This journal is
indexed in Scopus
Year 2019 Vol. 27 No 1
K.M. KUBRAKOV, V.I. PETUKHOV, A.V. KORNILOV
VACUUM THERAPY APPLICATION IN SURGICAL TREATMENT OF SPINAL EPIDURAL ABSCESSES
Vitebsk State Medical University, Vitebsk,
The Republic of Belarus
Objective. To improve the surgical treatment results in patients with spinal epidural abscesses.
Methods. Surgical removal of spinal epidural abscesses, including interlaminectomy using a vacuum-draining system, was performed in 5 patients. The median age of patients was 58 [52; 64] years, 3 patients were males, 2 -females. On admission, the neurological status was studied, laboratory, bacteriological and instrumental methods of examination (computed and magnetic resonance imaging, bone scintigraphy) were carried out. The intensity of the pain syndrome was determined by the visual analogue scale (VAS). Sepsis was confirmed in 3 patients.
Results. A positive clinical outcome was achieved in 5 patients. The severity of pain before treatment and 2-3 days after surgery significantly decreased from 8.0 [8.0; 9.0] points to 5.0 [4.0; 5.0] on the VAS scale. On discharge, pain in 4 patients had almost completely regressed, but 1 patient still had a mild pain (4 points on the VAS scale) in the postoperative wound area. All patients had a regression of neurological deficit – an increase in the strength and volume of active movements in the lower limbs up to 4 points, the normalization of the functions of the pelvic organs. There was no postoperative kyphotic spinal deformity in any patient. Recurrence of inflammatory process, requiring re-operations was not observed. Despite the positive neurological symptoms, regression of pain and an increase in the volume of active movements in the analyzed group, there was one death due to the extremely severe septic condition of the patient which had been already on admission.
Conclusions. The developed method of the spinal epidural abscesses surgical treatment, including interlaminectomy throughout the purulent focus and the installation of a vacuum-draining system, provides adequate sanitizing effect, rapid elimination of edema of the adjacent soft tissues, neural structures and high-quality tissue repair.
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210023, The Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical University,
Department of Neurology and Neurosurgery.
Tel. mobile +375 29 7349336,
Konstantsin M. Kubrakov
Kubrakov Konstantsin M., PhD, Associate Professor of the Department of Neurology and Neurosurgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Petukhov Uladzimir I., MD, Associate Professor, Head of the Surgery Department of the Faculty of Retraining and Advanced Training of Medical Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Kornilov Artyom V., Post-Graduate Student of the Surgery Department of the Faculty of Retraining and Advanced Training of Medical Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.