THE USE OF TOTAL LAMINECTOMY AND INTERNAL FIXATION WITH TRANSPEDICULAR SCREWS UNDER MICROSCOPIC SUPPORT IN TUMORS OF THE LUMBAR SPINE.

Abstract

The article presents a clinical case of the surgical treatment of a tumour of the lumbar spine by the method of total laminectomy with internal fixation by transpedicular screws and microscopic support. In a 51-year-old patient with a space-occupying lesion of the L3 vertebral body compressing the cauda equina and the roots of the spinal cord, a pronounced pain syndrome, paraesthesia of the right lower limb and disturbances of pelvic organ function were noted; the indicators were VAS - 6 points, ODI - 64%. According to MSCT, MRI and tractography data, a localised tumour with a risk of instability of the vertebral column was verified. Total laminectomy, transpedicular fixation at the L2-L4 level and cementing of the L3 body were performed. In the postoperative period no complications (cerebrospinal fluid leakage, purulent-inflammatory processes) were observed; after 1 month the VAS decreased to 3 points and the ODI to 27%, and after 12 months to 0 and 5% respectively. Follow-up CT/MRI confirmed the restoration of the posterior supporting column, the healing of the ligamentous apparatus and the absence of restenosis. The authors conclude that the combination of total laminectomy with transpedicular fixation contributes to the restoration of spinal stability and to the improvement of the long-term functional results in patients with tumour lesions of the lumbar region.