scholarly journals MULTICENTER ANALYSIS OF THE RESULTS OF APPLICATION OF DIRECT LATERAL INTERBODY FUSION (DLIF) AND TRANSCUTANEOUS TRANSPEDICULAR FIXATION IN PATIENTS WITH DEGENERATIVE DISC DISEASES OF THE LUMBAR SPINE

2017 ◽  
Vol 72 (2) ◽  
pp. 149-158
Author(s):  
V. A. Byvaltsev ◽  
A. A. Kalinin ◽  
S. K. Akshulakov ◽  
A. E. Krivoshein ◽  
T. T. Kerimbayev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Lumbar Spine ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Degenerative Disc ◽  
Pedicle Fixation ◽  
Multicenter Analysis ◽  
Lateral Interbody

Background: The technique of lateral lumbar interbody fusion for the surgical treatment of patients with degenerative diseases of the lumbar spine was developed in the early 2000s. But at the same time in modern literature there is no uniform approach to the use this technique, clinical outcomes and radiological findings are contradictory. Aims: to conduct a multicenter analysis of clinical outcomes and instrumental data of direct lateral interbody fusion (DLIF) approach combined with transcutaneous pedicle fixation in patients with single-level degenerative disc diseases of the lumbar spine. Materials and methods: The study included 103 patients (63 men and 40 women, mean age 45.8±9.7 years) who underwent surgery followed by DLIF transcutaneous pedicle fixation. The surgery was performed at neurosurgical and vertebrological departments in Irkutsk (Russia), Omsk (Russia), and Astana (Kazakhstan). Dynamic observation and comprehensive clinical and instrumental evaluation of the treatment results were carried out for an 18-month period after surgery. Results: After the simultaneous decompressive-stabilizing intervention, in all patients we detected a decrease in the severity of pain syndrome on VAS — from 6.9±1.6 to 1.7±1.2 cm (p0.001), and improved quality of life index (Oswestry) — from 21.3±6.8 to 12.3±4.4% (p0.001). The instrumental methods of examination determined the effective indirect decompression: an increase in the size of interbody gap in the middle of its department compared with the preoperative value from 8.6±3.1 to 15.7±4.2 mm (p0.001) and an increase in the area of the intervertebral foramen (on the left with an average of 98.7±32.3 and 156.8±45.1 mm2, p0.001; on the right —99.7±37.3 to 153.4±38.7 mm2, p0.001). We also registered the restoration of both the segmental (from 10.2±3.8 to 13.6±6.7°, p0.001) and regional (from 32.8±5.9 to 48.2±7.3°, р0.001) lumbar lordosis. Complete interbody fusion was diagnosed in 87 (86.4%) patients. Complications were observed in 8.7% of cases. Conclusions: DLIF technique combined with transcutaneous transpedicular stabilization has high clinical efficacy confirmed by significant reduction in the severity of pain according to VAS. The studied approach improves the quality of life of patients by Oswestry index and reveals a low number of postoperative complications. The described simultaneous minimally invasive method of surgical treatment in patients with degenerative disc diseases allows to restore the sagittal profile of the lumbar spine and implement an effective stabilization of the operated vertebral-motor segments with a high degree of formation of interbody bone block.

scholarly journals Interrelation of tropism and angulation parameters of facet joints and results of stabilization surgeries for degenerative diseases of the lumbar spine

2018 ◽  
Vol 15 (4) ◽  
pp. 70-79
Author(s):  
V. A. Byvaltsev ◽  
A. K. Okoneshnikova ◽  
A. A. Kalinin ◽  
S. S. Rabinovich
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Degenerative Diseases ◽  
Facet Joints ◽  
Group Iii ◽  
Group I ◽  
Transpedicular Stabilization

Objective. To clarify indications for dynamic and rigid stabilization based on the analysis of correlation between neuroimaging parameters of facet joints (FJ) and clinical outcomes of surgical treatment of patients with degenerative diseases of the lumbar spine. Material and Methods. A total of 141 patients with degenerative diseases of the lumbar spine were surgically treated. Patients were divided into three groups: patients of Group I (n = 48) underwent surgical intervention with artificial intervertebral disc prosthesis; those of Group II (n = 42) – with interbody fusion and combined transpedicular and transfacetal stabilization; and those of Group III (n = 51) – with interbody fusion and bilateral transpedicular stabilization. The correlation between long-term clinical outcomes (pain syndrome according to VAS, functional state according to ODI, and satisfaction with surgical result according to MacNab scale) and preoperative neuroimaging parameters of FJ (degenerative changes according to Fujiwara, facet angle magnitudes, and the presence of tropism) was analyzed. Results. A direct significant nonparametric correlation of neuroimaging parameters of facet angles and FJ tropism with long-term clinical outcomes of surgical treatment according to VAS and ODI was revealed. It was established that good clinical outcomes were achieved with the following preoperative parameters: in Group I, the facet angle was less than 60°, while the presence of tropism had no correlation dependence; in Group II, the facet angle – more than 60°, in the absence of FJ tropism; and in Group III, the facet angle – more than 60°, in the presence of FJ tropism. Conclusion. Objective neuroimaging parameters of the facet angle magnitude of less than 60°, regardless of the presence of tropism, allow performing total arthroplasty. If the facet angle is more than 60°, the rigid stabilization of the operated segment is indicated; in the absence of tropism, a contralateral transfacetal fixation is possible, and in its presence – a bilateral transpedicular stabilization is reasonable.

