ORTHOPEDONEUROSURGICAL TREATMENT FOR PRIMARY AND METASTATIC VERTETAL TUMORS WITH COMPRESSED SPINAL CORD
Abstract
Incomplete information about the localization, extent and nature of the tumor in spinal complications does not allow performing complex operations with an anterior approach, therefore, in such situations, most surgeons consider it possible to limit the surgical intervention to decompressive laminectomy with posterior fusion, in the most difficult cases, without spinal fixation. The aim of the work is to study the effectiveness of decompressive-stabilizing operations using anterior and posterior approaches in patients with tumors of the vertebral bodies complicated by spinal cord compression. Materials and methods. We examined 55 patients hospitalized for urgent indications with severe pain syndrome, which was difficult to stop with narcotic analgesics, and spinal disorders in the form of gross paresis (38) and paralysis (17, of which 15 in combination with dysfunctions of the pelvic organs) caused by a tumor in the cervical (35) and thoracic (20) spine. Results and discussion. Decompressive-stabilizing operations in patients with tumors of the vertebral bodies complicated by compression of the spinal cord, limiting diagnostic possibilities, prevented the progression of spinal complications and secondary compression of the spinal cord in 39 people. Surgical treatment did not significantly affect life expectancy, but to a large extent affected its quality. The most effective operations are anterior access. In our opinion, their best results are due to the possibility of removing tumor masses with complete decompression of the spinal cord and strong stabilization of the spine.
About the Authors
List of references
Dreghorn C.R., Newman R.J., Hardy G.J., Dickson R.A. Primary tumours of the axial skeleton. Experience of the Leeds Regional Bone Tumour Registry. Spine (Phila Pa 1976) 1990;15(2):137–40. DOI: 10.1097/ 00007632-199002000-00018.
Ciftdemir M., Kaya M., Selcuk E., Yalniz E. Tumors of the spine World J Orthop 2016;7(2):109–16. DOI: 10.5312/wjo.v7.i2.109.
Заборовский Н.С., Пташников Д.А., Топузов Э.Э и др. Эпидемиология опухолей позвоночника у пациентов, получивших специализированную ортопедическую помощь. Травматология и ортопедия России 2019;25(1):104–12. [Zaborovsky N.S., Ptashnikov D.A., Topuzov E.E. et al. Spine tumor epidemiology in patients who underwent orthopaedic surgery. Travmatologiya i ortopediya Rossii = Traumatology and orthopedics of Russia 2019;25(1):104–12. (In Russ.)]. DOI: 10.21823/2311-2905- 2019-25-1-104-112.
Galgano M.A., Goulart C.R., Iwenofu H. et al. Osteoblastomas of the spine: a comprehensive review. Neurosurg Focus 2016;41(2):E4. DOI: 10.3171/2016.5.FOCUS16122.
Mesfin A., McCarthy E.F., Kebaish K.M. Surgical treatment of aneurysmal bone cysts of the spine. Iowa Orthop J 2012;32:40–5.
Валиев А.К., Соколовский А.В., Неред А.С., Мусаев Э.Р. Малоинвазивные хирургические технологии при поражениях позвоночника в онкогематологии. Клиническая онкогематология 2013;6(2):177–94. [Valiyev A.K., Sokolovskiy A.V., Nered A.S., Musaev E.R. Minimally invasive surgical techniques in hematological malignancies with spinal involvement. Klinicheskaya onkogematologiya = Clinical oncohematology 2013;6(2):177–94. (In Russ.)].
Мусаев Э.Р. Первичные опухоли позвоночника: обзор литературы. Практическая онкология 2010;11(1):19–24. [Musayev E.R. Primary spine tumors: a comprehensive review. Prakticheskaya onkologiya = Practical oncology 2010;11(1):19–24 (In Russ.)].
Cho W., Chang U.-K. Survival and recurrence rate after treatment for primary spinal sarcomas. J Korean Neurosurg Soc 2013;53(4):228–34. DOI: 10.3340/jkns.2013.53.4.228.
Гуща А.О., Коновалов Н.А., Арестов С.О и др. Тактика и результаты хирургического лечения пациентов с первичными опухолями позвоночника. Хирургия позвоночника 2015;12(3):72– 82 [Gushcha A.O., Konovalov N.A., Arestov S.O. et al. Surgical treatment of primary spinal tumors: tactics and results. Hirurgia pozvonocnika = Spine Surgery 2015;12(3):72–82. (In Russ.)]. DOI: DOI: 10.14531/ss2015.3.72-82.
Джумабаев Э. С., Мирзаев К. К., Байбеков И. М. Ультраструктурная морфология огнестрельных ран при лимфотропной антибиотикотерапии с региональной лимфостимуляцией //Вестник лимфологии. – 2009. – №. 1. – С. 20-25.
Джумабаев Э. С., Мирзаев К. К. Современные подходы к лечению огнестрельных ранений конечностей //Вестник экстренной медицины. – 2010. – №. 4. – С. 5-7.
Джумабаев Э. С. и др. ОПЫТ ЛЕЧЕНИЯ ОГНЕСТРЕЛЬНЫХ РАН КОНЕЧНОСТЕЙ В УСЛОВИЯХ ВОЕННО-ГОРОДСКОЙ ХИРУРГИИ //Госпитальная медицина: наука и практика. – 2018. – Т. 1. – №. 1. – С. 4-13.
Мирзаев К. К., Джумабаев Э. С., Азизов Д. Т. Современные подходы в лечении огнестрельных ранений конечностей //Медицина Кыргызстана. – 2018. – №. 1. – С. 22-24.
HODJIMATOV G. M., MIRZAEV K. K., AZIZOV D. T. Pharmacokinetics Of Antibiotics In Experimental Gunshot Wounds //JournalNX. – Т. 7. – №. 02. – С. 120-123.
Мирзаев К. К., Джумабаев Э. С., Байбеков И. М. Патогенетические особенности гистореанимации тканей в профилактике и лечении хирургической инфекции огнестрельных ран //Вестник экстренной медицины. – 2013. – №. 3. – С. 118-118.