METHOD OF COMPLEX SURGICAL TREATMENT OF AN ANEURYSMAL BONE CYST OF THE SPINE Russian patent published in 2023 - IPC A61B17/70 A61K31/197 A61K33/14 A61P19/00 

FIELD: medicine, traumatology and orthopedics.

SUBSTANCE: invention can be used for complex surgical treatment of spinal aneurysmal bone cyst. Before performing surgical treatment, spatial visualization of the spinal lesion with an aneurysmal bone cyst of the spinal cyst is determined by the method of multilayer spiral computed tomography. The state of the surrounding soft tissues, vascular and nervous structures that are not visualized when performing multilayer spiral computed tomography is assessed using magnetic resonance imaging. Under x-ray control, preoperative puncture washing of the contents of the aneurysmal cyst cavity is performed using two trepanation needles with a cross section of 8g to 11g previously introduced into the cavity of the aneurysmal cyst. The first trepanation needle is inserted into the cyst cavity to inject the lavage solution, and the second trepanation needle is inserted contralaterally to remove the lavage solution from the cavity of the aneurysmal cyst. The cavity of the aneurysmal cyst is first washed with 0.9% saline until the appearance of a washing solution without staining with bloody contents at the exit from the cavity of the aneurysmal cyst and then washed with a solution of 5% aminocaproic acid in an amount of 95–105 ml and then the washing is repeated every 30–45 days cavity of the aneurysmal cyst with a solution of 5% aminocaproic acid in an amount of 95–105 ml until the aggressive growth of the cyst ceases and repair with its own bone tissue begins confirmed by repeated multilayer spiral computed tomography with an assessment of the repair of the bone membranes of the cyst. Surgical intervention is performed from the dorsal or ventral approach with the removal of the cyst membranes to healthy tissue, followed by the replacement of the formed bone tissue defect of the patient with bone autografts from the iliac wing or from a fragment of the rib or bone allograft, followed by the use of metal construction elements within the bone structures not affected by the formation of the aneurysmal cyst, followed by removal of the metal structure after the formation of the bone block. In the presence of compression of the contents of the spinal canal, decompression of the neural structures is additionally performed.

EFFECT: method provides effective formation of replacement bone tissue, reduction of bleeding volume during cyst puncture, reduction of risk of intraoperative bleeding, reduction of use of number and volume of bone autografts, as well as reduction of resection volume due to decompression of neural structures.

1 cl, 3 ex