BIOMECHANICAL EFFECTS OF DECOMPRESSING AND STABILIZING SURGERY FOR LUMBAR DEGENERATIVE DISEASE

The paper presents a descriptive kinematic radiographic study of changes in a shape, orientation and function of the lumbar spine in the sagittal plane due to various surgical interventions for lumbar degenerative disease. Literature analysis evidences for only few studies of spine shape and static interrelations in a spinal motion segment after surgical treatment. Any complex assessments of changes in a spine shape in the sagittal plane, its spatial orientation and function after surgical intervention has not been performed. The study includes a comparative kinematic computer analysis of pre- and postoperative radiographs of the lumber spine of 157 patients, including 62 patients after decompression, 50 after posterior interbody fusion, and 45 after dynamic transpedicular fixation. It was found that the overall range of motion has reduced during three years after any kind of surgical intervention; that surgery at the L5–S1 level takes the most significant biomechanical effect; and that decompressing and stabilizing procedures at the L5–S1 level facilitate a lumbar lordosis restoration. The L5–S1 interbody fusion results in interbody space increase and segmental angle decrease at the surgery level. The L4–L5 interbody fusion increases the range of motion in a subjacent motion segment; dynamic transpedicular fixation takes a minimal effect on a lumbar spine shape and vertebral interrelations and allows preserving the physiological mobility of all motion segments.

clinical biomechanics, spine, lumbar degenerative disease, radiography of the spine, microdiscectomy, posterior interbody fusion, dynamic transpedicular fixation

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