Surgical treatment of elderly and senile patients with degenerative central lumbar spinal stenosis
Objective. To analyze the results of surgical treatment of patients of the older age group with central spinal stenosis at the lumbar level. Material and Methods. A total of 107 patients of elderly and senile age with clinically significant degenerative central stenosis of the spi- nal canal were...
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| Format: | Article |
| Language: | English |
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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 |
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| Online Access: | https://www.spinesurgery.ru/jour/article/view/1493/1457 |
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| author | Roman V. Khalepa Vladimir S. Klimov Jamil A. Rzaev Ivan I. Vasilenko Evgeny V. Konev Evgenia V. Amelina |
| author_facet | Roman V. Khalepa Vladimir S. Klimov Jamil A. Rzaev Ivan I. Vasilenko Evgeny V. Konev Evgenia V. Amelina |
| author_sort | Roman V. Khalepa |
| collection | DOAJ |
| description | Objective. To analyze the results of surgical treatment of patients of the older age group with central spinal stenosis at the lumbar level.
Material and Methods. A total of 107 patients of elderly and senile age with clinically significant degenerative central stenosis of the spi-
nal canal were treated. They were divided into two groups: patients in Group 1 underwent bilateral decompression of nerve roots through
unilateral approach; those in Group 2 – nerve root decompression supplemented with interbody fusion and transpedicular fixation.
Results. The surgery resulted in statistically significant reduction in pain, improvement of the quality of life, enlargement of spinal canal
dimension parameters, and increase in the distance of walking. Statistical difference in the quality of life between Groups 1 and 2 was re-
vealed for the indicator characterizing the psychological component of the SF-36 questionnaire (p = 0.03); there were no statistical dif-
ferences for the remaining indicators. The key parameter for assessing central stenosis is the cross-sectional area of the dural sac.
Conclusion. Preoperative examination of patients of the older age group should be comprehensive and include CT myelography with 3D
reconstruction. The cause of nerve root compression in central stenosis is a combination of various factors in 41.9 % of cases. Differential
surgical tactics provides an improvement in the quality of life in 80 % of cases. Excessive decompression does not improve the quality of
life of patients. Instrumental fixation does not improve the outcome of surgical intervention and should be used only for clinically signifi-
cant instability of the spinal motion segment. |
| first_indexed | 2024-03-12T19:58:43Z |
| format | Article |
| id | doaj.art-3d8e00ac788e4db598a453ee2af073ad |
| institution | Directory Open Access Journal |
| issn | 1810-8997 2313-1497 |
| language | English |
| last_indexed | 2024-03-12T19:58:43Z |
| publishDate | 2018-09-01 |
| publisher | Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan" |
| record_format | Article |
| series | Хирургия позвоночника |
| spelling | doaj.art-3d8e00ac788e4db598a453ee2af073ad2023-08-02T02:34:48ZengMinistry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"Хирургия позвоночника1810-89972313-14972018-09-01153738410.14531/ss2018.3.73-84Surgical treatment of elderly and senile patients with degenerative central lumbar spinal stenosisRoman V. Khalepa0Vladimir S. Klimov1Jamil A. Rzaev2Ivan I. Vasilenko3Evgeny V. Konev4Evgenia V. Amelina5Federal Center of Neurosurgery, Novosibirsk, RussiaFederal Center of Neurosurgery, Novosibirsk, RussiaFederal Center of Neurosurgery, Novosibirsk, RussiaFederal Center of Neurosurgery, Novosibirsk, RussiaFederal Center of Neurosurgery, Novosibirsk, RussiaInstitute of Computational Technologies of SB RAS, Novosibirsk, RussiaObjective. To analyze the results of surgical treatment of patients of the older age group with central spinal stenosis at the lumbar level. Material and Methods. A total of 107 patients of elderly and senile age with clinically significant degenerative central stenosis of the spi- nal canal were treated. They were divided into two groups: patients in Group 1 underwent bilateral decompression of nerve roots through unilateral approach; those in Group 2 – nerve root decompression supplemented with interbody fusion and transpedicular fixation. Results. The surgery resulted in statistically significant reduction in pain, improvement of the quality of life, enlargement of spinal canal dimension parameters, and increase in the distance of walking. Statistical difference in the quality of life between Groups 1 and 2 was re- vealed for the indicator characterizing the psychological component of the SF-36 questionnaire (p = 0.03); there were no statistical dif- ferences for the remaining indicators. The key parameter for assessing central stenosis is the cross-sectional area of the dural sac. Conclusion. Preoperative examination of patients of the older age group should be comprehensive and include CT myelography with 3D reconstruction. The cause of nerve root compression in central stenosis is a combination of various factors in 41.9 % of cases. Differential surgical tactics provides an improvement in the quality of life in 80 % of cases. Excessive decompression does not improve the quality of life of patients. Instrumental fixation does not improve the outcome of surgical intervention and should be used only for clinically signifi- cant instability of the spinal motion segment.https://www.spinesurgery.ru/jour/article/view/1493/1457central spinal stenosissurgical treatmentelderly patients |
| spellingShingle | Roman V. Khalepa Vladimir S. Klimov Jamil A. Rzaev Ivan I. Vasilenko Evgeny V. Konev Evgenia V. Amelina Surgical treatment of elderly and senile patients with degenerative central lumbar spinal stenosis Хирургия позвоночника central spinal stenosis surgical treatment elderly patients |
| title | Surgical treatment of elderly and senile patients with degenerative central lumbar spinal stenosis |
| title_full | Surgical treatment of elderly and senile patients with degenerative central lumbar spinal stenosis |
| title_fullStr | Surgical treatment of elderly and senile patients with degenerative central lumbar spinal stenosis |
| title_full_unstemmed | Surgical treatment of elderly and senile patients with degenerative central lumbar spinal stenosis |
| title_short | Surgical treatment of elderly and senile patients with degenerative central lumbar spinal stenosis |
| title_sort | surgical treatment of elderly and senile patients with degenerative central lumbar spinal stenosis |
| topic | central spinal stenosis surgical treatment elderly patients |
| url | https://www.spinesurgery.ru/jour/article/view/1493/1457 |
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