Stegniy S. Traumatic injuries of lumbosacral department of spine and their treatment.

Object of research - the patients with the injuries of lumbar-sacrum department of spine. Research purpose: to improve the results of treatment of injuries of lumbar-sacrum department of spine on the basis of rentgenomorfometric analysis of disturbance of the stability and algorithmic choice of the medical tactic. Methods of researches. During investigation the clinico-neurological, roentgenological, instrumental and biomechanics methods and СT and MRI scan were used. Materials are worked up by the methods of mathematical statistics with the use of the "Statistica for Windows 6,0" and "Excel 2003" application packages. Scientific novelty of the received results. First by mathematical modelling the graphoanalytic estimation of disturbance of the stability of lumbar-sacrum department of spine at the trauma is carried out. The possibility of use of the minimal invasive technology of external transpedicular fixation of lumbar-sacrum department of spine at the trauma is grounded. It is shown first, that theuse of the minimal invasive external transpedicular fixation of the injuries of lumbar-sacrum department of spine allows not only to achieve of dosed repositions and rigid fixation of the injured vertebral-motive segment, but also to minimize of the traumatic operation, thereby to decrease of confinement to bed and in-patient treatment duration. First the diagnostics and rendering assistance algorithm to injured with trauma of lumbar-sacrum department of spine in depending on the character of neurological injuries and localization of bone damages is elaborated. The use of the algorithm regulates the adequate choice of both conservative and operative treatment of the damaged neurological structures and injured vertebral-motive segment, and choice the optimal fixation device. Practical significance of the received results. The development of the external fixation devices for treatment of injured vertebral-motive segment of lumbar-sacrum department of spine is continued, that allows minimizing of the traumatic operation and decreasing of confinement to bed up to 11 days and in-patient treatment duration up to 36,8 days. The diagnostics and rendering assistance algorithm to injured with trauma of lumbar-sacrum department of spine regulates diagnostic approach and determines tactic and choice of treatment methods in depending on the character of neurological injuries and level of damages of the vertebral-motive segment, and also on type of fixation devices. Results of dissertation research were inculcated in pedagogical practice of the department of traumatology, orthopedics and military surgery of the Donetsk state medical university, in the neurosurgery department of the Donetsk regional trauma centre, in clinical practice in the vertebrological department of the Donetsk SRI of the Donetsk state medical university, in the traumatological departments of city hospitals 9, 14, 17, 24 of Donetsk city, city hospitals 2 Drugkovka city, in traumatological departments of the central city hospital Artemovsk city, the LuganskCity hospital 9, central city hospital Anthracite city, city hospitals 11 and Road hospital of the Odessa city.