Clinical Neuroscience

[Changes in the approach and the methods in acute surgical treatment of severe thoraco-lumbar spinal injuries]

ZSOLCZAI Sándor, PENTELÉNYI Tamás

FEBRUARY 20, 2003

Clinical Neuroscience - 2003;56(01-02)

[The authors show the changes in the approach and methods concerning the acute surgical treatment of severe thoracolumbar spinal injuries. In the past 15 years, 878 acute surgical treatments have been done with ventral-, dorsal or combined method. The results are evaluated from the point of view of neurological function recovery, bony union, restoration of patients' comfort and complications. Authors discuss the changes of past 15 years regarding the basic ideas of the treatment of spinal injuries, the indications and methods of modern surgical techniques. The use of new surgical methods which are closely connected to the biomechanical characteristics of the injured spine are stressed, as well as the importance of the primary definitive ventral surgical treatment, in the case of a severe thoraco-lumbar spine injury.]

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[With the aim to compare results to those found in the literature, authors present a retrospective overview of the spinal stabilisations carried out in the Neurosurgical Department at the St. John’s Hospital, Budapest, Hungary between 1989 and 2002. This 37 bed department provides neurosurgical services to the Buda region with its one million inhabitants. Out of 156 000 injuries in total in the past 13 years, the department has dealt with 9360 neurotraumatologic cases, 560 of them suffering from spinal injuries. In parallel, non-traumatic cases were also treated for tumour, infections, degenerative diseases and for the instability of the spine. The 224 stabilised cases were classified into three groups: cervical, thoracic, lumbar. The authors enumerate the type of operation in each level and they present the number of cases belonging to each type. Septic complications occured in 2.5% of cases. Screw breaking or slackening of the implanted devices was observed in 2% of the cases. The types of spinal operations applied provide satisfactory method for controlling the problems caused by the instability the spinal trauma, degenerative and tumourous cases. These results do not diverge from those found in the literature.]

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