Novosti
Khirurgii

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Year 2016 Vol. 24 No 6

NEUROSURGERY

M.V. OLIZAROVICH 1,2, P.S. REMOV1,2

MICROSURGICAL INTERVENTION ON THE SPINE USING COMPUTER CALCULATION AND GRAPHIC VISUALIZATION

E "Gomel Regional Clinical Hospital"1,
EE "Gomel State Medical University"2
Gomel,
The Republic of Belarus

Objectives. Identification of the factors that determine the volume of resection of the posterior supportive complex bone structures, and evaluation of the effectiveness of microsurgical interventions on the lumbosacral part of spine conducted according to a pre-surgical computer calculation and graphical visualization.
Methods. Microsurgical interventions for dystrophic pathology of the spine had been performed in 43 patients.Resection of the bone and ligament structures was carried out according to the preoperative computer calculations. The type of bone resection in the dependence on the level of intervention and compressing factor, parameters of the interarch spaces have been analyzed. Quality-of-life considerations in patients undergoing surgical treatment was evaluated in the late postoperative period.
Results. The effect of compressing factor type and parameters of interarchspace on the resection volume of bone structures of the posterior supportive complex was established during the study. Interlaminectomy was performed reliably more often (p<0,05) at the level of LV-SI well as in cases of intervertebral disc hernias (IVD) without sequestration. Partial hemilaminectomy of both arches (above- and underlying vertebrum), supplemented by the medial facetectomy prevailed (p<0,05) at LIV-LV level, as well as in cases of the central segmental spinal canal stenosis. According to the calculations, the length of the bone window in cases of IVD hernias without sequestration was significantly less in comparison with the cases of sequestered hernias (p<0,01) and the central spinal canal stenosis (p<0,01). Analysis of the parameters of the interarch spaces has shown that in the segments of LIV-LV level, the interarch space on both sides is narrower (p<0,0001) and shorter (p<0,0001) compared to the segments of LV-SI level.
Conclusion. Technical aspects, laid down in the computer calculation algorithm, permitted to improve significantly the life quality of patients 6 months after the intervention (p <0,01). The developed methodology for the preoperative planning was carried out by means of the available software and didn’t require bulky, expensive equipment.

Keywords: spine surgery, spine canal stenosis, intervertebral disc hernia, facetectomy, computer, algorithm, preoperative planning
p. 592-600 of the original issue
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Address for correspondence:
246000, Republic of Belarus,
Gomel, Lange st., 5,
UO "Gomel State
Medical University",
Department of neurology and neurosurgery.
Tel. mob: +375 44 748 43 72
Tel.: 8 0232 40-76-01
E-mail: olism@mail.ru
Olizarovich Mikhail Vladimirovich
Information about the authors:
Olizarovich M.V. PhD, Ass. Professor of the neurology and neurosurgery department, EE "Gomel State Medical University", neurosurgeon of the neurosurgical unit N1 of "Gomel Regional Clinical Hospital".
Remov P.S. Assistant of the neurology and neurosurgery department, EE "Gomel State Medical University", neurosurgeon of the neurosurgical unit N1, E "Gomel Regional Clinical Hospital".
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