RU2377961C1 - Transpedicular vertebral fixation technique - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention concerns medicine, namely veterinary science. Several Kirschner's wires (in number multiple of four) are inserted into injured and adjacent vertebral bodies in cranial and caudal directions. The wires are delivered in quadrature to a vertebral body and at various angles to a saggital plane of the vertebral column. The wire is delivered through two cortical layers of the vertebral body, while its other part is bent towards the wire delivered in the adjacent vertebral body and fixed with wire. At the basis of spinous process on the right and left there are two spokes delivered with bending according to physiological position of the vertebral axis.

EFFECT: method ensures to reduce injuries, to provide extra durability, prevents wire migration and displacement of the vertebral bodies.

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Description

The invention relates to the field of medicine, namely veterinary medicine, and can be used to stabilize the spine in case of traumatic injury (fracture), tumor damage, after segmental corpectomy, as well as when performing a wide laminectomy to prevent secondary compression of the spinal cord when the vertebral bodies are displaced.

In connection with the horizontal position of the spine of the animal body, the vertebrae are prone to displacement in the dorsoventral and lateral directions. Therefore, fixation is necessary, which will prevent such a shift of the vertebral bodies relative to the axis.

A known method of stabilization of the spine using rods with thread and bone cement (methyl methacrylate) (H. Shebits, V. Brass. Surgical surgery of dogs and cats. M: Aquarium, 2001, pp. 345-346). The method consists in holding 4 rods with thread at an angle to each other in the bodies of adjacent vertebrae, after which the structure is fixed with bone cement. The disadvantage of this method is its invasiveness associated with a large diameter of the rods. In addition, the rods are fixed in cement in pairs on opposite sides of the spine, without creating a monolith, which can lead to displacement of the vertebrae.

The closest technical solution is the method described by the authors Nicoholas JH Sharp & Simon J Wheeler (Small animal spinal disorders, diagnosis and surgery, 2 ^nd edition, Edinburgh, London, New York, Oxford, Philadelphia, St. Lois, Sydney, Toronto, 2005, pg. 293-301). The essence of this method is to conduct several screws through the vertebral bodies at different angles, and parallel to the axis of the spine - Kirchner spokes, which are fastened with wire cerclages with screws and fixed with bone cement (methyl methacrylate).

The prototype has the following disadvantages:

1. Screws and knitting needles are fixed to each other only by wire cerclages and cement, which does not create a single monolith. In connection with the mobility of the spine of animals, screws and knitting needles can move relative to each other in the postoperative period.

2. Holding a screw into the vertebral body is more traumatic for the animal due to its larger diameter and the presence of a thread.

The objective of the present invention is to create a less traumatic method of transpedicular fixation of the spine, ensuring its reliable stabilization.

The problem is achieved by the fact that several Kirchner spokes (a multiple of four) are introduced into the bodies of the damaged and adjacent vertebrae in the cranial and caudal directions. The spokes are held at an angle of 45 ° to the vertebral body and at different angles to the sagittal plane of the spine. The needle is passed through two cortical layers of the vertebral body, the rest is bent towards the spoke held in the body of the adjacent vertebra, and fixed with a wire, forming a kind of rod parallel to the axis of the spine. The introduction of spokes at different angles relative to the sagittal plane of the spine and fixing them with wire to each other allow you to create a single monolith, which prevents the migration of spokes and displacement of the vertebral bodies. Before applying bone cement at the base of the spinous processes on the right and left sides, two spokes are carried out, bending them according to the physiological position of the axis of the spine, thereby preventing lateral displacement of the vertebral bodies. The needles held along the spinous processes are fixed with each other by wire. The final step is the application of bone cement (methyl methacrylate), which allows you to give extra strength and prevent the migration of spokes during the movement of the spine.

The inventive method is illustrated by figures 1, 2.

Fig 1. 4 Kirschner spokes (1) are held in the bodies of neighboring vertebrae at an angle of 45 °, bent towards each other and fixed with a wire (2). Two Kirschner spokes (1) are held along the spinous processes of neighboring vertebrae and are fastened together by a wire (2).

Fig 2. General view of the spine in a panoramic x-ray after the implementation of the transpedicular fixation of the spine: 2 Kirschner spokes (1) are drawn along the spinous processes of neighboring vertebrae and are fastened together by a wire (2) and bone cement.

The invention is illustrated by the following examples.

Example 1

A dog of the breed Border Terrier at the age of 3 years old was admitted to the clinic of Biocontrol LLC with pelvic paraparesis. An x-ray was performed on the animal, during which a swelling of the arch of 4-5 lumbar vertebrae was diagnosed.

The animal underwent segmental corpectomy and the claimed method of transpedicular fixation of the spine was applied.

6 days after the operation, full supportability of the limbs was restored.

Example 2

The Staffordshire Terrier dog was admitted to the clinic of Biocontrol LLC with paraplegia of the pelvic limbs. When performing myelography in an animal, a spinal fracture was diagnosed at the level of X-XI thoracic vertebrae. The animal underwent hemilaminectomy and the method of transpedicular fixation of the spine was applied.

2 months after the operation, the animal restored full supportability of the limbs.

The technical result of the proposed method is that it allows to prevent displacement of the vertebrae in the dorsoventral and lateral directions and to replace defects with segmental corpectomy performed with tumors of the body or arch of the vertebra, to stabilize the spine in case of fractures and wide laminectomy.

In addition, the claimed design is implanted inside the surgical wound, does not have external components and does not require special care and limitation of the movements of the animal.

Claims (1)

A method of transpedicular fixation of the spine, including the use of Kirschner spokes and bone cement, characterized in that Kirschner spokes are injected into the bodies of damaged and adjacent vertebrae in a multiple of four in the cranial and caudal directions at an angle of 45 ° to the vertebral body and at different angles to the sagittal plane of the spine, and the spoke is passed through two cortical layers of the vertebral body, the rest of it is bent towards the spoke held in the body of the adjacent vertebra, and fixed between Oloka; at the base of the spinous processes on the right and left sides spend two spokes, bend them in accordance with the physiological position of the spine and fix each other with a wire.

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