SU1447358A1 - Method of anterior lateral spondilodesis of super lumbar vertebra - Google Patents

Abstract

The invention relates to medicine, in particular to spinal surgery, and concerns a method of operative access to the bodies of the upper lumbar spine. The aim of the invention is to reduce the trauma of operative access by maintaining the integrity of the ribs and the diaphragm. For this, the operative access is performed taking into account the coincidence of the incision line with the projection of the bodies of the upper lumbar vertebrae and the alignment of the operative access plane with the axis of optimal operative action, thereby reducing the displacement of tissues and organs, eliminating the need for rib resection.

Description

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The invention relates to medicine, namely to spinal surgery, and concerns a method for the prompt treatment of injuries and diseases of the upper lumbar spine.

The purpose of the invention is to preserve the integrity of the ribs and the diaphragm.

The method is carried out as follows.

The victim is placed on the late posterior vertebral size equal to the width of the wing of the iliac bone in the area of coarse. The length of the groove is determined by the distance between the main locking plate of the body of the 1st lumbar vertebra and the covering lobe of the body of the 3rd lynical vertebra. In a similar size, a graft is taken from the crest of the wing of the right iliac bone through a separative skin incision. The collected translational table in position on the back, the planter is firmly inserted into the formed, the right edge of the body is raised under the angular groove, after which the roller is lowered with opel 30 ° to the plane of the operating table. At the same time it is necessary to follow

so that the graft does not come out of the groove.

Hemostasis. If possible, restore

Under the patient, a cassette with an X-ray film is inserted to intraoperatively clarify the location of the broken body.

vertebra. After treatment of the operative wound, the layers are sutured in layers tightly with an osmone, and a skin incision is made by subcutaneous suppression of the drainage tube in the area of cellulose and intercostal muscles prior to the abdominal operations. Tales The patient is placed in

the integrity of the anterior longitudinal ligament.

tires in the 9th intercostal space from the pleural sinus in the direction of the midline of the abdomen to the outer edge of the right 2o abdominal muscles. After exposure of the peritoneum, the latter is peeled off from the lower surface of the diaphragm towards the spine in a blunt way.

After displacement of the liver medially, the pararenal fatty tissue together with the adrenal gland and kidney exposes the antero-lateral surface of the large lumbar muscle, the anterolateral surface of the bodies of the 1, 2 and 3 lumbar vertebrae is exposed longitudinally. After ligation of the segmental vessels, they are dissected and their stumps are mixed sideways, the anterior longitudinal ligament is dissected H-shaped, and the osseous base of the bodies 1, 2, 3 of the lumbar vertebrae and intervertebral discs are exposed. Two needles are inserted into the intervertebral discs between 1-2 and 2-3 in the lumbar vertebrae in the frontal plane and spontalograms are made to clarify the localization of the broken vertebral body. Then, a pre-prepared rear polyvic (gypsum) bed is raised.

The proposed method makes it possible to reduce the trauma of the surrounding tissues and organs due to their minimal displacement, which is achieved by coinciding the incision line with the projection of the spinal cord 25 on the chest and the coincidence of the plane of the wound with the optimal axis of the surgical action.

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The proposed method eliminates the need to remove the rib, which also reduces access trauma.

Claims (1)

Invention Formula Method of anterolateral spinal fusion of the upper lumbar vertebrae by dissecting the tissues to the peritoneum with its detachment, mixing to the midline of the abdomen to sever the large lumbar muscles, resect the affected part of the vertebral bodies, and fix them with an autograft Method of anterolateral spinal fusion of the upper lumbar vertebrae by dissecting the tissues to the peritoneum with its detachment, mixing to the midline of the abdomen to sever the large lumbar muscles, resect the affected part of the vertebral bodies, and fix them with an autograft The roller of the operating table and 40 are removed from the iliac crest, which distinguishes the disks adjacent to the body of the compressed vertebra. The more completely the outer fibers of the fibrous ring are excised, the more fully the reclination of the spine is achieved at the level of damage. Then a groove is formed in the said vertebrae for insertion of the graft in the form of a truncated pyramid with a depth of at least one-third. so that, in order to preserve the integrity of the ribs and the diffraction, the soft tissues dissect from the pleural sinus in the 9th intercostal space towards the midline of the abdomen to the outer edge of the rectus abdominis muscle, additionally mix the perinephric tissue, kidney, adrenal glands in the distal direction . posterior size of the vertebral body, width equal to the width of the wing of the iliac bone in the area is rough. The length of the groove is determined by the distance between the main locking plate of the body of the 1st lumbar vertebra and the covering lobe of the body of the 3rd lynical vertebra. In a similar size, a graft is taken from the crest of the wing of the right iliac bone through a separative skin incision. The collected transran is sewn in layers tightly with the drainage tube in the area of operations. Tales The patient is placed in the integrity of the anterior longitudinal ligament. pre-cooked rear polyvikovu (gypsum) bed. The proposed method makes it possible to reduce the trauma of the surrounding tissues and organs due to their minimal displacement, which is achieved by coinciding the incision line with the projection of the vertebral bodies on the chest and the coincidence of the plane of the wound with the optimal axis of the operative action. The proposed method eliminates the need to remove the rib, which also reduces access trauma. Invention Formula Method of anterolateral spinal fusion of the upper lumbar vertebrae by dissecting the tissues to the peritoneum with its detachment, mixing to the midline of the abdomen to sever the large lumbar muscles, resect the affected part of the vertebral bodies, and fix them with an autograft from the iliac crest, distinguishing- from the iliac crest, distinguishing- so that, in order to preserve the integrity of the ribs and the diffraction, the soft tissues dissect from the pleural sinus in the 9th intercostal space towards the midline of the abdomen to the outer edge of the rectus abdominis muscle, additionally mix the perinephric tissue, kidney, adrenal glands in the distal direction .