is corrected and the hardware blocks are interconnected. The entire surgical cycle (closed surgery) is performed without skin incision and soft tissue trauma. The stability of fixation is achieved by increasing the contact area between the fixing devices and the spinal column. As a result, thanks

the compression capabilities of the devices, the consolidation of fractures occurs much earlier. The presence of a minimally invasive factor allows avoiding postoperative complications associated with a surgical infection. The devices do not create discomfort, animals move easily with them. The method allows to exclude the phase of wound healing from monitoring to restore cerebro-dependent reflexes.

An example implementation of the method.

The method was used in the Veterinary complex "BION" (Sevastopol, Ukraine) in 24 dogs aged 8 months. up to 5 years old weighing from 2 to 34 kg and 7 cats from one and a half to 8 years with fractures-dislocations of the spinal column in the thoracolumbar region.

VOSYS-OPTIMA devices were placed in the early stages, when no more than 2-3 days passed from the moment of fracture. After anesthesia and treatment of the surgical field, animals that were in a natural lateral position were injected with clamps and superimposed segments of the hardware block below the fracture, and in 7 dogs in the absence of pain sensitivity. In this group, anxiety was not noted, in the remaining animals, the segment block was superimposed after complete anesthesia. The body position in all operated animals was natural, lateral. The exception was cats, in which the position of the body during the application of the apparatus changed depending on the plane of the inserted clamps. After the sectors were assembled, they were connected to each other and the fixation strength of the entire block was determined, then a similar arrangement was applied to the pre-fracture region of the spine. Then, the spinal column was corrected and the blocks were interconnected (see Fig. 4,5). The introduction of fixatives was carried out using appropriate guidelines, the entire operating cycle took place without a skin incision and soft tissue trauma. The postoperative period did not include the process of wound healing, which saves time for the direct restoration of cerebrospinal reflexes. The clinical effectiveness of the measures in the form of reflexological improvements, the appearance of motor skills, the presence of pain sensitivity was assessed after the animal was withdrawn from anesthesia and, as a rule, was progressive, further reflexological assessment was carried out daily, using adequate

clinical objectives of therapy. In 5 cases in dogs and 3 cases in cats for 10 days. the appearance of expected reflexes was not observed. Animals were euthanized. The remaining 19 dogs and 4 cats underwent further treatment until the removal of the apparatus and stabilization of the spinal column with a further rehabilitation course.

The method has several advantages:

- the ability to fix the vertebrae at the earliest possible time without prior preparation of the patient;

- the operation is performed without loss of blood, is less traumatic;

- the absence of an operative wound minimizes the risk of infection of the fracture area in conditions of local circulation disorder;

- the ability to install a segment block of the post-fracture region halves the time of surgery and anesthesia of the animal, which is important during the period of increasing phenomena of spinal shock

- the operation allows for early reflexological studies of the spinal cord;

- operations can be of an outpatient nature, do not require the involvement of highly qualified specialists to solve complex surgical problems, with certain skills the method is quite simple.

Claims (2)

1. A method of treating injuries of the spinal column in the thoracic and lumbar spine in dogs and cats, comprising closed osteosynthesis of the damaged spine with knitting and an external fixation apparatus, characterized in that the external fixation apparatus is assembled from structural blocks for external transosseous osteosynthesis, which are installed before the fracture zone and after the fracture zone and are interconnected after correction of the spinal column. 2. The method according to claim 1, characterized in that the structural units for external transosseous osteosynthesis are made up of sector and semicircular arrangements in combination with a universal monoblock from the VOSYS-OPTIMA veterinary orthopedic kit.

Images