Modern Ideas About Epidural Fibrosis (Literature Review)

Животенко, А. П.; Sorokovikov, V. A.; Сороковиков, В. А.; Кошкарева, З. В.; Негреева, М. Б.; Потапов, Виталий; Potapov, Vitaliy; Горбунов, А. Ю.; Gorbunov, A.A.

doi:10.12737/article_5a0a7f9e412601.50968513

Cited by 8 publications

(6 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Значна частина (близько 20-36%) випадків FBSS і близько чверті повторних операцій з приводу нього зумовлені післяопераційним реактивним компресійним рубцево-спайковим процесом навколо твердої мозкової оболонки та судинно-нервових утворень хребтового каналу [4][5][6]. Епідуральний фіброз як основна або супутня патологія є практично облігатною знахідкою при повторних операціях на хребті [6][7][8].…”

Section: вступunclassified

“…Утворення рубцевої тканини -це фізіологічна реакція на будь-яку хірургічну травму, але http://theunj.org інтенсивність і тривалість цього процесу залежать від багатьох чинників. Важливим механізмом надмірного рубцеутворення вважають трансформацію післяопераційної гематоми у фіброзну тканину [8,12]. Установлено прямо пропорційний зв'язок між об'ємом гематоми і тяжкістю асептичного продуктивного епідурального запалення [13].…”

Section: вступunclassified

See 1 more Smart Citation

The comparative analysis of MRI data in the early period after lumbar microdiscectomies with epidural injection of polyacrylamide hydrogel

Pedachenko¹,

Khyzhnyak²,

Krasylenko³

et al. 2021

Ukr Neurosurg J

View full text Add to dashboard Cite

Objective: To perform a comparative analysis of MRI data obtained in the early postoperative period after repeated lumbar microdiscectomies in patients with and without epidural injection of “Nubiplant” polyacrylamide hydrogel (HG). Material and methods: The MRI data of the lumbar spine in the early postoperative period after repeated removal of herniated disc (on the 3-15th day) in 84 (100%) patients were analyzed: 30 (35,7%) patients were injected intraoperatively epidurally with “Nubiplant” HG to prevent epidural fibrosis (main group (MG) and in 54 (64,3%) patients the HG was not injected (control group (CG). Results: Comparative analysis of MRI data on the 3-15th day after surgery showed that the frequency of epidural edema and hemorrhage signs within the postoperative area in the MG was significantly lower as compared to the CG (p = 0,0444 and p = 0,0288 respectively). To assess the accuracy of the epidural administration of an artificial biopolymer Nubiplant during lumbar microdiscectomy, in the early postoperative period the following MRI criteria could be helpful: i) absence of the dural sac deformation and dislocations of the spinal root; ii) well-defined margin of the adjacent spinal root; iii) homogeneous MRI signals of the Nubiplant zone; iv) absence of Nubiplant areas outside the postoperative area; v) sufficient sectoral coverage of the adjacent root with epidurally administered Nubiplant (optimally >1800). Nubiplant” HG in the patients of the MG was evaluated, and MRI criteria for assessing the correctness of its introduction were proposed. Conclusions: In the early period after repeated lumbar microdiscectomies (on the 3-15th day), intraoperative epidural injection of “Nubiplant” HG was accompanied by a significant decrease of epidural edema and hemorrhage signs within the postoperative area. The proposed criteria of correctness of HG “Nubiplant” introduction allow unifying the approaches in radiological assessment of this patients.

show abstract

Section: вступunclassified

The comparative analysis of MRI data in the early period after lumbar microdiscectomies with epidural injection of polyacrylamide hydrogel

Pedachenko¹,

Khyzhnyak²,

Krasylenko³

et al. 2021

Ukr Neurosurg J

View full text Add to dashboard Cite

show abstract

“…Анализ данных современной литературы с метаанализом результатов лечения свидетельствует об эффективности ригидной транспедикулярной фиксации, как и межтелового спондилодеза, для стабилизации позвоночного столба [14][15][16][17]. В то же время эти хирургические технологии имеют и такие недостатки, как выключение из биомеханики позвоночно-двигательного сегмента с развитием синдрома «смежного уровня», что может быть уменьшено за счёт односторонней транспедикулярной стабилизации [18][19][20].…”

Section: Introductionunclassified

Experience of unilateral and bilateral transpedicular fixation in degenerative diseases of the lumbar spine

