Spuzyak S. Diagnosis and treatment of non-complicated compression fractures of thoracic spine in children

Object: diagnosis and treatment of traumatic injuries of thoracic spine in children – non-complicated compression fractures thoracic vertebrae bodies and concussion of spine. Purpose: to improve the diagnosis and results of the treatment of the children with compression fractures of thoracic vertebrae bodies via radio examination of peculiarities of structural functional state of spine and optimization of medical treatment method. Method: clinical examination, roentgenography, roentgenogramometry, mathematical modeling, ultrasound densitometry. For the first time a mathematical pattern of mediathoracic spine tension in children has been worked out and on the base of this the tension deformed state of vertebrae depending on their shape and body position has been studied, critical zones of vertebral tension at bending ( ventral vertebral bodies) have been established, the relation between their localization and X-ray signs of the compression fractures of thoracic vertebral bodies was revealed. For the first time the dependence of the quantity of the injured vertebrae on structural functional state of the osseous tissue are established, For the first time the risk factors for the compression thoracic vertebrae bodies fractures in children according to their physical development and ultrasound densitometry evidence have been established, which were characterized with the increased number of the injured vertebral 2 and 3 bodies in the children with the reduced physical development level , and cases of most fractures on the background of underdeveloped osseous tissue (85 %) – osteopenia (44,1 %) and osteoporosisа(41,2 %) respectively. For the first time the optimum method of treatment for the compression fractures of the thoracic vertebrae bodies in the children depending on the structural functional state of the bones and the physical development of the child was proposed (patent of Ukraine № 24017). The improvement of the method of medical treatment for compression fractures of the thoracic vertebrae bodies in children and optimization of its usage depending on the structural functional state of the vertebrae and physical development of child favors the reduced terms of in-patient treatment, more rapid formation of the musculature. The evidence obtained at mathematical modeling of the tensions in mediathoracic vertebrae in children in different phases of the body bending allowed not only to understand the mechanism of appearance, localization of the fractures, but also to explain the X-ray signs of the compression fractures of thoracic vertebrae bodies. The risk factors of the compression fractures (osteopenia, osteoporosis, reduced and increased level of the physical development of children) have been established which help to identify the “risk groups” among the children and to provide preventive measures that is of an important practical value. The results of the treatment have been introduced in the practice of the childhood traumatological unit of Kharkiv Multiprofile clinical hospital №17, Lugansk RegionalChildhood Hospital, Lviv Regional Childhood Specialized Clinical Hospital. Traumatology and Orthopedics.