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Surgical treatment of patients with metastatic pathological vertebral fractures


Author: Olaru Andrei
Degree:doctor of medicine
Speciality: 14.00.22 - Orthopedics and Traumatology
Year:2019
Scientific consultants: Ion Mereuţa
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Nicolae Caproş
doctor habilitat, associate professor (docent), Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 4 September, 2018
Approved by NCAA on the 25 January, 2019

Abstract

Adobe PDF document – 0.99 Mb / in romanian

Thesis

CZU 616.711-001-089.8 : 616.711-006-033.8-089.84

Adobe PDF document 12.28 Mb / in romanian
180 pages

Keywords

spine, metastases, vertebral tumors, pathological fracture, radiotherapy, vertebroplasty, kyphoplasty, Coblation, radiofrequency ablation

Summary

The paper contains 116 typewritten pages and includes: introduction, 4 chapters containing the material and methods and the results of the author’s own researches, general conclusions and practical recommendations, bibliography citing 245 literary sources, and 13 appendixes. The illustrative material: 35 tables and 26 figures. Eighteen scientific articles were published based on this thesis.

Field of Study: orthopedics and traumatology Aim: consists in comparative study of impact on quality of life and survival after combined minimally invasive surgical techniques and their implementation in therapeutical complex of the patients with pathological metastatic vertebral fractures.

Objectives: assessment and specification of indications and contraindications of minimally invasive techniques combined in the surgical treatment of patients with metastatic pathological vertebral fractures; multifactorial evaluation of the effectiveness of minimally invasive combined surgical techniques with the radiotherapy treatment method (applied alone); studying the clinical-evolutionary features of oncological, neurological and orthopedic status after treatment and assessing their influence on quality of life and survival; developing a decision model for the selection and application of minimally invasive combined surgical techniques that would reduce health risks and medical complications.

Scientific novelty and originality: This paper is a comparative complex study of the results obtained in the treatment of patients with metastatic pathological vertebral fractures. Was optimized indications of surgical treatment of patients with metastatic pathological vertebral fractures using minimal-invasive surgical techniques, taking into account the continuing need of special oncologic treatment.

Scientific problem solved in thesis: It was argued the need for an active and integrated approach in the surgical treatment of this category of patients in order to improve their quality of life and prepare for subsequent stages of special cancer treatment.

Theoretical importance and applicative value of the work: was motivated by a complex manner the need to active surgical involvement in the treatment of patients with metastatic pathological vertebral fractures in order to improve their quality of life and preparation for the later stages of the oncological targeted treatment.

Implementation of the scientific results: Results of the study was approved and implemented as scientific value in specialized clinics in Republic of Moldova. The work results and developed diagnostic algorithms will be included in the National Clinical Protocol „Pathological fractures”.