neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2018-20-2-74-82neurosurgery-555Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWДиагностика, патогенез и лечение повреждений твердой мозговой оболочки при позвоночно-спинномозговой травмеDiagnostics, pathogenesis and treatment of damage to the dura mater in spinal injuryМартикянА. Г.MartikyanA. G.

Аветик Гургенович Мартикян

129090 Москва, Большая Сухаревская пл., 3

amartikyan@mail.ruhttps://orcid.org/0000-0003-3515-8329ГриньА. А.GrinA. A.ГБУЗ «Научно-исследовательский институт скорой помощи им. Н. В. Склифосовского Департамента здравоохранения г. Москвы»РоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian FederationГБУЗ «Научно-исследовательский институт скорой помощи им. Н. В. Склифосовского Департамента здравоохранения г. Москвы»; ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А. И. Евдокимова» Минздрава РоссииРоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department; A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of RussiaRussian Federation2018190720182027482Copyright © Мартикян А.Г., Гринь А.А., 20182018Мартикян А.Г., Гринь А.А.Martikyan A.G., Grin A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/555

Цель исследования – проанализировать данные научных источников, посвященных проблемам патогенеза, диагностики и лечения повреждения твердой мозговой оболочки (ТМО) при позвоночно-спинномозговой травме (ПСМТ); описать факторы риска разрыва ТМО и осложнения при хирургическом лечении ее повреждений.

Результаты

Результаты. По данным литературы установлено, что частота повреждения ТМО при ПСМТ варьирует от 7,7 до 65,0 %. Наиболее информативный и безопасный метод диагностики – магнитно-резонансная миелография, однако ее специфичность не достигает 100 %. Для профилактики развития ранних и поздних осложнений в послеоперационном периоде в основном применяют герметизацию ТМО, предпочтительна расширяющая пластика.

Заключение

Заключение. Отсутствие «золотого стандарта» закрытия дефекта ТМО при ПСМТ связано с разнообразием форм повреждения ТМО и сложностями ее пластики и герметизации.

 

 

The study objective is to discuss the issues concerning to pathogenesis, diagnostics and treatment of dura mater tear in spinal injuries. The issues regarding to the risk factors for dura mater tears and complications of surgical treatment in spinal injuries were considered.

Results

Results. It is established that the frequency of dural tears in spinal trauma varies from 7.7 to 65.0 %. The most informative and safe method of diagnosis is magnetic resonance myelography, but its specificity does not reach 100 %. To prevent the development of early and late complications in the postoperative period is mainly used dura mater sealing, preferably expanding plastic.

Conclusion

Conclusion. The absence of the “gold standard” of dura mater defect closure in spinal trauma is associated with a variety of forms of dura mater damages and the difficulties of its plasticity and sealing.

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The authors declare that there are no conflicts of interest present.