Surgical treatment of multilevel lumbar vertebral canal stenosis using dynamic stabilization. Multicenter study

Abstract

Purpose: to compare the results of surgical treatment of patients with multilevel lumbar vertebral canal stenosis. Patients and methods. Prospective randomized multicenter study included 71 patients aged 41 - 79 years. In the 1st group of patients (n=38) a standard wide decompression of the spinal canal, transpedicular fixation of one clinically and roentgenologically significant spinal motion segment using rigid stabilization and interbody fusion was performed. In the 2nd group (n=33) microdecompression of the spinal canal, transpedicular fixation of one clinically and roentgenologically significant segment using the rods of nitinol transpedicular device. The results were assessed by the pain VAS, ODI and SF-36 questionnaires, roentgenologic, CT and MRI data. Results. Mean follow up made up 1.5 years, the maximum one - 3.0 years. Significant pain relief and im- provement in the quality of life as compared with the preoperative level was reported for both groups. No sig- nificant difference between the groups was observed. Functional roentgenograms showed within 5° (4.2 - 6.5°) preservation of motion in the stabilized segment only in patients from the 2nd group. Adjacent segment pathology in 12 months after operation was diagnosed only in 1 patient from the 1st group. Conclusion. Preliminary results allow considering the dynamic transpedicular fixation using nitinol rods as an effective surgical technique for the treatment of degenerative lumbar spine pathology.