scholarly journals LUMBAR SPINE SURGERY. IMPORTANCE OF SAGITTAL BALANCE IN THE QUALITY OF LIFE OF PATIENTS

2016 ◽  
Vol 15 (1) ◽  
pp. 48-51 ◽  
Author(s):  
Luiz Claudio Lacerda Rodrigues ◽  
Adalberto Bortoletto ◽  
Rodrigo Nakao ◽  
Virgilio Serquiz de Azevedo ◽  
Rafael Maurcio Beletato ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Lumbar Spine ◽  
Lumbar Spine Surgery ◽  
P Value ◽  
Sacral Slope ◽  
Lumbosacral Region ◽  
Degenerative Lumbar Diseases ◽  
Spinopelvic Balance

ABSTRACT Objective: To evaluate whether performing surgery in degenerative diseases of the lumbar spine modify the spinopelvic balance and influences the clinical outcome and the quality of life of patients. Methods: The spinopelvic balance was evaluated in 25 patients using plain radiographs of the lumbosacral region including the proximal femur, as well as evaluating the quality of life on two separated occasions. Results: The measure of spinopelvic balance was obtained by averaging the angles of sacral slope, pelvic version and pelvic incidence. Mean preoperative angles were 59.88º, 22.84º, and 37.44º, respectively, and the mean postoperative values were 61.56º, 24.64º, and 37.32º, respectively. Regarding the questionnaires on quality of life, the Oswestry index showed mean preoperative values of 46.24, characterized as severe disability and mean postoperative values of 13.29 denoting satisfactory response after surgical treatment. The SF-36 questionnaire showed important and significant improvement in quality of life in different domains, with the exception of physical limitation and social aspects, with a p-value of 0.02 and 0.025, respectively. Conclusion: Patients undergoing surgical treatment of degenerative lumbar diseases showed no significant changes in the spinopelvic balance, but showed significant improvement in quality of life after surgery.

scholarly journals Treatment of severely open tibial fractures, non-unions, and fracture-related infections with a gentamicin-coated tibial nail—clinical outcomes including quality of life analysis and psychological ICD-10-based symptom rating

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Nike Walter ◽  
Daniel Popp ◽  
Viola Freigang ◽  
Michael Nerlich ◽  
Volker Alt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Intramedullary Nail ◽  
Revision Surgery ◽  
Bone Consolidation ◽  
Patient Reported ◽  
Icd 10 ◽  
Symptom Rating

Abstract Background Implant-associated infections depict a major challenge in orthopedics and trauma surgery putting a high burden on the patients and health care systems, strongly requiring improvement of infection prevention and of clinical outcomes. One strategy includes the usage of antimicrobial-coated implants. We evaluated outcomes after surgical treatment using a gentamicin-coated nail on (i) treatment success in terms of bone consolidation, (ii) absence of infection, and (iii) patient-reported quality of life in a patient cohort with high risk of infection/reinfection and treatment failure. Methods Thirteen patients with open tibia fractures (n = 4), non-unions (n = 2), and fracture-related infection (n = 7) treated with a gentamicin-coated intramedullary nail (ETN ProtectTM) were retrospectively reviewed. Quality of life was evaluated with the EQ-5D, SF-36, and with an ICD-10-based symptom rating (ISR). Results At a mean follow-up of 2.8 years, 11 of the 13 patients (84.6%) achieved bone consolidation without any additional surgical intervention, whereas two patients required a revision surgery due to infection and removal of the implant. No specific implant-related side effects were noted. Quality of life scores were significantly lower compared to a German age-matched reference population. The mean ISR scores revealed mild psychological symptom burden on the scale depression. Conclusion The use of a gentamicin-coated intramedullary nail seems to be reasonable in open fractures and revision surgery for aseptic non-union or established fracture-related infection to avoid infection complications and to achieve bony union. Despite successful treatment of challenging cases with the gentamicin-treated implant, significantly reduced quality of life after treatment underlines the need of further efforts to improve surgical treatment strategies and psychological support.

