SU1600737A1 - Method of treating spondylolisthesis with radiculo-ischemic syndrome - Google Patents

Abstract

The invention relates to medicine, namely to vertebrology in the treatment of spondylolisthesis complicated by radiculo-ischemic syndromes. In order to ensure decompression of the spinal roots, epidural vessels, a laminectomy is performed, the displacement of the vertebra is eliminated, an additional posterior longitudinal ligament is dissected at the level of the lower third of the displaced vertebra, the suppurative adipose and scar tissue is removed, and the interdenal spondylodesis is removed.

Description

The invention relates to medicine, namely to orthopedics, traumatology and neurosurgery, and can be used as a method for the treatment of spondylolisthesis complicated by compression of the spinal roots and epidural vessels, or for the prevention of trogenic compression syndromes for the reduction of a displaced vertebra.

The purpose of the invention is the provision of decompression of the spinal roots, epidural vessels.

The method is carried out as follows.

Under general anesthesia, an offset vertebrae laminectomy is performed, the dural sac is shifted to the side. At the level of the lower third of the displaced vertebra, the dural sheath is bluntly peeled from the posterior longitudinal ligament. In the vacant space, a scalpel is inserted and dissected through the posterior longitudinal BIN. After displacing, the epidural vessels are isolated and the subcategory adipose and scar tissue is removed.

At the incision level, a diastasis is formed between the ends of the ligament. The intervertebral disc is resected at an offset level. After this, a resetting device is installed and the displaced vertebra is reduced. Bone autograft, taken from the iliac wing, is performed by interbody fusion. A reset device is disassembled and the surgical wound is harvested.

Example. Patient B., 27 years old, with degenerative spondylolisthesis of the L vertebra, 11 degree, segment instability, discirculatory myelopathy, inferior paraparesis, dysfunction of the pelvic organs.

Under general endotracheal anesthesia in the patient's position on the abdomen, a skin incision is made in the midline of the back from the spinous process L to S | vertebrae. The thoracolumbar fascia is dissected, the spinous processes and posterior parts of the L2-Lf arches and vertebrae are skeletal. Using Yanson's nippers, a laminectomy L is performed with the unders05

with

pelvic processes and inter-articular part of the du -i. The dural sac is displaced to the side; the tumes of the paths are separated from the posterior longitudinal ligament at the level of the lower third of the vertebral body 4. A revision of the spinal canal revealed varicose veins of the anterior epidural plexus, tension of the posterior longitudinal ligament between the upper edge of the body L4 and L4-5 intervertebral disc, LS tension of the spinal roots. The anterior venous epidural plexus is displaced laterally, the posterior longitudinal ligament is cut with a scalpel at the level of the lower third of the L vertebral body. Then, a subjacent formation is formed, consisting of adipose and scar tissue. This formation and 4-5 intervertebral disk are resected.

Metal rods are inserted through the roots of the arcs into the vertebral bodies and into the wings of the iliac bones outside the operative wound. A resetting device was mounted and the L4 vertebra was reduced. Visually and with the help of radiography, the control of the achieved correction was carried out. In interstitial defect 4-. introduced bone autotrans

plantation taken from the wing of the parasitic bone. The spinous processes of the La-S vertebrae are fixed with metal plates, and the adjusting device is dismantled. The wound is sutured in layers, left drainage tube.

in the postoperative period, it is allowed to turn in bed on the second day. The patient is lifted up in 2-4 weeks, depending on the general condition. There is no need for external fixation. Bone ankylosis is formed by 5-6 months after surgery.

Claims (1)

Invention Formula A method for treating spondylolisthesis Dikulja with the PA-ischemic syndrome by resection arc displaced vertebra, reduction, fusion, characterized in that in order to provide a decompression spinal roots, epidural vessels, further dissect the posterior longitudinal ligament at the level of the lower third of the displaced vertebra was removed subcutaneous adipose and scar tissue.