НЕБЛАГОПРИЯТНЫЕ ИСХОДЫ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ БОЛЬНЫХ СО СТЕНОЗИРУЮЩИМИ ПРОЦЕССАМИ ПОЗВОНОЧНОГО КАНАЛА НА ПОЯСНИЧНОМ УРОВНЕ

Зинаида Васильевна Кошкарёва; Александр Петрович Животенко; Оксана Васильевна Скляренко; Владимир Алексеевич Сороковиков; Виталий Энгельсович Потапов

Зинаида Васильевна Кошкарёва Irkutsk Scientific Centre of Surgery and Traumatology, Irkutsk, Russia http://orcid.org/0000-0002-4387-5048
Александр Петрович Животенко Irkutsk Scientific Centre of Surgery and Traumatology, Irkutsk, Russia http://orcid.org/0000-0002-4032-8575
Оксана Васильевна Скляренко Irkutsk Scientific Centre of Surgery and Traumatology, Irkutsk, Russia http://orcid.org/0000-0003-1077-7369
Владимир Алексеевич Сороковиков Irkutsk Scientific Centre of Surgery and Traumatology, Irkutsk, Russia; Russian Medical Academy of Continuing Professional Education, Moscow, Russia http://orcid.org/0000-0002-9008-6383
Виталий Энгельсович Потапов Irkutsk Scientific Centre of Surgery and Traumatology, Irkutsk, Russia

Abstract

Aim: to identify the causes of adverse outcomes of surgical treatment of patients with stenotic processes of the spinal canal at the lumbar level in the risk group.

Methods. The paper presents an analysis of 573 operated patients with stenosing processes of the spinal canal at the lumbar level with the use of stabilizing metal structures in order to identify unsatisfactory treatment outcomes and complications in the postoperative period.

Results. The data of domestic and foreign literature correspond to the results of this study to identify adverse factors, in particular – age> 60 years, BMI (body mass index)> 30 kg / m2, smoking, chronic diseases (anemia, coronary heart disease, hypertension, chronic obstructive lung disease), long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), diabetes mellitus, chronic infections, rheumatoid arthritis, immunodeficiency states, volume and trauma of surgery, duration of surgeries and> 3 hours the amount of blood loss over 1000 ml. So, marked marker adverse factors affecting the possibility of the development of purulent-inflammatory infection in the wound. Of the 573 patients analyzed, a risk group was identified in an amount of 273 patients. In 10 of them, a number of complications developed in the postoperative period, including the main clinical nosological forms of purulent-inflammatory complications in the wound. Bacteriological examination of postoperative wounds revealed the most common pathogens of purulent-inflammatory infection.

Conclusion. As a result of a comprehensive analysis of the surgical treatment of 573 patients, specific ways of reducing the incidence of adverse outcomes and purulent-inflammatory complications and their severity were identified.

Author Biographies

Зинаида Васильевна Кошкарёва, Irkutsk Scientific Centre of Surgery and Traumatology, Irkutsk, Russia

Koshkareva Zinaida Vasilyevna – Candidate of Medical Sciences, Leading Research Officer at the Research Clinical Department of Neurosurgery, Irkutsk Scientific Centre of Surgery and Traumatology http://orcid.org/0000-0002-4387-5048

Александр Петрович Животенко, Irkutsk Scientific Centre of Surgery and Traumatology, Irkutsk, Russia

Zhivotenko Aleksandr Petrovich – Research Officer at the Research Clinical Department of Neurosurgery, Irkutsk Scientific Centre of Surgery and Traumatology (e-mail: sivotenko1976@mail.ru) http://orcid.org/0000-0002-4032-8575

Оксана Васильевна Скляренко, Irkutsk Scientific Centre of Surgery and Traumatology, Irkutsk, Russia

Sklyarenko Oksana Vasilyevna – Candidate of Medical Sciences, Senior Research Officer at the Research Clinical Department of Neurosurgery, Irkutsk Scientific Centre of Surgery and Traumatology (664003, Irkutsk, ul. Bortsov Revolyutsii, 1; tel. (3952) 29-03-46; e-mail: oxanasklyarenko@mail.ru) http://orcid.org/0000-0003-1077-7369

Владимир Алексеевич Сороковиков, Irkutsk Scientific Centre of Surgery and Traumatology, Irkutsk, Russia; Russian Medical Academy of Continuing Professional Education, Moscow, Russia

Sorokovikov Vladimir Alekseevich – Doctor of Medical Sciences, Professor, Director, Irkutsk Scientific Centre of Surgery and Traumatology, Head of the Department of Traumatology, Orthopedy and Neurosurgery, Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional Education http://orcid.org/0000-0002-9008-6383

Виталий Энгельсович Потапов, Irkutsk Scientific Centre of Surgery and Traumatology, Irkutsk, Russia

Potapov Vitaliy Engelsovich – Candidate of Medical Sciences, Head of Neurosurgical Unit, Irkutsk Scientific Centre of Surgery and Traumatology (664003, Irkutsk, ul. Bortsov Revolutsii, 1. e-mail: pva454@yandex.ru http://orcid.org/0000-0001-9167-637Х)

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2018. Vol. 13. P.114. DOI: 10.1186/s13018-018-0821-2.
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12. Picada R., Winter R.B., Lonstein J.E., et al. Postoperative deep wound infection in adults after posterior lumbosacral spine fusion with instrumentation: incidence and management // J Spinal Disord. 2000. Vol. 13. P.42-45.
13. Whitehouse J.D., Friedman N.D., Kirkland K.B., et al. The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost // Infect Control Hosp Epidemiol. 2002. Vol. 23. P.183-189. DOI: 10.1086/502033.

PURULENT COMPLICATIONS OF POSTOPERATIVE WOUNDS IN PATIENTS WITH SPINAL CANAL STENOSIS AT THE LUMBAR LEVEL

Abstract

Author Biographies

References