Clinical signs for predicting the results of surgical treatment in patients with degenerative diseases of the lumbar spine
Background. One of the most commonly used surgical treatment for degenerative diseases of the lumbar spine is spondylodesis. Applying this method of treatment, we noticed that in different patients with similar surgical intervention, the results are often various. The purpose of the study is to determine the clinical factors that influence the results of surgical treatment. Materials and me
thods. We examined 129 operated patients: 15 — with the diagnosis of vertebral instability, 64 — with intervertebral disc herniation, 30 — with spondylolisthesis, and 20 patients with spinal stenosis. The onset of the disease, total duration and duration of the last exacerbation were evaluated. The severity of pain was assessed by a visual analogue scale. Assessment of the quality of life before and one year after surgical treatment was performed using Oswestry index. Methods of applied mathematical statistics were used to confirm the results. Results. In general, the statistical analysis indicates that the quality of life of patients is significantly improved after the surgery. However, in some patients, the quality of life improves but to a lesser extent, such variability of results is noteworthy. The effect of age on the value of Oswestry index after surgery can be judged by the significant positive correlation of these parameters evaluated from all observations — in elderly patients the results are worse. In case of vertebral instability and spondylolisthesis, the age of the patient especially affects the results of surgical treatment. Patients who had had the greatest Oswestry index before the operation showed the worst results of surgical treatment. In patients with worse surgical outcomes, the duration of the disease is usually greater. Before intervention, patients with spinal stenosis and spondylolisthesis suffered longer than patients with instability and intervertebral disc herniations, this makes diagnoses of spinal stenosis and spondylolisthesis less favorable for recovery. That is, in other words, if intervertebral disc herniations can lead to recovery after timely surgical treatment, then in case of spinal stenosis and spondylolisthesis, it is only about improving the quality of life. Conclusions. Clinical signs of less satisfactory recovery after surgical treatment are older age (> 48 years), longer duration of the disease (more than 6–7 years), duration of the last deterioration more than 2–2.5 months, diagnosis of spinal stenosis and spondylolisthesis. In addition, this group includes patients with the Oswestry index more than 78 % before surgery.
Full Text:PDF (Українська)
Stokes, I. A., and Frymoyer, J. W.: Segmental motion and instability. Spine, 12: 688-691, 1987.
Е. N. Hanley, jr., and S. M. David. Current concepts review lumbar arthrodesis for the treatment of back pain. The journal of bone and joint surgery Vol. 81-a, №. 5, may 1999
Kaiser MG, Eck JC, Groff MW, et al. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 1: introduction and methodology. J Neurosurg Spine 2014;21:2-6.
Mobbs RJ, Phan K, Malham G, et al. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg 2015;1:2-18.
Wu AM, Zou F, Cao Y, et al. Lumbar spinal stenosis: an update on the epidemiology, diagnosis and treatment. AME Med J 2017;2:63.
Richard A. Deyo, Patrick J. Heagerty, Judith A. Turner, Brook I. Martin, Bryan A. Comstock,november 2013, Vol.13, Issue 11, P.1421-1433.
Kevin Phan, Vignesh Ramachandran, Tommy M. Tran, Kevin P. Shah, Matthew Fadhil, Alan Lackey, Nicholas Chang, Ai-Min Wu, Ralph J. Mobbs. Systematic review of cortical bone trajectory versus pedicle screw techniques for lumbosacral spine fusion. J Spine Surg 2017;3(4):679-688.
Anterior lumbar interbody fusion (ALIF) as an option for recurrent disc herniations: a systematic review and meta-analysis. Kevin Phan, Alan Lackey, Nicholas Chang, Yam-Ting Ho, David Abi-Hanna, Jack Kerferd, Monish M. Maharaj, Rhiannon M. Parker, Gregory M. Malham, Ralph J. Mobbs. J Spine Surg 2017;3(4):587-595.
Lee SH, Kang BU, Jeon SH, et al. Revision surgery of the lumbar spine: anterior lumbar interbody fusion followed by percutaneous pedicle screw fixation. J Neurosurg Spine 2006;5:228-33.
Sohail K. Mirza, Richard A. Deyo, Patrick J. Heagerty, Judith A. Turner, Brook I. Martin, Bryan A. Comstock,november 2013, Vol.13, Issue 11, P.1421-1433.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000; 25:3186 -91.
Xiao-Feng Lian, Tie-Sheng Hou, Jian-Guang Xu, Bing-Fang Zeng, Jie Zhao, Xiao-Kang Liu, Cheng Zhao, Hao Li, Posterior lumbar interbody fusion for aged patients with degenerative spondylolisthesis: is intentional surgical reduction essential? October, 2013, Vol.13, Issue 10, P.1183-1189.
Wang H, Zhang D, Ma L, et al. Factors Predicting Patient Dissatisfaction 2 Years After Discectomy for Lumbar Disc Herniation in a Chinese Older Cohort: A Prospective Study of 843 Cases at a Single Institution. Medicine (Baltimore) 2015;94:e1584.
Fairbank J. C. I. The oswestry disability index / Fairbank J.C.I., Pyncent P. B. // Spine. – 2000. – Vol. 25, № 22. – Р. 2940-2953.
Korzh N.A. Pathogenetic classification of degenerative diseases of the spine / N.А. Korzh, A.I. Prodan, A.E. Barysh // Orthopaedics, Traumatology, and Prosthetics. - 2004. - No. 3. - P. 5-13.
- There are currently no refbacks.
Copyright (c) 2018 TRAUMA
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2018