STRATIFICATION OF SURGICAL AND REHABILITATION TREATMENT FOR POST-TRAUMATIC MYELOPATHIES AT THE CERVICAL AND THORACIC SPINE LEVELS
Keywords:
post-traumatic myelopathy, treatment stratification, surgical treatment, rehabilitation, spinal canal stenosis, neurogenic bladder and bowel dysfunction (NBD), motor disordersAbstract
The article presents a developed stratification of surgical and rehabilitation treatment for post-traumatic myelopathies based on a retrospective analysis of 170 patients. The study confirmed the high relevance of the problem (68% of spinal cord injuries, disability of working-age individuals, frequent neurogenic bladder and bowel dysfunction (NBD) and motor disorders). Key factors for stratification included the degree of spinal canal stenosis and stability of metal constructs. Differentiated surgical intervention algorithms (from conservative tactics to revision surgeries) and personalized rehabilitation programs (focusing on NBD correction and spasticity management) were developed based on risk groups (mild, moderate, severe). Unfavorable prognostic factors were identified (stenosis >70%, urinary retention, age >50 years, construct instability). Long-term results (at 12 months) showed significant improvement in functional outcomes across all groups, especially with early decompression and a multidisciplinary approach. The proposed stratification optimizes the management strategy for patients with post-traumatic myelopathy.
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