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Ασθενής θεραπεύτηκε με αναίμακτη σπονδυλοδεσία

Ασθενής θεραπεύτηκε με αναίμακτη σπονδυλοδεσία

Δημοσιεύτηκε: Κυριακή, 4 Νοεμβρίου 2012 | ΑΓΓΕΛΙΟΦΟΡΟΣ ΤΗΣ ΚΥΡΙΑΚΗΣ
ΡΕΠΟΡΤΑΖ ΜΑΡΙΑ ΛΙΤΟΥ
Ενας 27χρονος στη Θεσσαλονίκη είναι ο τέταρτος ασθενής στον κόσμο και ο πρώτος στην Ευρώπη στον οποίο εφαρμόστηκε πρωτοποριακή τεχνική σπονδυλοδεσίας, η οποία, καταργώντας την ανοιχτή επέμβαση, θεραπεύει αναίμακτα όσους έχουν αστάθεια της σπονδυλικής στήλης.
Είναι η τελευταία κατάκτηση της χειρουργικής της σπονδυλικής στήλης και μέχρι πρόσφατα η εφαρμογή της έμοιαζε αδιανόητη ακόμη και για το χειρουργό ορθοπεδικό, ειδικευμένο στη σπονδυλική στήλη, ο οποίος την έφερε σε πέρας με επιτυχία.
Ο Βασίλης Λυκομήτρος, διδάκτωρ Ιατρικής Σχολής του Πανεπιστημίου Αθηνών και εκπρόσωπος της χώρας μας στην European Spine Society (Ευρωπαϊκή Εταιρεία Σπονδυλικής Στήλης), πρωτοστάτησε εφαρμόζοντας την πρόσθια λαπαροσκοπική σπονδυλοδεσία σε τραυματία - θύμα τροχαίου στη Γενική Κλινική.
Η λαπαροσκοπική προσπέλαση έγινε από το γενικό χειρουργό, στρατιωτικό γιατρό Δημοσθένη Αποστολίδη, ενώ ο κ. Λυκομήτρος συνδύασε τις εξειδικευμένες γνώσεις του στην αρθροσκοπική γόνατος και τη λαπαροσκόπηση κοιλιάς, στα οποία έχει εκπαιδευτεί εδώ και χρόνια στην Ελλάδα και το εξωτερικό.
Καινοτόμα τεχνική
Το μυστικό στην πρωτοπόρα τεχνική κρύβεται στα ειδικά εργαλεία και στην εκπαίδευση των χειρουργών. «Κάνουμε μια τομή μόλις ενός εκατοστού στην κοιλιά. Με λαπαροσκοπικά εργαλεία τοποθετούμε ειδικά υλικά, όπως κλωβοί και βίδες, τα οποία, όπως θα συνέβαινε στην ανοιχτή σπονδυλοδεσία, κρατούν το σώμα του ασθενή σταθερό. Οταν δεν έχουμε πρόβλημα, το σώμα μας στηρίζεται σε τέσσερις δίσκους και πέντε σπονδύλους. Ο 27χρονος ασθενής που αντιμετωπίσαμε πριν από λίγες μέρες έφερε βαρύ τραυματισμό και είχε εγχειριστεί με αποτυχία. Μέσα από τέσσερις τρύπες, περάσαμε μια κάμερα για να βλέπουμε συνεχώς την εικόνα στις οθόνες μας, λαπαροσκοπικά εργαλεία για την προετοιμασία των αγγείων και των σπονδύλων, ενώ τοποθετήσαμε και τα υλικά σπονδυλοδεσίας, έναν κλωβό και τέσσερις βίδες. Ολη η διαδικασία έγινε αναίμακτα και ο ασθενής σηκώθηκε σε μόλις δυο μέρες», εξηγεί στον «ΑτΚ» ο κ. Λυκομήτρος. Ο ίδιος παρουσίασε την τεχνική στο 68ο Πανελλήνιο Ορθοπεδικό Συνέδριο, τον περασμένο Οκτώβριο στην Αθήνα.
Ασύγκριτα πλεονεκτήματα
Η διενέργεια σπονδυλοδεσίας λαπαροσκοπικά προσφέρει στον ασθενή μικρή τομή, σημαντικά μικρότερο χρόνο νοσηλείας και ανάρρωσης συγκριτικά με την ανοιχτή σπονδυλοδεσία, που είναι επώδυνη και συνδέεται με αυξημένη απώλεια αίματος.
Συνήθως χρειάζονται δυο μέρες νοσηλείας και η επανάκαμψη είναι πολύ πιο γρήγορη, αφού οι κακώσεις στους μύες και στα υπόλοιπα μαλακά μόρια είναι ελάχιστες.
Σύμφωνα με τον κ. Λυκομήτρο, η τεχνική μπορεί να χρησιμοποιηθεί σε όλες τις εκφυλιστικές και τραυματικές δισκοπάθειες με ένδειξη σπονδυλοδεσίας. Ωστόσο, σε ασθενείς κάτω των 50 ετών με εκφυλιστικές βλάβες του δίσκου ενδείκνυται η τεχνική της ολικής αντικατάστασης μεσοσπονδύλιου δίσκου, ώστε να διατηρηθεί η φυσιολογική κινητικότητα του σώματος.
«Κάναμε στη Θεσσαλονίκη ένα βήμα για όλη την Ευρώπη, διότι η πρωτοπόρα τεχνική έχει εφαρμοστεί μέσα σε μια διετία μόνο σε δυο ασθενείς στις ΗΠΑ και σε έναν στην Κορέα. Εξάλλου, τα υλικά που χρησιμοποιούνται δεν έχουν κωδικό για την Ευρώπη, ενώ στην Ελλάδα δεν έχει προβλεφθεί η διενέργεια τέτοιων επεμβάσεων στα δημόσια νοσοκομεία. Για να γίνει αυτό απαιτείται οργάνωση για προμήθεια υλικών, εκπαίδευση προσωπικού και εξασφάλιση εργαλείων για τα χειρουργεία», δηλώνει ο γιατρός, που θεωρείται πρωτοπόρος στην αποκατάσταση προβλημάτων της σπονδυλικής στήλης. Εξάλλου, ως ολυμπιονίκης και παγκόσμιος πρωταθλητής κωπηλασίας, με συμμετοχή στους Ολυμπιακούς Αγώνες του 1988 στη Σεούλ, ο κ. Λυκομήτρος θέλει να πρωτοπορεί.
Είναι χαρακτηριστικό ότι φέτος εφάρμοσε άλλες δυο καινοτόμες τεχνικές, για πρώτη φορά στην Ελλάδα, που αφορούν στην ολική αντικατάσταση μεσοσπονδύλιου δίσκου στην οσφυϊκή μοίρα της σπονδυλικής στήλης και στη διαυχενική τοποθέτηση βιδών στους αυχενικούς σπονδύλους, κάτι που έχει γίνει σε 4-5 ασθενείς στον κόσμο.

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