Vertebroplasty spine: types and methods
Every day the volume of medical services increases, and the operations for the treatment of the spine, such as vertebroplasty and various types of plastic knee joint become commonplace. Plastic is a surgery whose goal is the elimination of deformation or defect. Most often these operations are performed after injury or long term disease of the joints, leading to their deformation.
It should be noted that against the backdrop of increasing number of accidents, serious injuries and a sedentary lifestyle are the most frequently observed lesions of the spine or the knee joint. Fractures of the spine most commonly occur in young adults. In the structure of all fractures they occupy up to 20 % and are among the most serious injuries in traumatology and orthopedics. Diseases of joints are each of a third at the age of 45 years and 60 years suffer from them 90 % of the elderly. In connection with such a high incidence of lesions of the knee joint and the dire consequences of fracture of the spine requires the extensive application of modern methods of treatment.
Plastic damage of the vertebrae
Vertebroplasty is a surgical treatment and pathological compression fractures of the spine. It runs with minimal incisions and the introduction into the vertebral body special cement, designed for bone tissue. (A pathological fracture of the spine is a violation of the integrity of bone tissue that occurs because of the damaging effect of metastases or other diseases to the bone.)
Effective vertebroplasty in the presence of metastatic tumor in the spine that is accompanied by softening of the bone and pathological fracture of the vertebral body. Vertebroplasty allows you to quickly repair the bone defect with special cement and to connect bone fragments, which makes it an effective treatment in uncomplicated traumatic compression fractures. The cement also stops the progression of the lesions of the spine metastases.
Indications for carrying out vertebroplasty are also fractures of the spine on the background of pronounced osteoporosis of the active currents of vertebral angioma or any other oncological process, which violates the structure of the bone. Also, vertebroplasty is effective in pain caused by the death of bone tissue in diseases of Kümmel or uncomplicated compression fracture of the vertebral body.
Vertebroplasty is performed under local anesthesia. The patient is placed on stomach or back, depending on what the surgeon has selected access: front or rear. Front access is optimal for injuries of the cervical spine, and the rear – for all other departments. Access is a small skin incision for the subsequent insertion of a special needle with a trocar, which is necessary to puncture the bone tissue. Insert the needle through the anterior wall of the vertebral body or the back handle. After being hit directly into the vertebral body injected dissolved medical cement, which hardens in 10-15 minutes and is heated inside the vertebra to 70°. Vertebroplasty also provides damage cancer cells, destroyed a vertebra due to the temperature rise of the cement.
After surgery, the patient stays in hospital for 1-2 days. Vertebroplasty is a safe procedure and has a very low risk of complications.
The operation to restore function of the knee
The total knee replacement is an operation that aims to eliminate defects that prevent the normal functioning of the joint. The most popular form of arthroplasty is joint replacement. This method has proved popular due to the short recovery period after surgery, early mobilization of patients and quick recovery of motion in the operated joint. When replacement is carried out replacing the whole joint or parts of artificial surfaces, which can reduce or eliminate pain and to ensure the full mobility of the knee joint.
Indications for arthroplasty: deforming osteoarthritis, avascular necrosis, cystic restructuring of the articular surface, rheumatoid arthritis and tumor, tibia or femur. Knee replacement surgery is contraindicated if the patient has infectious diseases, aggravation of thrombophlebitis, and chronic infection foci. Operation is inappropriate if the patient cannot straighten the leg because of a violation of the muscles of the knee. Also, joint replacement is not possible in case of gross traumatic scarring in the area of the knee that are soldered to the underlying bones.
Depending on the model number of the articular surfaces there are several types of knee replacement:
In total hip arthroplasty replace the articular surfaces as the femur and the tibia and patella. It is conducted with long-term disease of the knee joint, accompanied by severe deformity not amenable to medical treatment. For odnoselchanka endoprosthesis is characterized by the restoration of the femoral-tibial articulation. Also pursuing replacement of the surfaces of the knee joint between the femur and patella.
Joint replacement is appointed in the absence of effect after comprehensive medical treatment. But we should not delay the surgical intervention, because the more you saved a function of the joint prior to surgery, the better the effect will be after it.
Methods of restoration of cartilage of the knee joint
To restore the integrity of cartilage tissue is chondroplasty the knee joint. Its application is necessary, when there is a breach in a small area, as the cartilage regenerates very slowly, and its damage can lead to serious complications in the form of deforming arthrosis. It is worth remembering that a small damage to the cartilage is very hard to diagnose, but only with early diagnosis and adequate treatment in the early stages, you can achieve maximum results. In the absence of effect from chondroplasty and spreading lesions of the cartilage of the knee joint endoprosthesis is carried out.
There are two kinds of chondroplasty is abrasive and mosaic. Abrasive chondroplasty is an arthroscopic surgical intervention aimed at enhancing cartilage regeneration. (The arthroscope is a special device that allows to carry out diagnostics and treatment of joints through the incisions.) Immediately before the abrasive arthroplasty inspecting the cartilaginous tissue to confirm the diagnosis, and then using special arthroscopic instrument produce micro-holes in the cartilage. Such a minor trauma to the cartilage act positively, it activates the division and the regeneration of cartilage tissue. However, initially human hyaline cartilage, and we seek the regeneration of fibrous. Function and structure it is identical to hyaline but fibrous cartilage less resistant to stress and damage.
Mosaic chondroplasty is based on the transplantation of cartilage that is taken from the patient’s healthy joint, which is not exposed to significant loads. The important point is the fence intact cartilage. Operation of extraction and transplantation is performed using the arthroscope.
After the closure of the defect with healthy flap of cartilage regeneration starts with replacement of the defect in the fibrous cartilage. However, this regeneration is more pronounced, which can lead to the decrease in the area of hyaline cartilage.
Mosaic chondroplasty is an inexpensive operation and with proper implementation can prevent further destruction of cartilage and the need for joint replacement.