RESUMO
Adequacy of diagnostic actions, choice, on their basis, of a treatment for patients with vertebral fractures and spinal cord injury, improvement of the results of surgical treatment are anactual problem of modern traumatology and neurosurgery. The purpose of the study was to define the role of immunological monitoring in the evaluation of patients' condition in the presence of spinal damage. Blood was tested in 111 patients during two-stage surgical treatment for spinal damages: 1) osteosynthesis by an external fixation device and 2) anterior spinal fusion. The results of general clinical blood checks, lymphocytic phenotyping, determination of neutrophilic functional and metabolic activity, the levels of circulating immune complexes and immunoglobulins, the concentrations of cytokines (IL-1alpha, IL-1beta, IL-1ra, IL-8, tumor necrosis factor-alpha) and acute-phase proteins were estimated before surgery and in different periods up to 6 months inclusive. Statistical studies were conducted using the STATISTICA program. Examination of three groups of patients (two of which had postoperative complications, the other was a control group) has ascertained that immunological monitoring in the treatment of spinal injure may be used to predict postoperative complications, such as delayed consolidation and impaired formation of a bone block in the vertebral segment, be made in different management periods (before surgery and on follow-up days 2 or 10), and include prognostic tests, by taking into account the capacities of a laboratory service.
