Preview

Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika)

Advanced search

Assessment of new method of posterior spinal fusion in the treatment of patients with posttraumatic kyphotic deformity of the thoracic and lumbar spine

https://doi.org/10.14531/ss2021.3.30-35

Abstract

Objective. To carry out a comparative analysis of two methods of the posterior bone block formation (with autograft bone chips or with a whole vertebral arch) and to assess the rate of bone block formation, the degree of surgery invasiveness and the patient-reported cosmetic satisfaction with the results.

Material and Methods. The study involved 31 patients with kyphotic deformity of the thoracic spine, of which 15 patients underwent spinal fusion using autograft bone chips (control group), and 16 were operated on using a new technique with a whole vertebral arch. The results of treatment were assessed using a modified MacNab scale. During the follow-up period from 1.5 to 2 years, pain syndrome was assessed according to VAS, quality of life according the Oswestry Disability Index, and cosmetic satisfaction was assessed using the SRS-22 scale.

Results. In the course of the work, it was revealed that in patients who were operated on using new method, the time of bone block formation according to CT data was shorter, the overall satisfaction with surgery result was higher (mainly due to the absence of a cosmetic defect), and the indicators of the operation duration and blood loss did not differ compared to those in the control group.

Conclusion. Based on the results obtained, spinal fusion using a whole vertebral arch can be recommended in clinical practice for surgical interventions in patients with kyphotic deformities of the spine.

About the Authors

D. A. Ptashnikov
National Medical Research Center of Traumatology and Orthopedics n.a. R.R. Vreden; North-Western State Medical University n.a. I.I. Mechnikov 8 Akademika Baikova str., St. Petersburg, 195427, Russia; 41 Kirochnaya str., St. Petersburg, 191015, Russia
Russian Federation

DMSc, Prof.,  Head of the Department No.18



S. S. Magomedov
Russian Research Institute of Traumatology and Orthopedics n.a. R.R. Vreden 8 Akademika Baikova str., St. Petersburg 195427, Russia
Russian Federation

MD, PhD, Head of the Department No.12



S. P. Rominskiy
National Medical Research Center of Traumatology and Orthopedics n.a. R.R. Vreden 8 Akademika Baikova str., St. Petersburg, 195427, Russia
Russian Federation

orthopedic trauma surgeon, Department No. 12



P. G. Mytyga
National Medical Research Center of Traumatology and Orthopedics n.a. R.R. Vreden 8 Akademika Baikova str., St. Petersburg, 195427, Russia
Russian Federation

orthopedic trauma surgeon, Department No. 12



References

1. Дулаев А.К., Шаповалов В.М., Гайдар Б.В. Закрытые повреждения позвоночника грудной и поясничной локализации. СПб., 2000. [Dulaev AK, Shapovalov VM, Gaydar BV. Closed Thoracic and Lumbar Spine Injuries. St.Petersburg, 2000. In Russian].

2. Schwab F, Blondel B, Chay E, Demakakos J, Lenke L, Tropiano P, Ames C, Smith JS, Shaffrey CI, Glassman S, Farcy J-P, Lafage V. The comprehensive anatomical spinal osteotomy classification. Neurosurgery. 2014;74:112–120. DOI: 10.1227/NEU.0000000000000182o.

3. Albee FH. Transplantation of a portion of the tibia into the spine for Pott’s disease: a preliminary report. JAMA. 1911;57:885–886. DOI: 10.1001/jama.1911.04260090107012.

4. Wiltse LL. Proceedings: lumbar spine: posterolateral fusion. J Bone Joint Surg Br. 1975;57:261.

5. Рерих В.В., Борзых К.О. Посттравматические деформации грудного и поясничного отделов позвоночника в позднем периоде позвоночно-спинномозговой травмы после ранее проведенных оперативных вмешательств // Международный журнал прикладных и фундаментальных исследований. 2015. № 12–4. С. 657–660. [Rerikh VV, Borzykh KO. Posttraumatic deformities of the thoracic and lumbar spine at patients in the late period of the vertebral and spinal trauma after earlier carried out surgeries. Journal of Applied and Fundamental Research. 2015;(12–4):657–660. In Russian].

