METHOD OF C1-C2 TRANSARTICULAR VERTEBRAL FIXATION

FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to neurosurgery, traumatology with the C1-C2 vertebral fixation. Location of the skin incision (marker) is determined for the introduction of a tubular retractor with an endoscope, for which under X-ray control in the lateral and transoral projections, x-ray needles are applied in the same direction as screws tips. Wherein the intersection points of these needles are the middle of the skin incision. In these locations, two skin incisions of 3 cm are made, the subcutaneous fat and the aponeurosis are dissected. To the articular process C2 of the vertebrae, the Kirchner needle is set, along the Kirchner needle, the muscular canal is distended by using dilator systems and a tubular retractor is installed. Under the control of the endoscope, the right and left articular processes of the C2 vertebrae are skeletonised, the cortical bone is perforated in the place of insertion of the screw tip firstly in the right articular process, then in the left one. This place is supported by the tapered end of the guide wire for the needles, performing the further steps of the operation under the biplanal X-ray control. Kirschner needles are set by turns, firstly on one side, then on the other side through the port and the guide wire for the needles from the point of screw tip insertion through the rear structures of the C2 vertebrae into the lateral masses of the atlas, with the help of a drill. Bone canaliculus are drilled in the C1 and C2 vertebrae by the needles and then the cannulated screws are alternately installed. Wounds are closed in layers, beginning with the aponeurosis, finishing the operation with an intradermal suture.EFFECT: method prevents postoperative complications.1 cl, 14 dwg, 2 ex Изобретение относится к медицине, а именно к нейрохирургии, травматологии при фиксации С1-С2 позвонков. Определяют локализацию кожных разрезов (разметку) для введения тубулярного ранорасширителя с эндоскопом, для чего под рентгенологическим контролем в боковой и трансоральной проекциях прикладывают рентгенконтрастные спицы соответственно ходу винтов. При этом точки пересечения этих спиц являются серединами кожного разреза. В этих локализациях выполняют два кожных разреза по 3 см, рассекают подкожно-жировую клетчатку и апоневроз. К суставному отростку С2 позвонка устанавливают спицу Киршнера, по которой выполняют расширение мышечного канала при помощи системы дилататоров и устанавливают тубулярный ранорасширитель