Interrelation of spondylometric parameters with the outcome of surgical treatment of patients with degenerative diseases of the lumbosacral junction
Objective. To evaluate the relationship between the radiological and neuroimaging parameters of the spinal motion segment and the clini- cal outcome of surgical treatment of patients with degenerative diseases of the lumbosacral junction to clarify the indications for dynamic and rigid stabilizat...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"
2018-09-01
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| Series: | Хирургия позвоночника |
| Subjects: | |
| Online Access: | https://www.spinesurgery.ru/jour/article/view/1492/1454 |
| Summary: | Objective. To evaluate the relationship between the radiological and neuroimaging parameters of the spinal motion segment and the clini-
cal outcome of surgical treatment of patients with degenerative diseases of the lumbosacral junction to clarify the indications for dynamic
and rigid stabilization.
Material and Methods. The study included 267 patients with degenerative diseases of the lumbosacral spine. Depending on the stabiliza-
tion method, patients were divided into two groups: Group I (n = 83) with dynamic intervertebral disc (IVD) prosthesis; and Group II
(n = 184) with interbody fusion and transpedicular fixation. Long-term clinical parameters and biomechanical characteristics before and
after surgery were analyzed.
Results. A significant nonparametric correlation of the long-term result of surgical treatment assessed by VAS and Oswestry Disability
Index with radiological parameters and results of neuroimaging was revealed. It was determined that the use of artificial IVD allows achiev-
ing a minimum level of pain syndrome and good functional recovery with effective preservation of the volume of physiological movements
in the operated segment and restoration of the total angle of lumbar lordosis.
Conclusion. Objective neuroimaging data (grade II–IV of degeneration according to the measured diffusion coefficient) and radiological parameters
(linear displacement of vertebrae not more than 4 mm, sagittal volume of movements in the spinal motion segment less than 6°, decrease in the height
of intervertebral disc space no more than 2/3 of the superjacent one) make possible using total arthroplasty. It is advisable to perform interbody
fusion and rigid stabilization in grade IV–V of degeneration, linear displacement of vertebrae more than 4 mm, sagittal volume of movements of
at least 6°, and decrease in the interbody space height over 2/3 of the superjacent one. |
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| ISSN: | 1810-8997 2313-1497 |