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Journal of Neurology and Neurorehabilitation Research | Volume 3
allied
academies
November 26-27, 2018 | Dubai, UAE
Spine and Spine Disorders
Addiction Research and Therapy
3rd International Conference on
International Conference on
Joint Event
&
T
he study that was carried out is a comparison between
patients, suffering from a severe degenerative pathology,
treated surgically by an interspinous fixation system and
by Spinal Arthrodesis instrumented with rods and screws.
The requirement of stability is of primary importance for
the vertebral column in order to prevent a premature
mechanical and biological degeneration of its components.
In biomechanics, instability is defined as a lack of stability
caused by an increase in mobility in the motion segments
from the presence of anomalous vertebral movements
and a slight rigidity of the FSU (Functional Spine Unit).
Spinal Arthrodesis is currently the gold standard in the
treatment of severe lumbar instability and severe deformities.
The aim of the surgeon is to restore the mechanical stability
and the physiological balance of the spine in both the coronal
and sagittal planes. To achieve these objectives it is necessary
to use a means of synthesis endowed with great force
associated with the execution, in selected cases, of specific
techniques (osteotomies, cages, intersomatic cages, etc.).
In serious degenerative diseases and in deformities, Minimally
Invasive Surgery does not allow optimal achievement of all
the objectives of the case, furthermore there is an important
exposure to ionizing radiation with risks to the patient, higher
percentagesofpseudo-osteoarthritisandimpossibilitytocorrect
a deformity: in fact it is not possible to perform a cruentation
of the joint apophyses and to implement a stable arthrodesis.
Open surgery, on the other hand, provides the possibility
to improve the correction on both the coronal and sagittal
planes, promote the arthrodesis which is more likely to obtain
it, minimise radiation exposure with modest blood loss, easily
control postoperative pain, have patients standing up on the
first day and allow discharge on the third or fourth day. The
success rate is around 95% in the medium term and in complex
surgical cases, ie coronal and/or sagittal deformities, the success
rate is around 87-90%.
All this, in most cases, is the result of combined anterior, lateral
and posterior surgical approaches, with good results observed
in the medium term. In the operating room average surgical
times vary between one and a half hours and two hours with
modest blood loss andeasilymanagedpost-operativepain relief.
Table: * Stabilization of 2/3 vertebral segments associated with decompression;
** Opiates and NSAIDs
Speaker Biography
Pierpaolo Mura is an orthopedic specialist in scoliosis and an expert in Spinal Ssurgery.
He also serves as a professor at La Sapienza University of Rome, Polo Pontino and
Chair in Orthopedics contract. He is specialized in Orthopedics and Traumatology
and diagnostic radiology. He is the Director of the Department of Orthopedics; and
Founder and Director of the Unit Complex Spine Surgery Center and Scoliosis Surgery
Section. He is the head of unit of Orthopaedics and Regional Delegate of the Italian
Society of Spine Surgery GIS (Italian Scoliosis Group) as well as an active member
of SRS (Scoliosis Research Society). He is also scientific director of the research
project on biomaterials in spine surgery at the Science and Technology Park in Pula.
e:
pierpaolomura1@gmail.comPierpaolo Mura
Sapienza University of Rome, Italy
Spinal Arthrodesis with instrumentation: Open Surgery vs Percutaneous Surgery