METHOD OF PERFORMING SURGICAL TREATMENT OF PATIENTS WITH LUMBAR INTERVERTEBRAL HERNIAS USING METAL FIXING CAGE Russian patent published in 2023 - IPC A61B17/70 A61F2/28 

FIELD: medicine; traumatology; orthopedics; neurosurgery.

SUBSTANCE: invention can be used to perform surgical treatment of patients with lumbar intervertebral hernias using a metal fixing cage. When diagnosing a patient with stage II–III intervertebral disc degeneration according to Pfirrmann, protrusive type of intervertebral hernia, changes in the red bone marrow and endplates of adjacent vertebral bodies according to Modic I type, and intervertebral disc height index more than 0.3, range of motion in the spinal motion segment more than 10°, and the angle of lumbar lordosis less than 40°, surgical treatment of lumbar intervertebral hernia is carried out, during which an incision is made in the skin and subcutaneous fat in the projection of the affected spinal motion segment, the spinous processes, arches and facet joints are skeletonized to the transverse processes, transpedicular screws are installed in the pedicles of adjacent vertebrae on the right and left, which are fixed with rods on the right and left. Next, the yellow ligament and facet joint are removed from the side of the hernia, and the part of the intervertebral disc, nucleus pulposus, and hyaline cartilage of the endplates that prolapses into the spinal canal is removed. A metal fixing interbody cage, banana-shaped in the axial plane and rectangular in the frontal plane, measuring 10×28 mm with the height from 7 to 14 mm is installed in the anterior 1/3 of the formed bed of the intervertebral space. The posterior 2/3 of the formed bed of the intervertebral space is filled with osteoinductive material. The correct placement of transpedicular screws and interbody cage is assessed using image intensifier control. The position of the dural sac and spinal roots is inspected. The wounds are washed with saline solution with drainage. The wounds are sutured layer by layer. The BBraun TSPACE cage is used as a metal fixing interbody banana-shaped cage. Herewith, granules of a complex alloplastic preparation based on hydroxyapatite containing 60 wt.% of collagen, or granules of bone-plastic biological material based on bone tissue or autologous bone crumb are used as osteoinductive material. Transpedicular screws, fixing rods and a metal interbody banana-shaped cage are made of VT6 titanium alloy.

EFFECT: method eliminates the risk of compression of the nerve roots along with the accompanying artery, the possibility of restoring the height of the interbody space, reliable restoration of the sagittal profile of the patient’s lumbar spine while maintaining the physiological load on the overlying adjacent spinal motion segment, as well as a significant increase in the patient’s quality of life due to the features execution of the method.

4 cl, 3 ex