The most complex high-tech operation was performed by neurosurgeons from the Moscow City Clinical Hospital named after. V.V. Veresaev, a 64-year-old patient who, after a fall, had fractures of the first and second cervical vertebrae and the occipital bone of the skull.
In the State Clinical Hospital named after. V.V. Veresaev performed a rare operation on a trauma patient delivered by ambulance. A computed tomography scan showed a fracture of the occipital bone and a brain contusion, a burst fracture of the first cervical and damage to the second vertebrae. It was impossible to fix the damaged bones with a regular plate, so neurosurgeons performed a jewelry operation, the press service of the Moscow Department of Health reported.
Trauma to the upper cervical spine accounts for up to 10% of the total number of spinal injuries, and in 70–80% of cases, when the first vertebra is fractured, the second also suffers. Damage to the junction of the skull and the cervical spine is very dangerous due to the unique anatomy of this area – the brain stem, vertebral arteries, and upper segments of the spinal cord are located here. Such injuries can lead to complete immobility and death of the victim. Therefore, it was extremely important for the patient to urgently rigidly fix the cervical spine; the slightest movement could lead to injury to the brain and spinal cord.
“The first cervical vertebra was completely destroyed, which made it impossible to attach it to the neighboring one. Therefore, it was not possible to fix the damaged bones with a conventional plate,” said the head of the neurosurgical department Alexander Zavyalov. – For such injuries, the only solution is attachment to the occipital bone. This is a very rare operation.”
Previously, patients with such injuries wore special bulky structures for up to six months, which had to be periodically adjusted. High-tech operations are now available.
The operation was carried out with pinpoint precision and lasted 3.5 hours. It required serious preparation – examinations and calculations, since the screws had to be screwed into the vertebrae at strictly adjusted angles and to a certain depth so as not to damage the spinal cord and brain, while maximizing the mobility of an important part of the body.
Under X-ray control, the damaged skull bones and upper cervical vertebrae were connected into a single block using special fasteners. A personal modular design was urgently ordered for this patient.
Operation was successfully completed. The woman was discharged from the neurosurgical department on the eighth day.