MINIMALLY INVASIVE METHOD OF STABILIZATION IN COMMINUTED FRACTURES OF VERTEBRAS OF THORACOLUMBAR SPINE Russian patent published in 2020 - IPC A61B17/70 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to traumatology and vertebrology and can be used for stabilization in comminuted fractures of vertebras of thoracolumbar spine. External non-invasive dosed spinal reclination is performed. For this purpose, an external device intended for reclination and reduction is installed under local Novocaine blockade as per Schneck. Posterior lumbar frame of the external device, with a support pad, is placed under the place of vertebral fracture of the thoracolumbar region. Front sternal and pubic carcasses of the device are interconnected by threaded rods. Front frames are laid with support pads on front body, front frames and rear carcass are connected by means of threaded rods. Frames are moved on rods and an anterior breast frame is placed above the episternum, an anterior pubic carcass above the pubic articulation, a posterior lumbar frame above the injured region of vertebral column. Vertebral column is dosed unbend for 4 days in a sagittal plane, wedging the damaged segment, and fixed in the achieved position up to 10 days by an external device. That is followed by surgical intervention to stabilize the spinal column in the achieved position by the transpedicular system. Submersible transpedicular fixation system is mounted during the surgical intervention. When mounting the transpedicular system in the vertebrae, transpedicular screws are inserted symmetrically on both sides so that the transpedicular screw passes through the vertebra foot into its body. Transpedicular screws are connected by rods and fixed by clamps. Two lengthwise rods are mounted. Each longitudinal rod is bent in the form of a spinal column. Without surgical approach, the height of the broken vertebra and the physiological curves of the spinal column are restored. Percutaneously under X-ray control, a soft tissue puncture is performed at points of insertion of transpedicular screws into vertebrae above and underlying from a fractured vertebra, transpedicular screws are inserted, after assessing the absence of complications of the surgical intervention, without performing reposition manipulations by distraction, compression, in the postoperative period, the patient is vertically positioned. If necessary, fibrin glue is introduced into the vertebra through transpedicular screws equipped with channels, an external device for reclination and reposition is preserved, on the body during surgical intervention and in the postoperative period, a device containing a posterior lumbar frame with a window is used.

EFFECT: method provides reduced time and surgical intervention, correction of multiplanar posttraumatic deformation in two projections and stabilization of spinal column by submerged fixation system with minimal risk of postoperative complications and reduced blood loss ensured by low invasiveness.

4 cl, 11 dwg