METHOD FOR CHOOSING TREATMENT TACTICS FOR ISOLATED COMMINUTED FRACTURES OF THE L5 VERTEBRAL BODY Russian patent published in 2022 - IPC A61B6/03 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used to select treatment tactics for isolated comminuted fractures of the L5 vertebral body. A bisegmental transpedicular system is installed from the posterior approach with simultaneous reclination of the damaged vertebra, the X-ray method for examination is performed with obtaining a digital image and determining anatomical landmarks and their quantitative parameters on it. The X-ray method for research is performed after surgery by performing multislice computed tomography of L4-5 and S1 vertebrae with measurement on CT scans of the anteroposterior size of the lower endplate of the L4 vertebra and the height of the body of the L5 vertebra achieved during reclination. The degree of reclination is determined by the formula: E = (F/(2,04 + 0,76 × B)) × 100%, where E is the degree of reclination,%; B – anteroposterior dimension of the lower endplate L4, mm; F is the height of the body of the L5 vertebra achieved during reclination, mm. When E is less than or equal to 50%, the L5 vertebral body is resected and the supporting corporodesis of the L4-S1 vertebrae is performed; at a value of E more than 50% to 80% inclusive, discectomy of L4-L5 and L5-S1 vertebrae, interbody fusion with osteoinductive material in combination with supporting interbody implants are performed; with an E value of more than 80%, the second stage of surgical intervention is not performed.

EFFECT: method provides a ranked determination of the need and scope of the second stage of surgical intervention by quantifying the degree of restoration of the support ability of the spinal column.

1 cl, 3 ex