[Principles in sequelae of spinal injuries.].
Persisting or newly developed sequelae of spinal injuries can be encountered after conservative as well as surgical treatment. On the spine it is a deformity, most frequently a pathological kyphosis, instability or possibly stenosis of the spinal canal. All these factors can evoke pain and lead secondarily to progression of an already present nervous affection or to its late development. In the first place it is necessary to deal in these conditions with the deformity which along with the instability leads to permanent pain. The usual indication for surgery is a pathological kyphosis of the thoracolumbal transition above 15 degrees, but its tolerance is frequently individual. Late nervous lesions are usually the result of the intra- and extradural development of scars, spinal cord atrophy and posttraumatic syringomyelia. Failure of the original treatment is due to incorrect assessment of the type of injury, inadequate conservative or surgical treatment, incorrect surgical technique and errors as regards the selection of the surgical procedure. Correct assessment of the posttraumatic condition calls for detailed radiodiagnostic assessment. Many posttraumatic deformities call for a combined anterior and posterior operation. However, if there is no posterior obstacle for correction it is possible to implement only an anterior operation. Contemporary surgical techniques and implantation systems make short fusion with a minimal functional loss possible. Key words: posttraumatic deformity, neural deficit, surgical tactics.
Vlach
O
O
Ortopedická klinika, Brno - Bohunice.
Chaloupka
R
R