Sagittal balance Sagittal disbalance 180 Sagittal index JP

Sagittal balance

Sagittal disbalance

~180

Sagittal index JP Farcy and coll. . , 1993

3 D Multispiral Flexible system shp all pll Rosmanov 1996

Trauma, intraop. , x – ray, profile Criteria for sagital balance / index/ restauration of anterior distance between subhondral lamina

32♀ - 9 m. post laminectomy

posterior instrumentations • Less volume surgery • Good recovery of sagittal index in lowgrade fractures • Self-walking the next day

anterior instrumentations • Choice method at “burst””fractures • Direct recovery of Sagittal Index /SI/ • Access to the front of the spinal canal

APPROACHES • LUMBOTOMIES /Levels: L 2, L 3, L 4/ • THORACO-PHRENOLUMBOTOMIES /Levels: Th 11 - L 1/ • THORACOTOMIES / Proximal to Th 11/

Simultaneous anterior/posterior

Simultaneous anterior/posterior anterior graft from cristra iliaca

Simultaneous anterior/posterior Optimal recovery SI Volume of surgery Trained team Hospital and organization

Degenerations intraop. , x – ray, profile Criteria for sagital balance / index/ restauration of intervertebral spaces for two and more segments

Coronal and sagital To stretch posterior longitudinal ligament for additional decompression of the channel