FIELD: medicine; traumatology; orthopedics.
SUBSTANCE: invention can be used for surgical treatment of spondylolisthesis using osteoinductive material. In the preoperative period, the spatial visualization of the bone anatomical structures of the spine affected by high-grade spondylolisthesis is determined using multilayer spiral computed tomography, the state of the surrounding soft tissues, vascular and nervous structures is assessed using magnetic resonance imaging. With the patient in the prone position, after anesthesia, an incision of the skin over the spinous processes of the spine is performed, followed by dissection of the subcutaneous tissue and its own fascia. Laminectomy of L5 and S1 vertebrae, foraminotomy of L5-S1 on both sides are performed. A channel with a diameter of 14–15 mm is formed under the control of an image intensifier using a sequential set of drills with an increasing diameter through the vertebral body S1 and through the intervertebral disc L5-S1 into the vertebral body L5 without going beyond it. A discothomes is introduced into the formed canal, and the structure of the intervertebral disc is removed using it. The space formed after removal of the intervertebral disc is filled with osteoinductive material. A cage in the form of a hollow perforated tube, the length of which corresponds to the depth of the channel formed in the body of the L5 and S1 vertebrae, is filled with osteoinductive material and placed in the channel formed in the body of the L5 and S1 vertebrae, the wound is sutured with drainage placed. Herewith, granules of a complex alloplastic preparation based on hydroxyapatite containing 60 % wt collagen, or granules of bone-plastic biological material based on bone tissue or autologous bone crumb are used as osteoinductive material. In this case, the wall thickness of the hollow perforated tube of the cage is chosen to be 0.9–1.0 mm, and the perforations of the hollow perforated tube of the cage are made round, square or diamond-shaped.
EFFECT: method provides reliable anatomical restoration of the shape and supporting function of the vertebra during positioning of pedicle screws, absence of a high incidence of malposition of pedicle screws and postoperative complications, formation of a stable bone block in high-grade spondylolisthesis, and early social rehabilitation of the patient.
2 cl, 3 ex
