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1.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-37011327

RESUMO

OBJECTIVE: To evaluate the effectiveness and safety of skip corpectomy in surgical treatment of cervical spondylotic myelopathy. MATERIAL AND METHODS: The study included 7 patients with cervical myelopathy following extended cervical spine stenosis. All patients underwent skip corpectomy. Clinical examination included degree of neurological disorders according to the modified scale of the Japanese Orthopedic Association (JOA) with assessment of recovery rate and Nurick score, as well as VAS score of pain syndrome. Verification of diagnosis was based on the data of spondylography, magnetic resonance and computed tomography. The indications for surgical treatment were conduction disorders and their spondylotic genesis confirmed by neuroimaging methods. RESULTS. VAS: Score of pain syndrome decreased by 2-4 points (mean 3.1) in long-term postoperative period. The JOA, Nurick scores and recovery rate (mean 42.5%) demonstrated significant improvement of neurological status in all patients. In all cases, the follow-up examination confirmed adequate decompression and spinal fusion. CONCLUSION: Skip corpectomy provides adequate spinal cord decompression in case of extended cervical spine stenosis and minimizes the risk of complications typical for multilevel corpectomy. Recovery rate indicates the effectiveness of this method in surgical treatment of cervical myelopathy caused by multilevel stenosis. However, further studies on sufficient clinical material are needed.


Assuntos
Doenças da Medula Espinal , Fusão Vertebral , Estenose Espinal , Espondilose , Humanos , Constrição Patológica/patologia , Constrição Patológica/cirurgia , Doenças da Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/cirurgia , Descompressão Cirúrgica/métodos , Estenose Espinal/diagnóstico por imagem , Estenose Espinal/cirurgia , Fusão Vertebral/métodos , Espondilose/diagnóstico por imagem , Espondilose/cirurgia , Espondilose/patologia , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Vértebras Cervicais/patologia , Dor/patologia , Dor/cirurgia , Resultado do Tratamento , Estudos Retrospectivos
2.
Artigo em Russo | MEDLINE | ID: mdl-35942837

RESUMO

OBJECTIVE: To analyze the results of herniated thoracic disc resection via transthoracic extrapleural approach. MATERIAL AND METHODS: The study included 16 patients with 18 symptomatic herniated thoracic discs wo underwent transthoracic extrapleural surgery. In 11 cases, clinical pattern of disease was represented by myelopathy with radicular or axial pain syndrome. Five patients had radiculopathy alone. Median localization of hernias was observed in 8 (44.4%) cases, paramedian hernias - in 10 (55.6%) cases. There were 10 (55.6%) ossified hernias, 5 (27.7%) giant, 10 (55.5%) large and 3 (16.6%) medium hernias. RESULTS: In most patients, VAS score of pain syndrome decreased by 2-6 points (mean 3.6). In 4 patients, this value remained the same. Among 11 patients with myelopathy, regression of conduction disorders in 1 year after surgery was achieved in 9 (82%) cases including complete recovery in 6 (55%) patients (Frankel E, Nurick - 0-I). In 2 patients, neurological status was equal to preoperative one. In all cases, the follow-up examination confirmed total removal of compressive substrate and found no signs of spine instability. Surgery time varied from 80 to 210 min (mean 161), blood loss - from 300 to 800 ml (mean 378 ml). Two patients had transient neurological deterioration. There was damage to dura mater in 4 cases. Intercostal neuralgia was observed in 3 patients. CONCLUSION: While retaining the advantages of open thoracotomy, transthoracic extrapleural approach is less traumatic, allows complete spinal cord decompression, minimizes the risk of iatrogenic spinal cord injury and avoids certain postoperative complications.


Assuntos
Deslocamento do Disco Intervertebral , Neuralgia , Doenças da Medula Espinal , Humanos , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Neuralgia/etiologia , Estudos Retrospectivos , Doenças da Medula Espinal/cirurgia , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/cirurgia , Resultado do Tratamento
3.
Artigo em Russo | MEDLINE | ID: mdl-34463453

RESUMO

The authors describe the result of combined surgical treatment of a patient with symptomatic multiple-level cervical spine stenosis following ossification of posterior longitudinal ligament. The first stage included decompressive laminectomy and cervical spine fusion using a screw. At the second stage, CIV-CV-CVI-CVII corporectomy with total resection of the ossified posterior longitudinal ligament and CIII-ThI corporodesis with a bone autograft were carried out. This approach was valuable to minimize the risk of iatrogenic damage to the spinal cord, eliminate long spinal stenosis and perform circular fusion of the cervical spine. These measures led to regression of cervical myelopathy symptoms. A brief review is presented.


Assuntos
Ossificação do Ligamento Longitudinal Posterior , Doenças da Medula Espinal , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Descompressão Cirúrgica , Humanos , Laminectomia/efeitos adversos , Ligamentos Longitudinais/diagnóstico por imagem , Ligamentos Longitudinais/cirurgia , Imageamento por Ressonância Magnética , Ossificação do Ligamento Longitudinal Posterior/diagnóstico por imagem , Ossificação do Ligamento Longitudinal Posterior/cirurgia , Osteogênese , Doenças da Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/etiologia , Doenças da Medula Espinal/cirurgia , Resultado do Tratamento
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