RELATIONSHIP BETWEEN VERTEBRAL METRIC PARAMETERS AND OUTCOME OF SURGICAL TREATMENT OF DEGENERATIVE SPONDYLOLISTHESIS WITH MULTILEVEL LUMBAR INTERVERTEBRAL DISC LESIONS

Abstract

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.