Reconstruction of the spinal canal in case of multilevel stenosis of the cervical spine

摘要

FIELD: medicine.SUBSTANCE: invention refers to medicine, namely to neurosurgery, and can be used in the surgical management of multilevel stenosing compression disorders of the cervical spine for the purpose of maximum decompression of neural structures. Method involves separating the interfacial space within the stenosing process, resection of the vertebral arches, mobilization of the posterior wall of the spinal canal, performing the intra-channel manipulations, restoring the integrity of the posterior spinal wall. When performing access to the spinal canal, the supraspinous and interobspiratory ligamentous excision is performed. Then, between the spinous processes of the adjacent vertebrae, the base of the underlying spinous processes is layer-by-layer drilled, keeping its part together with the attached muscles and ligaments. Arches of superior and underlying vertebra are resected. That is followed by microsurgical reconstruction of the spinal canal with increasing its diameter preserving the facet joints. That is followed by an intra-channel manipulation: a yellow ligament is mobilized from the underlying bone, a hypertrophied portion of the yellow ligament is excised throughout the stenotic process to a dural sac and spinal roots. Then the posterior wall of the spinal canal is recovered, the remaining parts of the adjacent spinous processes of the resected vertebrae are fixed to each other and to the adjacent spinous processes of the overlying and underlying spines with the lavsan thread through the holes in them.EFFECT: method provides maximum decompression of neural structures and preservation of natural biomechanics in operated vertebral-motor segments by increasing the size of spinal canal and absence of destabilizing effect.1 cl, 10 dwg, 1 ex