METHOD OF TREATING UNSTABLE SPINAL FRACTURES AT THORACOLUMBAR TRANSITION LEVEL Russian patent published in 2024 - IPC A61B17/56 A61B17/70 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely neurosurgery and traumatology, and can be used in treating unstable vertebral fractures at the thoracolumbar transitional level. A transpedicular fixation system (TFS) is inserted; two central pairs of screws are placed in the injured spinal motion segments (SMS), and the outermost pairs of screws are placed in the healthy SMS, disabling them from movement. Then, consolidation of injured SMS involves a stage of partial dismantling of TFS to restore mobility of healthy segments of SMS previously disabled from movement. Partial dismantling is carried out by removing the extreme pairs of screws and part of the rods adjacent to them: first, between the heads of each of the extreme pairs of screws, lines of the proposed two cuts passing along the old scar are marked, access to the TFS elements – the head of the first screw of the pair subject to the nut and the rod sections adjoining from the opposite sides of the screw, fixing rod is shortened directly in the wound with the help of a high-speed bur; a nut, a part of the rod, a screw installed in a vertebral body is removed, followed by filling the cavity left after the screw with allogenic bone chips. After removal of the first one, the soft tissues are displaced into the projection of the head of the second screw of the given pair with further removal of the said screw and the adjoining section of the rod in a similar manner. Then, a second incision of skin, soft tissues and subcutaneous fat is performed along the marked line, and similarly to the first extreme pair of screws, the second extreme pair of screws with adjacent sections of the rod are removed, followed by layer-by-layer closure of subcutaneous fat and skin.

EFFECT: method allows to reduce operative injuries, to reduce intraoperative blood loss, to refuse setting of wound drainage, to reduce time of surgical intervention, reduce postoperative pain syndrome by performing two small midline incisions with performing the above set of techniques for removing removed TPF elements with minimum possible traumatic effect on adjacent anatomical structures, including soft tissues, muscles, nerves, without expansion of the incisional wound.

1 cl, 7 dwg, 1 ex