The comparative analysis of surgical treatment of patients with spinal cordinjury at the cervical level, operated by methods of anterior and posterior stabilization
Abstract
Objective: to study the results of surgical treatment of patients with spinal cord injury at the level of the cervical spine, operated by methods of anterior and posterior stabilization.
Materials and methods: A statistical analysis of the treatment of 49 patients with spinal cord injury who was performed anterior spondylodesis or pedicle screw fixation at the level of the cervical spine.
Results: Patients with severe myelopathy (according to the Japanese orthopedic Association’s vertebrogenic cervical myelopathy rating scale JOAm — 0–10 points) had a lower index recovery of neurological function than patients with moderate myelopathy (р=0,0001 for ACDF, р=0,04 for ACCF, р=0,002 for pedicle screw fixation). Blood loss in anterior cervical corpectomy and fusion (ACDF) is significantly lower than in pedicle screw fixation (p=0,002). The orthopedic effect of pedicle screw is significantly higher than ACDF, and angulation after pedicle screw fixation is less than after ACDF (p=0,003). A high inverse correlation coefficient was found between the subaxial injury classification (SLIC) index and the index recovery of neurological function, r= –0,75.
Conclusion: The technique of anterior stabilization of the cervical spine is less traumatic for the patient, while pedicle screw fixation provides more reliable stabilization of the spine for active rehabilitation of the patient.
About the Authors
O. A. Borisova
Tyumen State Medical University, Tyumen Regional Clinical Hospital № 2
Russian Federation
Russian Federation
Tyumen
N. A. Spiridonova
Federal State Budget Educational Institution of Higher Education «Industrial University of Tyumen»/IUT; Tyumen State University, department of fundamental mathematics and mechanics
Russian Federation
Russian Federation
Tyumen
K. S. Sergeev
Tyumen State Medical University, Tyumen Regional Clinical Hospital № 2
Russian Federation
Russian Federation
Tyumen
I. A. Lebedev
Tyumen State Medical University, Tyumen Regional Clinical Hospital № 2
Russian Federation
Russian Federation
Tyumen
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Review
For citations:
Borisova O.A., Spiridonova N.A., Sergeev K.S., Lebedev I.A. The comparative analysis of surgical treatment of patients with spinal cordinjury at the cervical level, operated by methods of anterior and posterior stabilization. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2020;12(4):14-19. (In Russ.)
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