Anterior spine stabilization and decompression for thoracolumbar injuries

In a series of patients with thoracolumbar spine injuries, anterior spinal canal decompression resulted in better neurologic recovery than did previously reported posterior instrumentation or nonoperative treatment. The technique allows stabilization over a much shorter segment of the spine than posterior instrumentation and therefore is indicated for fractures at L2 and below and in all patients with burst fractures and neurologic compromise.     

Delayed anterior decompression in patients with spinal cord and cauda equina injuries of the thoracolumbar spine

Forty-nine patients with complete and incomplete injuries of the spinal cord or cauda equina who had undergone anterior decompression at a minimum of 3 months after injury were examined. Follow-up was from 12 months to 19 years. Postoperative neurologic improvement occurred in 46.5% of patients with incomplete injuries. If the surgery was performed less than 2 years after injury, neurologic improvement occurred in 68% with an improvement in Frankel grade of 32%. Bladder function improved in 27% of patients and if operated on less than 2 years after injury improvement occurred in 43%. Conus medullaris decompression resulted in a 50% improvement. There was an 83% improvement in the pattern of pain after decompression. Of 23 patients with preoperative spasticity, 10 improved but 6 were worse after surgery.     

Effectiveness of local hypothermia in the complex treatment of patients with complicated injuries of the spine

Having analysed her observations of 84 scheduled patients with complicated injuries of the spinal column the author comes to the conclusion that local cooling of the spinal cord during the postoperative period exerts positive influence: it contributes to a decrease in excitability of alpha motoneurons of the spinal cord which is manifest by reduced muscular tension, improves the local blood flow in the spinal cord, raises the vascular tension and provides the analgetic effect.     

Use of dalargin in the complex treatment of complicated injuries of the thoraco-lumbar segments of the spine]

In the present report there has been pursued an object of studying the efficiency of the preparation dalargine (synthetic preparation, analogous to encephaline) in case of unstable spine and spinal cord injuries. Under the observation there were 32 operated patients. Dalargine was administered endolumbally by 2 mg, dissolved in 2 ml of physiologic salt solution. The results were evaluated by several categories: locomotive function, sensitivity, pelvic organ function, pain, spasticity, trophic disturbances.     

Birth injuries of the spine

Results of treatment of 204 children with labour traumas of the vertebral column are presented. Among the 204 patients there were 151 neonates, 28 infants and 25 patients with consequences of labour trauma. The cervical part is traumatized most frequently. Injury of the cervical vertebrae was diagnozed in 154 patients, of lumbar vertebrae in 18 patients. One child has an injury of the cervical and thoracic vertebra. In 41 patients there were ischemias in the vertebrobasilar area. An associated labour trauma of the vertebral column was diagnozed in 36% of the cases. Results of treatment were followed-up in 174 patients. Good results were obtained in 133 patients (76%). Satisfactory results were noted in 36 children (20%). Five patients died. Early and complex treatment gave good results in 93% of the cases.