neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2018-20-3-81-90neurosurgery-606Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWФактор времени в хирургии позвоночно-спинальной травмы (обзор литературы)The timing in surgery of spinal trauma (a review)https://orcid.org/0000-0003-3515-8329ГриньА. А.Grin’A. A.https://orcid.org/0000-0001-5344-3970КордонскийА. Ю.KordonskiyA. Yu.

Антон Юрьевич Кордонский

129090 Москва, Большая Сухаревская пл., 3

akord.neuro@mail.ruhttps://orcid.org/0000-0003-1718-0792ЛьвовИ. С.LvovI. S.https://orcid.org/0000-0001-8547-3322КайковА. К.KaikovA. K.https://orcid.org/0000-0001-5565-4018СытникА. В.SytnikA. V.https://orcid.org/0000-0002-1804-9836БогдановаО. Ю.BogdanovaO. Yu.ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России; 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»РоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian Federation2018190920182038190Copyright © Гринь А.А., Кордонский А.Ю., Львов И.С., Кайков А.К., Сытник А.В., Богданова О.Ю., 20182018Гринь А.А., Кордонский А.Ю., Львов И.С., Кайков А.К., Сытник А.В., Богданова О.Ю.Grin’ A.A., Kordonskiy A.Y., Lvov I.S., Kaikov A.K., Sytnik A.V., Bogdanova O.Y.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/606

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

Результаты

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

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.

The study objective is analyze the modern ideas about the influence of time factor on the treatment outcome of patients with spinal cord injury. 

Results

Results. Experimental studies clearly demonstrate the effectiveness of early decompression. According to the results of meta-analyses, in patients who underwent early decompression of the cervical segment of spinal canal, the outcomes of treatment may be better compared with the treatment outcomes of patients who underwent delayed intervention. The benefit of early decompression of the thoracic and lumbar spinal cord is not statistically significant. The difference in the rate of intraand postoperative complications and lethality between early and late decompression groups is also statistically insignificant.

Conclusion

Conclusion. Early decompression of the spinal canal and spinal stabilization (≤24 h) should be performed in a specialized hospital as fully as possible and as early as the severity of the patient condition allows.

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