6. Патент на изобретение № 2435540C1. Способ коррекции врожденного кифоза (деформации) поясничного и грудопоясничного отделов позвоночника у детей при нарушении сегментации передних отделов позвонков // Виссарионов С.В., Голубев К.Е. МПК A61B17/56; № 2010110760/14; заявл. 22.03.2010; опубл. 10.12.2011. Бюл. № 34. [Vissarionov SV, Golubev KE. Method of correction of congenital kyphosis of lumbar and thoracolumbar spine in children in case of disturbed segmentation of anterior parts of vertebrae. Patent RU 2435540 C1. App. 22/03/2010, publ 10/12/2011. Bul. 34. In Russian].

7. Schwab F, Farcy JP, Bridwell K, Berven S, Glassman S, Harrast J, Horton W. A clinical impact classification of scoliosis in the adult. Spine. 2006;31:2109–2114. DOI: 10.1097/01.brs.0000231725.38943.ab.

8. Губин А.В., Прудникова О.Г., Камышева В.В., Коваленко П.И., Нестерова И.Н. Клиническая апробация русскоязычной версии анкеты SRS-22 для взрослых пациентов со сколиозом // Хирургия позвоночника. 2017. Т. 14. № 2. С. 31–40. [Gubin AV, Prudnikova OG, Kamysheva VV, Kovalenko PI, Nesterova IN. Clinical testing of the Russian version of the SRS-22 questionnaire for adult scoliosis patients. Hir. Pozvonoc. 2017;14(2):31–40. In Russian]. DOI: 10.14531/ss2017.2.31-40.

9. Булкин А.А., Боков А.Е., Млявых С.Г. Факторы, влияющие на формирование костного блока у пациентов с дегенеративной патологией поясничного отдела позвоночника // Российский нейрохирургический журнал им. проф. А.Л. Поленова. 2019. Т. 11. №. 2. С. 12–16. [Bulkin AA, Bokov AE, Mlyavykh SG. Factor affecting bone formation in patients with degenerative lumbar spine pathology. Russian Neurosurgical Journal n.a. Prof. Polenov. 2019;11(2):12–16. In Russian].

10. Chen WJ, Tsai TT, Chen LH, Niu CC, Lai PL, Fu TS, McCarthy K. The fusion rate of calcium sulfate with local autograft bone compared with autologous iliac bone graft for instrumented short-segment spinal fusion. Spine. 2005;30:2293–2297. DOI: 10.1097/01.brs.0000182087.35335.05.

11. Blanco JF, Villaron EM, Pescador D, da Casa C, Gomez V, Redondo AM, Lopez-Villar O, Lopez-Parra M, MuntiÓn S, Sanchez-Guijo F. Autologous mesenchymal stromal cells embedded in tricalcium phosphate for posterolateral spinal fusion: results of a prospective phase I/II clinical trial with long-term follow-up. Stem Cell Res Ther. 2019;10:63. DOI: 10.1186/s13287-019-1166-4.

12. Buser Z, Jakoi A, Katbamna B, Basho R, Wang JC. Bone grafting and spinal fusion options. In: Holly L., Anderson P., eds. Essentials of Spinal Stabilization. Springer, Cham, 2017:453. DOI: 10.1007/978-3-319-59713-3_34.

13. Wang H, Lv B. Comparison of clinical and radiographic results between posterior pedicle-

14. based dynamic stabilization and posterior lumbar intervertebral fusion for lumbar degenerative disease: a 2-year retrospective study. World Neurosurg. 2018;114:

15. e403–e411. DOI: 10.1016/j.wneu.2018.02.192.


Review

For citations:


Ptashnikov D.A., Magomedov S.S., Rominskiy S.P., Mytyga P.G. Assessment of new method of posterior spinal fusion in the treatment of patients with posttraumatic kyphotic deformity of the thoracic and lumbar spine. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2021;18(3):30-35. https://doi.org/10.14531/ss2021.3.30-35



Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1810-8997 (Print)
ISSN 2313-1497 (Online)