METHOD OF CONDUCTING TRANSPEDICULAR FIXATION OF LOWER CERVICAL SPINE Russian patent published in 2019 - IPC A61B17/70 

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, namely, neurosurgery, and can be used when fixing the lower cervical spine from the dorsal access. Perform preoperative multiplanar reconstruction of the vertebra in the axial plane. Based on the data of a computer tomogram, according to which, according to the transpedicular trajectory, the following is determined: length of the screw (a), its thickness corresponding to the thickness of the leg of the vertebra (b), the angle of installation of the screw relative to the midline connecting the middle of the body of the vertebra and the spinous process (c), the distance of indentation in the lateral direction from the midline to make a skin incision (d) and the angle of installation of the C-arc of the x-ray machine relative to the midline for visualization of the leg (e). Then perform skin access markup on the patient's body. For this purpose from the midline corresponding to the spinous processes of the vertebrae, leave some lateral space of value (d), then perform x-rays in the anterior-posterior projection to determine the cranial and caudal border of the skin incision. In accordance with the marking, a skin incision is performed, after which the subcutaneous fatty tissue and the aponeurosis are dissected, the bundles of muscle fibers are moved apart to the lateral parts of the lateral vertebral masses. Next, to the point of insertion of the screws, a port with a spokes guide is installed, which is placed under x-ray control according to the screw installation trajectory at an angle (c). Port is rigidly fixed and under X-ray control with positioning of the X-ray arc at angles (c) and (e) transpedicular to the body of the vertebra establish a Kirchner needle, according to which, after preliminary reaming of the bone canal, a cannulated screw is installed with the parameters (a) and (b) determined at the preoperative stage. Intervention zone is visualized using an operating microscope, for which a small dilator retractor is fed into the screw installation area at a right angle to the line through a previously performed skin incision and expansion of the muscular canal. Wounds are closed in layers, beginning with the aponeurosis, finishing the operation with an intradermal suture.

EFFECT: method provides a reduction in the risk of postoperative complications and faster healing of postoperative wounds due to the implementation of preoperative multiplanar vertebra reconstruction and transpedicular fixation of the lower cervical spine.

1 cl, 10 dwg, 2 ex