RESULTS OF INTERVERTEBRAL DISC REPLACEMENT FOR DISEASES OF THE ADJACENT SEGMENT OF THE LUMBAR SPINE

DOI:

https://doi.org/10.54890/.v4i4.1079

Abstract

The study included 20 patients with adjacent segment disease who were re-operated using the ALIF technique from 2019 to 2022. All patients were divided into two groups depending on the surgical technology. The first group included 11 patients aged from 30 to 60 years (M ± SD = 48.0:11.9 years) who underwent surgery using ALIF technology using interbody implants. There were 6 men (54.6%), 5 women (45.4%). The second included 9 patients aged 35 to 55 years (M ± SD = 42.4:8.6 years), operated on with ALIF technology using an M6 intervertebral disc prosthesis. The ratio of men to women in this group was 5 (55.5%):4 (44.5%). In group I, anterior decompression of the spinal canal using the ALIF method with the use of interbody implants, statistically significant results were observed: VAS before surgery 7.5 ± 0.9 – after 2.2 ± 1.3 p < 0.001, ODI index before surgery 52.4 ± 8.8 – after 14.5 ± 6.9 p <0.001. In ALIF group II using M6 intervertebral disc endoprosthesis, significant results were also noted: VAS before surgery 8.1 ± 0.9 – after surgery 1.2 ± 0.2 p <0.001, ODI before surgery 63.6 ± 9.9 – after 11.5 ± 4.2 p <0.001. However, ODI indicators in the second group in a comparative analysis are better than in group I, p <0.05. Thus, the long fixation lever, the level of spinal fusion, influences the development of diseases of the adjacent segment. In the present study, we performed a comparative analysis using ALIF technology using a conventional titanium cage and an endoprosthesis. We came to the conclusion that by using an intervertebral endoprosthesis as an alternative to spinal fusion, it is possible to reduce the risk of progression of degenerative changes in adjacent segments and the development of diseases at adjacent levels.

Keywords:

disc herniation, adjacent segment stenosis, adjacent segment disease, ALIF, M6-L intervertebral endoprosthesis.

Author Biographies

S.A. Dzhumabekov, Kyrgyz State Medical Academy named after I.K. Akhunbaev

Department of Traumatology, Orthopedics and Extreme Surgery

S.T. Mamyrbaev, Kyrgyz State Medical Academy named after I.K. Akhunbaev

Department of Traumatology, Orthopedics and Extreme Surgery

N.A. Atakulov, Kyrgyz State Medical Academy named after I.K. Akhunbaev

Department of Traumatology, Orthopedics and Extreme Surgery

M.Zh. Bekov, Kyrgyz State Medical Academy named after I.K. Akhunbaev

Department of Anesthesiology and Intensive Care

References

1. Donnally ChJ 3rd, Parthik D, Patel Jose A. Canseco Current incidence of adjacent segment pathology following lumbar fusion versus motion-preserving procedures: a systematic review and meta-analysis of recent projections. MBA Show less. 2020;20:1554-1565. https://doi.org/10.1016/j.spinee.2020.05.100

2. Harrod CC, Hilibrand AS, Fischer DJ, Skelly AC. Adjacent segment pathology following cervical motion-sparing procedures or devices compared with fusion surgery: a systematic review. Spine (Phila Pa 1976). 2012;37:96-112. https://doi.org/10.1097/BRS.0b013e31826cb2d6

3. Matgé G, Berthold C, Gunness VR. Stabilization with the Dynamic Cervical Implant: a novel treatment approach following cervical discectomy and decompression. J Neurosurg Spine. 2015;22:237-45. https://doi.org/10.3171/2014.10. SPINE131089

4. Ye J, Yang S, Wei Z, Cai C. Incidence and Risk Factors for Adjacent Segment Disease After Transforaminal Lumbar Interbody Fusion in Patients with Lumbar Degenerative Diseases. Int J Gen Med. 2021;14:8185-8192. https://doi.org/ 10.2147/IJGM.S337298

5. Bagheri SR, Alimohammadi E, Zamani Froushani A. Adjacent segment disease after posterior lumbar instrumentation surgery for degenerative disease: incidence and risk factors. J Orthop Surg. 2019; 27(2):2309499019842378. https://doi.org/10.1177/2309499019842378

6. Park P, Garton HJ, Gala VC. Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature. Spine. 2004;29:1938-1944. https://doi.org/10.1097/01.brs.0000137069.88904.03

7. Абакиров М.Дж., Нурмухаметов Р.М., Мамырбаев С.Т. Результаты ревизионных операций при дегенеративно-дистрофических заболеваниях пояснично-крестцового отдела позвоночника. Политравма. 2020;1:31-40. [Abakirov MJ, Nurmukhametov RM, Mamyrbaev ST. Results of revision surgeries for degenerative-dystrophic diseases of the lumbosacral spine. Polytrauma. 2020; 1: 31-40 (In Russ.).] https://doi.org/10.24411/1819-1495-2020-10005

8. Sakalkale DP, Bhagia SA, Slipman CW. A historical review and current perspective on the intervertebral disc prosthesis. Pain Physician. 2003;6:195–198.

9. Абакиров М.Д., Круглов И.А., Абдрахманов Р.Р., Селезнев А.С., Мадер А.Е. Эндопротезирование межпозвонковых дисков поясничного отдела позвоночника. Хирургия позвоночника. 2016;13:59–66. [Abakirov MD, Kruglov IA, Abdrakhmanov RR, Seleznev AS, Mader AE. Endoprosthetics of intervertebral discs of the lumbar spine. Spine surgery. 2016;13:59–66 (In Russ.).]

