Relationship Between Vertebral Metric Parameters and Outcome of Surgical Treatment of Degenerative Spondylolisthesis With Multilevel Lumbar Intervertebral Disc Lesions

Abstract

Relationship between vertebral metric parameters and outcome of surgical treatment of degenerative spondylolisthesis with multilevel lumbar intervertebral disc lesions A.A. Kalinin, V.A. Byvaltsev Objective. To analyze the relationship between radiographic parameters of spinal motion segment and clinical outcome of surgical treatment of patients with degenerative spondylolisthesis with multilevel lesions of intervertebral discs in the lumbar spine. Material and Methods. The study included 90 patients with Meyerding grade I degenerative spondylolisthesis involving more than two adjacent lumbar intervertebral discs. In Group 1 (n = 45) the rigid interspinous fixation was used, in Group 2 (n = 45)-transpedicular stabilization. Results. Significant positive nonparametric correlation was detected between the long-term surgical outcome evaluated with VAS and Oswestry scores and radiographic parameters: segmental angular amplitude, the angle of lumbar lordosis, and the degree of linear displacement of vertebrae. The rigid interspinous implant and pedicle fixation allow achieving minimum level of pain and good functional recovery with effective elimination of pathological linear displacement of vertebrae and formation of interbody bone block. Conclusion. Linear displacement of vertebrae of no more than 8 mm and sagittal range of motion in the spinal motion segment of no more than 14° permit performing interbody fusion with cage and rigid interspinous fixation, and those no more than 13 mm and 16°, respectively, transpedicular stabilization and interbody fusion with cage.

Analysis of Postoperative Outcomes of Degenerative Diseases of the Lumbosacral Junction

“…2,7 Rigid stabilization leads to biomechanical stress of adjacent segments with their accelerated degeneration, contributing to the formation of bone block failure, development of infectious complications, postoperative pain syndrome, instability of fixation elements, and resorption of bone tissue around the implants. 1,2,18 The study of technical capabilities aimed at reducing the unsatisfactory outcomes of rigid stabilization is associated with protection of adjacent segments from biomechanical overload, a reduction in the risk of breakage of the fixing structure, and elimination of pathological mobility, with preservation of the physiological volume of movements in the operated segment. 2,19 It is determined that the posterior dynamic stabilization allows the physiological volume of movements in the lumbar spine to be restored, and reduces the degeneration of the adjacent segment.…”

“…The dominant causes of the pain syndrome in the lumbar spine are associated with degeneration of the intervertebral discs (IVD), facet joints (FJ), or a combination of these facotrs. 1,2 Different puncture, 3,4 decompressive 5,6 and decompressive-stabilizing surgical procedures 7,8 are used to treat different stages of the formation of degenerative disease of the vertebral segment.…”

Surgical tactics for multilevel displacements of lumbar intervertebral discs

“…Вступ У хворих із поперековим болем та радикулопатією одночасне зміщення двох і більше поперекових міжхребцевих дисків (ПМХД) явище не рідкісне [1]. За даними авторів, багаторівневе зміщення ПМХД трапляється в 38-56 % випадків [2,3]. Йдеться не лише про грижі дисків, а і про симптомні протрузії, які нерідко зумовлюють клінічну картину, роблячи її атипової [4].…”

The Importance of Psychological Testing in Predicting the Effectiveness of Lumbar Spine Surgery

“…Progression of pain, or chronic pain syndrome, the development of a neurological deficit, or failure of conservative treatment, may be factors that require surgical intervention. Even though spinal interventions have demonstrated surgical efficacy, the clinical outcomes of the surgeries range from 35 to 75% improvement, depending on the type of surgery perfomed performed, [3][4][5][6][7] with up to 23% incidence of repeated surgeries. 8 Up to 40% of patients note that the pain continues after the surgical treatment, albeit with lower intensity.…”