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The Surgical Treatment Options in Thoracolumbar Spine Degeneration: The Importance of Morphological and Clinical Classifications in Preoperative Decision Making
Bludovský, David ; Přibáň, Vladimír (advisor) ; Chaloupka, Richard (referee) ; Rudinský, Bruno (referee)
The surgical treatment options in thoracolumbar spine degeneration: The importance of morphological and clinical classifications in preoperative decision making David Bludovský Abstract: Objective: The aim of our study was to investigate the relations between subjective difficulties, clinical findings and the MR imaging in patients who have been operated for symptomatic lumbar spinal stenosis (LSS), and the possibility of using these relations for surgical treatment decision. Methods: Patients operated for lumbar spinal stenosis in 2009-2010 were included in the study. Subjective difficulties were assessed using the Oswestry Disability Index (ODI), the clinical symptoms with the modified Neurological Impairment Score for Lumbar Spinal Stenosis (mNIS-LSS). We measured the spine canal area, dural sac area, and nerve root sedimentation classification on MR. By correlation analysis at significance level p <0.05, we tested the relations between these categories. 61 patients with a median age of 67 were included. Overall, we evaluated 162 spinal segments. Results: Median of ODI values were 48. Correlation coefficients for ODI, mNIS-LSS and graphical findings were less than 0.5. Correlation coefficients greater than 0.5 were between all the MR measurement methods. Conclusions: In the group of patients indicated...
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Reconstructive operations in spine region with bio-ceramic materials use
Lukáš, Richard ; Karpaš, Karel (advisor) ; Štulík, Jan (referee) ; Chaloupka, Richard (referee) ; Rudinský, Bruno (referee)
1. SUMMARY Introduction: During the period of the last 25 years remarkable changes occurred in the treatment of traumas of thoracolumbar spine. The surgical treatment was extended in cases where instability and impairment of its physiological shape are expected. This development is based on the progress in imaging technologies, more detailed understanding of spine biomechanics and a pathophysiology of its impairment. The situation was also influenced by the progression in surgical instruments and implants and also in the technology of bone substitutes. Aim of the study: The aim of the study is to analyze the long term morphological and clinical results after the surgical treatment of thoracolumbar fractures, in which the bioactive glass-ceramics in the form of granules was used as a bone substitute. Material and method: A series of 140 patients treated surgically for unstable thoracolumbar fracture (LSC points 4 - 6) during the period from 1997 to 2003 was studied. The average age of patients was 44 years (14 - 78). The patient collection consists of 83 males in the average age of 43,7 years (14-73) and 57 females in the average age of 44.9 years (15-78). The minimum follow-up was 24 months, the average follow-up period was 29 months. Patient series includes a group of 91 cases, in which the implant was...
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