Sorokovikov,

Potapov,

Zhivotenko

et al. 2023

Acta biomedica scientifica

View full text Add to dashboard Cite

The aim. To study the effectiveness of using monosegmental fixation systems in surgeries involving resection of part of the facet joint in patients with posterolateral and foraminal hernias in the lumbar spine. Materials and methods. The study included 40 patients with degenerative diseases of the lumbar spine who underwent medial facet resection and the removal of posterolateral or foraminal disc hernia. Among them, 10 patients underwent unilateral single-level transpedicular fixation with interbody fusion using titanium cage (UTPF cage group), and the other 10 patients underwent unilateral monosegmental transpedicular fixation (UTPF group). The remaining 20 patients underwent bilateral transpedicular fixation (BTPF group). The amount of intraoperative blood loss, duration of surgery and length of hospital stay, as well as the frequency of perioperative complications in the groups were assessed. Visual analogue scale (VAS) pain score, Oswestry index and McNab score were assessed before and 6 and 12 months after surgery. Results. Intraoperative blood loss in the UTPF cage and UTPF groups was less than in the BTPF group, as was the duration of surgery; the differences were statistically significant (p < 0.05). Indicators of VAS score and Oswestry Quality of Life Index in the studied groups indicated the effectiveness of the technology. Discussion. Unilateral decompressive and stabilizing surgeries in patients with posterolateral and foraminal hernias of the lumbar spine can reduce the duration of the surgery, the volume of blood loss and the severity of pain in the postoperative period due to adequate decompression of the neurovascular formations of the spinal canal and stabilization of the spinal motion segment, which prevents the relapse of the disease and provides early rehabilitation of patients. Conclusion. Unilateral transpedicular fixation is acceptable and safe for lumbar degenerative diseases and improves the quality of life of the patients.

show abstract

“…Существующие способы хирургического лечения дегенеративно-дистрофических заболеваний позвоночника, к сожалению, не могут считаться идеальными [1,2]. Использование микрохирургической техники и современных инструментальных технологий при хирургии позвоночника не исключает рецидива болевого синдрома [3][4][5]. Попытки улучшить результаты и избежать экзацербации боли подталкивают специалистов к поиску новых решений проблемы [6][7][8].…”

Section: Introductionunclassified

Revision surgery for failure of the dynamic stabilization system of the lumbar spine

Potapov,

Larionov,

Zhivotenko

et al. 2023

Acta biomedica scientifica

View full text Add to dashboard Cite

The aim. To study the frequency and treatment options for dysfunction of the dynamic stabilization system of the lumbar spine. Materials and methods. We carried out a retrospective analysis of the treatment of 58 patients with degenerative pathology of the lumbar spine and instability of the spinal motion segments, who were treated at the neurosurgical unit of the Irkutsk Scientific Centre of Surgery and Traumatology in 2011–2020. The stability of spinal motion segment was assessed using X-ray imaging, magnetic resonance imaging and multi-layer spiral computed tomography of the lumbar spine. Revision surgery was performed in 7 out of 58 previously operated patients using the dynamic fixation system of spinal motion segments “Coflex” (Paradigm Spine LLC, Germany). Results. Revision surgery was performed in 7 out of 58 patients with dynamic fixation of the spinal motion segments with an interosseous implant due to an increase in pain syndrome. In 1 patient, the reason for repeated surgery was primary instability of the hardware caused by a fracture of the spinous process. In the delayed period, 4 patients had an X-ray picture with heterotopic ossification of the implant and instability of PDS. In two observations, a recurrence of intervertebral hernia was diagnosed at the level of the operated spinal motion segment. During revision surgery, a facetectomy was performed with stabilization by a peek cage, followed by pain management and clinical manifestation regression. Conclusion. The conducted study shows that a number of patients after discectomy and dynamic stabilization of the spine using “Coflex” system have inconsistency and heterotypic ossification of the implant and neoarthrosis. Implantation of a lumbar peek cage while maintaining the “Coflex” device makes it possible to form a rigid interbody fusion, which means it is sufficient and justified surgical technology for treating the failure of the dynamic stabilization system.

show abstract

Modern Ideas About Epidural Fibrosis (Literature Review)

Cited by 8 publications

References 14 publications

The comparative analysis of MRI data in the early period after lumbar microdiscectomies with epidural injection of polyacrylamide hydrogel

The comparative analysis of MRI data in the early period after lumbar microdiscectomies with epidural injection of polyacrylamide hydrogel

Experience of unilateral and bilateral transpedicular fixation in degenerative diseases of the lumbar spine

Revision surgery for failure of the dynamic stabilization system of the lumbar spine

Contact Info

Product

Resources

About