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The choice of performing tactics of dorsal decompressive-stabilizing interventions on the lumbar spine for the prevention of degenerative disease of an adjacent segment

Year: 2020, volume 16 Issue: №3 Pages: 762-768
Heading: neurosurgery Article type: Original article
Authors: Byvaltsev V.A., Kalinin А.А., Pestryakov Yu.Ya., Spiridonov A.V.
Organization: Clinical Hospital "Russian Railways Medicine", Irkutsk State Medical University, Krasnoyarsk Regional Clinical Hospital, Russian Railways
Summary:

Purpose: Comparative analysis of the results of dorsal decompressive-stabilizing interventions (DDSI) on the lumbar spine for substantiating the method of prevention of adjacent segment degenerative disease (ASDd). Material and Methods: 79 patients were included in the retrospective research, 2 groups were identified: in group I (n=41) single-level research, in group II (n=38) two-level DDSI, with rigid stabilization of the spinal motion segment, in the presence of signs of its degeneration was made. Clinical outcomes, instrumental data and surgical complications were evaluated. Results: It was a decrease of pain syndrome in the postoperative period, an improvement in the quality of life in two groups (p<0.001). In the inter-group comparison of the visual analog scale (VAS) — back, legs, ODI, SF-36 in group II, the results at discharge were lower than in group I (p<0.001), after 3.6.12 months there is a comparable improvement in a quality of life and a decrease in pain by VAS in both groups (p>0.05). In the distant period (24, 36 months), clinical results are better in-group II (p<0.05). The number of late surgical complications and revision interventions is higher in a group II (17.1 and 4.0%) (p<0.05). Conclusion: Preventive rigid stabilization of adjacent segment with signs of initial degeneration improves long-term results, reduces the number of repeated operations, despite the larger volume of primary medical intervention.

Keywords: adjacent level syndrome, degenerative diseases of the lumbar spine, dorsal decompressive-stabilizing interventions

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