ANALYSIS OF REASONS FOR REVISION SURGERY IN PATIENTS TREATED FOR DEGENERATIVE LUMBAR SPINAL STENOSIS
https://doi.org/10.14531/ss2014.1.86-93
Abstract
Objective. To analyze the reasons for revision surgery after decompression and stabilization in patients with degenerative lumbar spinal stenosis.
Material and Methods. A total of 308 patients with degenerative lumbar spinal stenosis were operated on. They underwent decompression and stabilization surgery using transpedicular fixation involving from 1 to 8 spinal motion segments.
Results. Clinical manifestations of radiculopathy and back pain were completely eliminated in 166 (53.9 %) patients. Another 86 (27.9 %) patients reported the absence of radicular pain syndrome with sustained mild low back pain during physical exertion. Significant reduction in radicular and low back pain was achieved in 49 (15.9 %) patients. Poor long-term results of surgical treatment requiring revision surgery in the long-term period were detected in 30 (16.1 %) patients.
Conclusion. Multi-level surgery for lumbar spinal stenosis increases the risk and probability of indications for revision in the long-term period. When performing extended decompression and stabilization procedure at four or more spinal motion segments including the L5-S1segment stabilization, it is advisable to insert caudal pedicle screws into posterior portions of the os illium instead of the S1 vertebral body. Hir. Pozvonoc. 2014;(1):86-93.
About the Authors
Asker Alievich Afaunov
Kuban State Medical University, Krasnodar
Russian Federation
Russian Federation
Igor Vadimovich Basankin
Regional Clinical Hospital No. 1 n.a. Prof. S.V. Ochapovsky, Krasnodar
Russian Federation
Russian Federation
Aleksandr Veniaminovich Kuzmenko
Regional Clinical Hospital No. 1 n.a. Prof. S.V. Ochapovsky, Krasnodar
Russian Federation
Russian Federation
Vladimir Konstantinovich Shapovalov
Kuban State Medical University, Krasnodar
Russian Federation
Russian Federation
References
1. Абакиров М.Д. Хирургическое лечение дегенеративных стенозов поясничного отдела позвоночника: Автореф. дис. … д-ра мед. наук. М., 2012.
2. Белова А.Н., Щепетова О.Н. Шкалы, тесты и опросники в медицинской реабилитации. М., 2002.
3. Норов А.У. Клиника, диагностика и лечение поясничного стеноза // Здравоохранение Узбекистана. 2007. № 7. С. 24-27.
4. Радченко В.А. Алгоритмы выбора оптимального оперативного вмешательства при различных клинических вариантах поясничного остеохондроза // Вертебрология - проблемы, поиски, решения: Тез. докл. науч.-практ. конф. М., 1998. С. 151-152.
5. Руцкий А.В., Шанько Г.Г. Нейроортопедические и ортопедоневрологические синдромы у детей и подростков. Минск, 1998.
6. Airaksinen O, Brox JI, Cedraschi C, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006; 15(Suppl 2): S192-S300.
7. Breivik Н, Collett B, Ventafridda V, et al. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006; 10: 287-333.
8. Gu Y, Chen L, Yang HL, et al. Efficacy of surgery and type of fusion in patients with degenerative lumbar spinal stenosis. J Clin Neurosci. 2009; 16: 1291-1295.
9. Kleinstueck FS, Diederich CJ, Nau WH, et al. Acute biomechanical and histological effects of intradiscal electrothermal therapy on human lumbar discs. Spine. 2001; 26: 2198-2207.
10. Malis LI. Lumbar stenosis. Mt Sinai J Med. 1991; 58: 121-124.
11. Vaccaro AR, Ball ST. Indications for instrumentation in degenerative lumbar spinal disorders. Orthopedics. 2000; 23: 260-271.
12. Yanase M, Sakou T, Taketomi E, еt al. Transpedicular fixation of the lumbar and lumbosacral spine with screws. Application of the Diapason system. Paraplegia. 1995; 33: 216-218.
Review
For citations:
Afaunov A.A., Basankin I.V., Kuzmenko A.V., Shapovalov V.K. ANALYSIS OF REASONS FOR REVISION SURGERY IN PATIENTS TREATED FOR DEGENERATIVE LUMBAR SPINAL STENOSIS. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2014;(1):86-93. (In Russ.) https://doi.org/10.14531/ss2014.1.86-93
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