34th Annual Scientific Meeting proceedings

Traumatic spinal cord injuries (SCI) have devastating physical, psychosocial and vocational implications for patients and caregivers. The goals of treatment in managing spine trauma are prevention of neurological injury, providing stability to the spine, and correcting post-traumatic deformity. SCI can be divided into primary and secondary phases. Primary CSI is caused by the physical forces of the initial traumatic event and is often the most important determinant of injury severity. After the primary injury, a cascade of secondary injury events is initiated which serves to expand the zone of neural tissue injury and exacerbate neurological deficits. We cannot influence the primary injury, but quick and appropriate surgery followed by conservative management and rehabilitation can help reduce untoward sequelae of the primary injury. The goal of early surgical decompression after SCI is to relieve compression of the spinal cord, thereby improving the vascular supply to the injured area and limiting the zone of secondary injury expansion.

The lecture will present current strategies in surgery of spinal injuries in humans. Examples of spinal injuries will be shown together with surgical methods to address these injuries.

The dynamic development of minimally invasive techniques and advances in technologies supporting the surgeon in the operative field offer a range of new possibilities for use in daily clinical practice. Minimally invasive percutaneous fracture fixation is popular nowadays. These procedures rely on intraoperative navigation to safely and precisely place implants in the spine. Minimally invasive spine surgery techniques have the potential to reduce open approach-associated morbidity and improve postoperative care and rehabilitation in a variety of spine fractures and clinical scenarios.

The decision-making process regarding the technique for treating spine fractures, especially atypical fractures, should account for the patients’ quality of life after the operation. The preservation of as much of the physiological range of motion as possible with maintained spinal stability should be the goal of therapy in every case. The use of modern minimally invasive surgical techniques aided by intraoperative navigation and the recently introduced surgical robots significantly aids surgical treatment of spine and spinal cord injuries.