Применение технологии LLIF у пациентов с дегенеративным сколиозом поясничного отдела позвоночника: анализ ретроспективной когорты и обзор литературы

Применение технологии LLIF у пациентов с дегенеративным сколиозом поясничного отдела позвоночника: анализ ретроспективной когорты и обзор литературы

Автор: Климов Владимир Сергеевич, Василенко Иван Игоревич, Евсюков Алексей Владимирович, Халепа Роман Владимирович, Амелина Евгения Валерьевна, Рябых Сергей Олегович, Рзаев Джамиль Афет Оглы

Журнал: Гений ортопедии @geniy-ortopedii

Статья в выпуске: 3, 2018 года.

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Введение. Распространенность дегенеративного сколиоза взрослых - ADS (Adult degenerative scoliosis) - среди населения старше 50 лет достигает 68 %. Оперативные вмешательства, направленные на коррекцию деформации позвоночника у пациентов старшей возрастной группы, сопровождаются высоким риском осложнений. Применение LLIF (Lumbar Lateral Interbody Fusion) сопряжено с более низким количеством осложнений по сравнению с открытым передним или задним спондилодезом. Материалы и методы. 71 пациент (13 мужчин и 58 женщин) с ADS был прооперирован в ФГБУ ФЦН. Средний возраст пациентов составил 60.4/60 [55;64,5] лет (формат: среднее/медиана [1;3 квартиль]). Проводили рентгенографию, спиральную компьютерную томографию (СКТ), магнитно-резонансную томографию (МРТ) поясничного отдела позвоночника. Анкетирование по визуально-аналоговой шкале боли (VAS), опроснику Oswestry Disability Index (ODI) и по шкале The Short Form-36 (SF-36). Оценивали параметры сагиттального баланса: PI (Pelvic incidence), SS (Sacral slope), PT (Pelvic tilt), LL (lumbal lordosis). Целевое значение интегрированных показателей SVA, PT и PI-LL (PI минус LL) определяли с поправкой на возраст. Результаты. Статистически значимо через 12 месяцев отмечено уменьшение болевого синдрома в спине по VAS с 6.1/6 [4;8] до 2.2/2 [2;3] баллов (p Introduction Incidence of adult degenerative scoliosis (ADS) among individuals over 50 years old reaches 68%. Surgical interventions aimed at correcting the spinal deformity in patients of the older age group are accompanied by a high risk of complications. The use of LLIF is associated with lower complications as compared with open anterior or posterior fusion. Materials and methods Seventy-one patients with ADS (13 men, 58 women) were operated at the Federal Neurosurgical Center. Their average age was 60.4/60 (average/median) [55;64.5] (1: 3 quartile) years. The follow-up was from 12 to 18 months. X-ray study, SCT, MRI of the lumbar spine were used. Questionnaire surveys were conducted using the visual analog pain scale (VAS), Oswestry Disability Index (ODI) and the Short Form-36 (SF-36). Deformity correction was estimated in the frontal plane with Cobb’s method. Scoliosis was classified according to SRS-Schwab classification. Parameters of sagittal balance were estimated: PI (Pelvic incidence), SS (Sacral slope), PT (Pelvic tilt), LL (Lumbar lordosis). SVA, PT and PI-LL (PI minus LL) were defined adjusted for the age. Results Back pain according to VAS relieved from 6.1/6 [4;8] to 2.2/2 [2;3] points (p

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Поясничный боковой межтеловой спондилодез, сагиттальный баланс, дегенеративный сколиоз поясничного отдела позвоночника, качество жизни

Короткий адрес: https://sciup.org/142213581

IDR: 142213581   |   DOI: 10.18019/1028-4427-2018-24-3-393-403

Список литературы Применение технологии LLIF у пациентов с дегенеративным сколиозом поясничного отдела позвоночника: анализ ретроспективной когорты и обзор литературы

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