Abstract
Background. Minimally invasive technology of fusion broadly introduced in clinical practice represent one of modern trends in spinal surgery on the other hand those technical solutions lack to provide posterior fusion. As a consequence, patients treated with minimally invasive techniques are vulnerable in terms of pseudarthrosis and implant instability therefore measures focused on those complications’ prevention are still actual.The study objective is to evaluate efficacy and safety of suggested percutaneous facet joints arthrodesis technique as an auxiliary option to interbody fusion.Materials and methods. This is a prospective non-randomized study of 80 patients with degenerative diseases of the lumbar spine who were treated applying minimally invasive transforaminal lumbar interbody fusion, lateral lumbar interbody fusion and anterior lumbar interbody fusion. In 20 cases out of those enrolled interbody fusion was supplemented with percutaneous posterior facet joints arthrodesis. Computed tomography was administered at the period of 6 and 12 months after surgery to assess anterior and posterior fusion. The minimal follow-up period accounted for 12 months.Results. The suggested percutaneous facet joints arthrodesis fifty-fold increased the probability of posterior fusion formation compared to the rate of spontaneous spinal fusion (p <0.0001, logistic regression was applied). In three cases posterior fusion formed prior to interbody fusion providing stability of segment operated on. No adverse events and no complications associated with percutaneous arthrodesis were detected.Conclusion. The suggested percutaneous facet joints arthrodesis is safe and effective minimally invasive technique that facilitates additional posterior spinal fusion formation in a short-term period herewith decreasing symptomatic pseudarthrosis development in patients operated on using minimally invasive spinal fixation and fusion.
Highlights
Invasive technology of fusion broadly introduced in clinical practice represent one of modern trends in spinal surgery on the other hand those technical solutions lack to provide posterior fusion
Patients treated with minimally invasive techniques are vulnerable in terms of pseudarthrosis and implant instability measures focused on those complications’ prevention are still actual
In 20 cases out of those enrolled interbody fusion was supplemented with percutaneous posterior facet joints arthrodesis
Summary
ФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава России; Россия, 603950 Нижний Новгород, пл. Цель исследования – оценить безопасность и эффективность разработанной авторами техники перкутанного артродеза дугоотростчатых суставов (ПАДС) как метода, дополняющего межтеловой спондилодез и перкутанную заднюю фиксацию в хирургическом лечении дегенеративных заболеваний поясничного отдела позвоночника. Проведен сравнительный анализ результатов лечения 80 пациентов с дегенеративными заболеваниями поясничного отдела позвоночника, у которых выполнены минимально инвазивные декомпрессивно-стабилизирующие вмешательства с использованием заднего трансфораминального, латерального забрюшинного и переднего забрюшинного доступов. ПАДС – безопасная и эффективная малоинвазивная методика, позволяющая в более ранние сроки сформировать задний костный блок, снижая риск развития псевдоартроза после выполнения минимально инвазивных декомпрессивно-стабилизирующих операций на поясничном отделе позвоночника. Ключевые слова: дегенеративные заболевания поясничного отдела позвоночника, минимально инвазивные вмешательства, межтеловой спондилодез, задний спондилодез, перкутанный артродез дугоотростчатых суставов. Техника перкутанного артродеза дугоотростчатых суставов в хирургическом лечении дегенеративных заболеваний поясничного отдела позвоночника. Avdonina Privolzhskiy Research Medical University, Ministry of Health of Russia; 10 / 1 Minin & Pozharsky Sq., Nizhny Novgorod 603950, Russia
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