10. Круглов И.А., Гизатуллин Ш.Х., Селезнев А.С., Вовкогон В.Б., Сычев В.А. Опыт хирургического лечения грыж межпозвонковых дисков поясничного отдела позвоночника. Труды Главного военного клинического госпиталя им. академика Н.Н. Бурденко: Сб. науч. статей. 2012; 9(ч.1). Режим доступа: https://neuro1586.ru/publ.html [Kruglov IA, Gizatullin ShKh, Seleznev AS, Vovkogon VB, Sychev VA. Experience in surgical treatment of herniated discs of the lumbar spine. Proceedings of the Main Military Clinical Hospital named after. Academician N.N. Burdenko: Sat. scientific articles. 2012;9(Pt.1). (In Russ.).]

11. Byvaltsev VA, Kalinin AA, Stepanov IA, Pestryakov YY, Shepelev VV. Results of total lumbar intervertebral disk replacement with m6-l: a multicenter study. Coluna/Columna.2017;16(4): 288-291. https://doi.org/10.1590/S1808-185120171604182049

12. Джумабеков С.А., Абакиров М.Д., Ушмаев А.Е., Сооронкулов У.П. Обоснование применения цилиндрического кейджа после вентральной декомпрессии при дегенеративных поражениях пояснично-крестцового отдела позвоночника. Вестник КРСУ. 2013;13(1):146-151. [Dzhumabekov SA, Abakirov MD, Ushmaev AE, Sooronkulov UP. Rationale for the use of a cylindrical cage after ventral decompression for degenerative lesions of the lumbosacral spine. Bulletin of the KRSU. 2013;13(1):146-151 (In Russ.).]

13. Panjabi MM, White AA 3rd. Basic biomechanics of the spine. Neurosurgery.1980;7:76-93.

14. Pfirrmann CW, Metzdorf A, Zanetti M. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2001;26(17):1873-1878. https://doi.org/10.1097/00007632-200109010-00011

15. Modic MT, Steinberg PM, Ross JS, Masaryk TJ, Carter JR. Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology.1988;166(1 Pt.1): 193-199. 10.1148/radiology.166.1.3336678

16. Schizas C, Theumann N, Burn A, Tansey R, Wardlaw D, Smith FW. Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images. 2010;35(21):1919-1924. https://doi.org/10.1097/BRS.0b013e3181d359bd

17. Lee S, Lee JW, Yeom JS, Kim KJ, Kim H-J, Chung SK, Kang HS. A practical MRI grading system for lumbar foraminal stenosis. Am. J. Roentgenol. 2010;194(4):1095-1098. https://doi.org/10.2214/AJR.09.2772

18. Черепанов ЕА. Русская версия опросника Освестри: культурная адаптация и валидность: практические рекомендации. Хирургия позвоночника. 2009;3:93-98. [Cherepanov EA. Russian version of Oswestry questionnaire: cultural adaptation and validity: practical recommendations. Spine Surgery. 2009;3:93-98 (In Russ.).] https://doi.org/ 10.14531/ss2009.3.93-98

19. Kristen ER, Christopher KK, Andre J, Gursukhman SS, Rihn J, Vaccaro AR et al. Adjacent segment disease in the lumbar spine following different treatment interventions. Spine Journal.2013;13:1339-1349. https://doi.org/10.1016/j. spinee.2013.03.020

20. Caroline S, Baptiste M, Philippe G, Pierre G. Risk of adjacent-segment disease requiring surgery after short lumbar fusion: results of the French Spine Surgery Society Series. J Neurosurg Spine. 2016; 25(1):46–51. https://doi.org/10.3171/2015.11.spine15700

21. Sears WR, Sergides IG, Kazemi N. Smith M, White GJ, Osburg B. Incidence and prevalence of surgery at segments adjacent to a previous posterior lumbar arthrodesis. Spine J. 2011;11(1):11-20. https://doi.org/10.1016/j.spinee.2010.09.026

22. Ghiselli G, Wang JC, Bhatia NN, Hsu WK, Dawson EG. Adjacent segment degeneration in the lumbar spine. J Bone Joint Surg Am. 200486(7):1497–1503. https://doi.org/10.2106/00004623-200407000-00020

23. Афаунов А.А., Басанкин И.В., Кузьменко А.В., Шаповалов В.К. Осложнения хирургического лечения поясничных стенозов дегенеративной этиологии. Хирургия позвоночника. 2016;13(4):66–72. [Afaunov AA, Basankin IV, Kuzmenko AV, Shapovalov VK. Complications of surgical treatment of lumbar stenosis of degenerative etiology. Spine surgery. 2016;13(4):66–72 (In Russ.).] https://doi.org/10.14531/ss2016.4.66-72

24. Sears WR, Sears WR, Sergides IG, Kazemi N. Incidence and prevalence of surgery at segments adjacent to a previous posterior lumbar arthrodesis. Spine J. 2011;11(1):11-20. https://doi.org/10.1016/j.spinee.2010.09.026

25. Wang T, Ding W. Risk factors for adjacent segment degeneration after posterior lumbar fusion surgery in treatment for degenerative lumbar disorders: a meta-analysis. J Orthop Surg Res. 2020;15(1):582. https://doi.org/10.1186/s13018-020-02032-7

Published

2023-12-18

How to Cite

Джумабеков, С., С. Мамырбаев, Н. Атакулов, and М. Беков. “RESULTS OF INTERVERTEBRAL DISC REPLACEMENT FOR DISEASES OF THE ADJACENT SEGMENT OF THE LUMBAR SPINE ”. Euroasian Health Journal, vol. 4, no. 4, Dec. 2023, pp. 169-80, doi:10.54890/.v4i4.1079.

Issue

Section

QUESTIONS OF TRAUMATOLOGY AND ORTHOPEDICS