актуальные вопросы хирургии позвоночника

advertisement
53
616.711'001.5'089
.
.
.
0,8⋅0,075
,
,
25'35
60%
.
0,3
.
:
,
,
,
,
'
'
'
,
'
'
'
,
.
' (2
40'45% [2, 10].
18 10
18
)
0,15
0,3 .
,
.
.
.
,
,
,
'
'
'
'
,
'
'
'
'
,
.
.
'
'
63
'
91%
,
.
'
.
«
'
.
»
'
'
'
'
17
'
'
[1'5].
,
[1, 3'6].
'
.
'
,
'
,
(
,
. 1).
'
.
0,1
60'80
.
,
'
'
'
,
.
. 1.
:
–
–
1–
0,2
25'35
.
,
'
,
'
, 2–
, 4–
,6–
(
_»
», 3 –
, 5–
0,2
,2
(
), 8 –
0,8
.
), 7 –
_
_
54
20'45
.
V
.
V
'
.
,
II
(
1
8).
,
1/2
,
.
'
2,2
'
.
(
11).
'
(
'
0,1
.
. 2).
.
,
,
( ),
,
15
,
0, 6, 7, 9, 10).
,
.
(
'
.
'
«
»
'
'
:
:0–
, 2–
, 4 –
'
'
,1–
,3–
Q = q +q ,
Q–
,q –
'
,
; q –
4, 5 –
, 6–
,
'
'
'
,7–
«
», 8 –
'
.
,
(Q)
'
, 9 –
,
'
,
,
(
, 10 –
, 11 –
. 3,
0'11).
'
,
«
».
15
'
'
,
,
0,2'0,3
(
1,
2, 3).
'
'
,
'
. 2.
«
'
»:
Q–
–
,P–
'
'
,
'
.
0,5
,
,f
_
,
.
. 3.
,
).
'
'
55
.
,
4'6
,
'
27'42
«
.
,
'
'
,
'
,
,
.
60'
(55
178 .
,
27'42
.
31
.
–
,
,
(3'
'
'
'
)
.
'
,
,
,
,
).
1,5'2'
'
'
'
.
'
'
.
'
'
»
,
,
1/3.
.
,
,
«
»
.
'
'
5
,
,
.
'
'
.
,
'
,
,
III
.
'
.
–
3'4
3'4
'
'
'
'
'
,
.
.
.
12
'
.
.
'
.
[9].
8'
12
,
.
'
)
.
,
«
«
»
,
.
'
»
[2, 10].
,
,
.
,
'
'
'
(III
,
,
'
'
'
'
'
'
'
'
,
,
,
.
164
21
'
'
55
.
,
1
101
12
,
23
16'57
1
'
,
'
5
'
.
.
.
,
.
20
.
'
'
'
'
56
(16
(12
(
)
)
'
'
'
).
20
(1993),
(1988),
( 1995).
(1994)
'
.
.
(18),
:
'
'
'
(6),
(7).
'
,
,
.
'
'
(5)
.
23
,
.
12
.
10
.
[8].
20
1.
'
'
'
'
'
.
'
'
'
.
.
.
18
.
.
.,
.//
.
2001. –
2.
3.
4. – . 30_33.
.
:
28631, 1970.
.
.–
.
.
.
.
.
.
,
'
5.
.
* * *
.
.
.–
, 1997.
:
6.
.,
,
12. – . 17_18.
.
.,
.//
.,
,
7.
,
.
.
8.
:
1811385 3, 1992.
.// II
'
,
.–
[2]
[7].
'
'
300
9.
10.
.
'
,
'
'
,
.
'
'
'
.
,
.
1974'1976
.
«
» (1988), «
» (1989), «
.
'
'
'
» (1979).
'
_
.
.
.
_
– 1984. –
.//
, 1988.
.–
,
_
_
.
)
.
.–
, 2002.
4.
(
2'3
.,
.
, 1971.
.
. – 1989. –
_
, 1994.
.–
.//
11. – . 61_64.
.:
_
.
17.06.03.
RELEVANT ISSUES OF SPINAL COLUMN SURGERY
A.M. Khodov
Vladivostok State Medical University
Summary – The issues relating to the treatment of patients with
spinal column injuries are of current importance in the present'day
traumatic surgery. The paper summarizes the research activities of
the chair of surgical vertebrology, and studies the biomechanical
characteristics of the «fixation device'spinal column» system while in
experiment. Experimental results have predetermined the choice of
spinal column fixation technique in the clinical practice. Only rigid
metal constructions could create optimal conditions for re'
covering anatomic and functional disorders. Open treatment of com'
pound fractures and fracture'dislocations of the vertebras prevails
over traditional conservative approaches. According to the overall
results of the research studies, two inventions have been developed
and introduced into a practice. Furthermore, the author shows
methodical role of the chair in developing the spinal column sur'
gery in Primorsky region.
Pacific Medical Journal, 2004, No. 1, p. 53_56.
Download