METHOD OF SURGICAL FIXATION OF THE ZONE OF BILATERAL SPONDYLOLYSIS OF L VERTEBRA USING A METAL FIXING DEVICE Russian patent published in 2023 - IPC A61B17/70 

FIELD: medicine; traumatology; orthopedics; neurosurgery.

SUBSTANCE: invention can be used for surgical treatment of a zone of bilateral spondylolysis of L₅ vertebra using a fixation device with transpedicular polyaxial screws. 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. An incision of the skin and subcutaneous fat along the line of the spinous processes is performed with the patient in the position on the abdomen under intubation anesthesia. The top point of the incision is determined in the projection of L₃-L₄ vertebrae and the incision is made to the level of L₅-S₁ with exposure of the bone tissue of the posterior vertebrae. At the intersection of the horizontal lines drawn through the upper third of the transverse processes of L₅ vertebra on the left and right, and the vertical lines drawn through the middle of the left and right facet joints of L₄-L₅ vertebrae, the posterior elements of the spine are skeletonized and hemostasis is performed. The posterior elements of the spine are skeletonized and hemostasis is performed. Using nippers, the lateral parts of L₅-S₁ facet joints are resected on the left and right, along the relief of the arch of L₅ vertebra, a metal fixation device in the form of a figured plate is placed along the relief of the arch of L₅ vertebra of the patient's vertebra to fix the bilateral zone spondylolysis of L₅ vertebra. The lower part of the metal fixing device is curved, repeating the anatomical relief of the arch of the patient's L₅ vertebra and having two protrusions for performing sublaminar fixation with a hole made in each of them in the projection of the arch roots by introducing fixing transpedicular screws. Through the holes made in the metal fixing device, transpedicular screws with a socket head are inserted into the body of L₅ vertebra on the left and right. The final fixation of the metal fixing device is performed on the arc of L₅ vertebra, hemostasis, drainage and suturing of the wound are carried out. The metal fixing device and pedicle screws are made of titanium alloy or stainless steel for medical purposes.

EFFECT: method enables reduction of the vertebrae, eliminates violations of the anatomy of the posterior sections of the spine, ensures thorough skeletonization of the posterior part of the vertebral arch, compliance of the fixing device used with the relief of L₅ vertebral arch for their snug fit, ensuring a reduction in the rehabilitation period of patients with a simultaneous increase in their quality of life through the use of fixing device.

2 cl, 2 dwg, 3 ex