Indications and contraindications for pedicle fixation of the spine and peculiarities of rehabilitation
In some cases, when there are complex injury or other damage to the spinal column, is applied transpedicular fixation of the spine. Thanks to this effective treatment range, improves the quality of life of critically ill patients.
Indications for use
Transpedicular fixation of the spine is to install supporting structure made of metal rods and screws in the vertebrae for the treatment of certain segments of the spinal column. The system used in excessive mobility of the ridge, when the result of the rotation of individual vertebrae pinch the nerve roots, there is strong pressure on the intervertebral joints. As a result, start inflammatory processes, degeneration of spinal segments.
Indications for DFT are fractures and dislocation of the thoracic and lumbar vertebrae, increased mobility of the ridge, spondylolistheses, stenosis. Indications for the installation transpedicular system are injuries to the front, middle, rear sections of the spinal cord, and combinations thereof. Indications for this method of fixation when there is kyphosis or scoliosis, when the curvature of the spine, deformation of the vertebrae, and destruction of cartilage between the vertebrae.
In addition, transpedicular fixation of the spine is needed to improve the quality of life with issues such as:
- progressive spinal deformity with pain;
- decompression of the spinal canal;
- the appearance of a neurological defect, when the spine is unstable;
- instability of the spine the displacement of the vertebrae;
- degenerative dystrophic lesions of the intervertebral discs.
Many surgeons are of the opinion that in these cases contraindications to the use of this system of fixation of the spinal column are virtually absent.
Is Not a contraindication to surgery predisposition to allergies. But there is a possibility contraindications in cases when the body is overly sensitive to a foreign body.
fractures of contraindications to the installation of the DFT is damage to the upper parts of the thoracic ridge. The cause of failure is the inability to install the mounts due to the small size of the vertebral arches in this part of the spinal column. In addition, contraindications to DFT exist in cases such as pregnancy and obesity.
Contraindication for the installation of DFT exist in severe forms of osteoporosis. Developing infection in the affected segment of the vertebrae also will not allow use of DFT.
Correct setup of the system
During the installation of the fixation system is of paramount importance not so much the operation itself, how the selection of required sizes of screws and rods. Important to match the size of the vertebrae, not peredavlivali vessels and nerve endings.
This is Especially important in cases where the spine is injured in several parts or needs a complete fixation. Before installing the DFT, the doctor is obliged in each case to take into account all features of structure and bending of the spinal column to provide a reliable fixation of each vertebra. If the damage is in one segment of the spinal column, is set from 4 to 6 screws. The danger of the screws outside of the vertebrae or changes in the shape of rods of a small system.
If necessary the installation of transpedicular fixation at multiple points or the entire column of the spine, the dimensions of the individual parts of the system and the reliability of its fixation is of paramount importance.
If not installed DFT there are cases of damage to the segmental nerve roots, arteries, spinal cord as a result of perforation of the surface of the vertebral body, an infection.
With proper selection and installation of the system will be able to avoid some of the difficulties during the rehabilitation period and subsequent time-of-use system.
Life after surgery
If the earlier rehabilitation of the patient after installation of the DFT took a long period, thanks to a new method and more sophisticated systems of fixing it short.
The Screws and rods are introduced into the bone tissue of the vertebrae in special guides, which reduces the time of operation, minimizes mistakes made by surgeons during the installation of the system; surgical intervention is virtually without blood loss, which also facilitates rehabilitation.
Patients may move in the same day was carried out surgical intervention. Rehabilitation in the hospital they go for a week, then you can be at home. DFT due to easier splicing of the parts of the vertebral column, reducing the recovery period.
Rehabilitation of the house continues. She is wearing a corset. Rehabilitationlasts only a month. In the next 6-12 months, when the fused part of the spine, patients can lead a full life.
Thanks to modern methods of TFP during the recovery period, there are practically no cases of suppuration in the parts of the fastening screws, which previously often happened. Due to the fact that contraindications to DFT virtually absent in the number of severe injuries and diseases of the spine, many patients have found a chance to walk. Easy rehabilitation to allow patients to adapt quickly and to live a full and happy life.
For writing we used the following literature:
1. E. I. Slyn'ko, N. E .Polishchuk, V. A. Muravsky. The use of transpedicular stabilization system in traumatic injuries of the thoracic and lumbar spine.
2. E. P. Kostiw. To the question of transpedicular fixation in fractures of the thoracolumbar spine.