Decompressive and reconstructive spinal surgeries - effective treatment in Ternopil

Manifestations

In degenerative-dystrophic diseases of the spine , primarily in:

• osteochondrosis,
• spondyloarthrosis
• and spondylosis.

Complication

Complications often arise in the form of:

• herniated intervertebral discs ,
• scoliosis (curvature of the spine) ,
• stenosis (narrowing) of the spinal canal ,
• spondylolisthesis (“slipping” of vertebrae from each other).

Neurological deficit

This leads to a disruption of the normal anatomy of the spinal canal, which affects the nerve structures located in it – the spinal cord and its roots, which, in turn, leads to the appearance of neurological deficits in the form of:

• movement disorders,
• sensitivity,
• pelvic organ functions, etc.

In this situation, it seems most appropriate for a neurosurgeon to help the patient with a combined surgical intervention – a decompressive-stabilizing operation, which involves decompression (elimination of compression of nervous structures by a pathological substrate) and stabilization of the spinal column to restore its axis and biomechanics, and therefore, normalize its physiological functions.

A few examples

When performing operations to remove herniated intervertebral discs at the cervical, thoracic, or lumbar levels, the installation of an interbody cage is used to prevent instability in the spinal motor segment and further “subduction” of the vertebrae.

A cage is a small “washer”-like structure that is inserted between the vertebral bodies after a disc is removed and keeps the vertebrae in an optimal position throughout life. Essentially, a cage is a prosthesis for the removed intervertebral disc .

In some cases, a special titanium plate is used for additional stabilization, which is installed in front of the bodies of adjacent vertebrae, between which a cage has already been installed.

In some cases, our department installs various types of cages at the lumbar level after removing herniated discs (the so-called techniques:

• PLIF,
• TLIF,
• OLIF,
• ALIF

with fixation of adjacent vertebrae with titanium screws and beams).

Microsurgical decompression and dynamic interspinous stabilization

One of the most effective methods of surgical treatment of spinal canal stenosis (narrowing) is considered to be a combination of microsurgical decompression and dynamic interspinous stabilization.

During decompression, the structures that compress the nerve root are removed:

• bone growths (osteophytes),
• yellow bundle,
• intervertebral (facet) joints, etc.

Dynamic interspinous spinal fixation systems are so called because they allow for the preservation of some mobility in the operated spinal segment.

They are divided into designs with and without screws (interspinous implants). Such systems allow for more physiological fixation, preventing overgrowth of the intervertebral joints, which occurs when using other systems with more rigid fixation.