Фактор времени в хирургии позвоночно-спинальной травмы (обзор литературы)

Цель исследования – рассмотреть современные представления о влиянии сроков декомпрессивно-стабилизирующих вмешательств на исход лечения пациентов с повреждением спинного мозга.

Результаты. Экспериментальные исследования, посвященные декомпрессии спинного мозга, убедительно свидетельствуют об эффективности раннего вмешательства. Согласно результатам метаанализов у пострадавших с травмой шейного отдела спинного мозга, перенесших раннюю декомпрессию позвоночного канала, исходы лечения могут быть лучше по сравнению с пациентами, у которых выполняли отсроченное вмешательство. Преимущество ранней декомпрессии грудного и поясничного отделов спинного мозга статистически не доказано. Также статистически незначима разница между группами ранней и поздней декомпрессии по частоте интраи послеоперационных осложнений и летальности.

Заключение. Ранняя декомпрессия спинномозгового канала и стабилизация позвоночника (≤24 ч) должна быть выполнена в условиях специализированного стационара в максимально полном объеме и настолько рано, насколько позволяет тяжесть состояния пострадавшего.

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