scholarly journals SURGICAL TREATMENT OF VERTEBRAL FRACTURES ASSOCIATED WITH LOW MINERAL BONE DENSITY

2010 ◽  
Vol 16 (2) ◽  
pp. 116-119
Author(s):  
V. V. Rerikh ◽  
M. A. Sadovoy ◽  
Sh. N. Rakhmatillaev ◽  
K. Q. Borzykh
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Bone Density ◽  
Internal Fixation ◽  
Clinical Outcomes ◽  
Vertebral Fractures ◽  
Transpedicular Fixation ◽  
Vertebral Bodies ◽  
Mineral Bone Density

Surgical treatment of 177 patients with monolocal fractures of thoracic and lumbar vertebral bodies was performed using transpedicular fixation (n=17), transpedicular fixation and osteoplasty (n=101), vertebroplasty (n=48) or kyphoplasty (n=ll). Restoration of support ability of the fractured osteoporotic vertebrae within ventral column by means of plasty particularly in combination with internal fixation allows achievement of better clinical outcomes, improvement of the quality of life in patients in the early and late periods after surgery.

scholarly journals RESULTS OF COMBINED FIXATION OF SCOLIOTIC SPINAL DEFORMITY IN ADULTS

2010 ◽  
Vol 16 (2) ◽  
pp. 89-92
Author(s):  
V. D. Usikov ◽  
D. A. Ptashnikov ◽  
O. A. Smekalenkov ◽  
D. A. Mikhailov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Lumbar Spine ◽  
Spinal Deformity ◽  
Dynamic Stabilization ◽  
Adult Patients ◽  
Spinal Fixation

The results of surgical treatment of adult patients with scoliosis in the form of different fixation of L5-S1 segment. The best results were obtained in patients who underwent combined spinal fixation (transpedicular system and the system interspinous dynamic stabilization). In this group good indicators of quality of life of patients in the form of lack of pain and preservation of the normal volume movements in the lumbar spine were received.

scholarly journals ANALYSIS OF RESULTS OF THE INTERVERTEBRAL TOTAL DISK ARTHROPLASTY OF THE LUMBAR SPINE BY M6-L PROSTHESIS: A MULTICENTER STUDY

2017 ◽  
Vol 72 (5) ◽  
pp. 393-402 ◽  
Author(s):  
V. A. Byvaltsev ◽  
A. A. Kalinin ◽  
A. Y. Pestryakov ◽  
V. V. Shepelev ◽  
I. A. Stepanov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Lumbar Spine ◽  
Range Of Motion ◽  
Heterotopic Ossification ◽  
Mean Value ◽  
T Test ◽  
Lumbosacral Spine ◽  
The Mean

Background: Pain in the lower back is an urgent health issue in industrialized countries. The dominant cause of pain in the lumbosacral spine is the degeneration of the inter vertebral discs (I VD). The total prosthetics I VD is a modern method of surgical treatment of I VD degenerative diseases, an alternative method of rigid stabilization.Aim: To analyze the results of surgical inter vention (I VD prosthesis M6-L implantation) in patients with I VD degeneration of lumbar spine at the 6, 12, 24, and 36 months after the surger y.Materials and methods: The study included 156 patients (92 men, 64 women) aged 23 to 45 years who under went a single-level discectomy with implantation of an artificial IVD prosthesis M6-L  at the bases of three neurosurgical centers. For dynamic assessment, clinical parameters (pain intensity from the visual analogue pain scale (VAS), quality of life according to the Oswestry index, subjective satisfaction with the result of surgical treatment on the Macnab scale) and instrumental data (amplitude of movements in the operated spinal-motor segment, degree of heterotopic ossification according to McAfeeSuchomel classification) were applied at 6, 12, 24, and 36 months after surger y.Results: The mean value of the quality of life for the Oswestr y index before surger y was 40.2±6.9%, after ― 12.3±6.1% (t-test, p0.001). The mean value of the level of pain according to VAS before surger y was 6.9±1.6 cm; after surger y ― 1.3±1.2 cm (t-test, p0.001). The average range of motion in the operated segment at baseline was 36.8±2.6°, within 36 months after the operation increased up to 41.2±2.9°. During the entire period of obser vation the initial (13.4%) or moderate (10.2%) signs of heterotopic ossification were revealed. Conclusions: The use of prosthetic I VD M6-L can significantly reduce the level of pain, improve the life quality, and maintain the physiological range of motion in the operated spinal motion segment with a low level of adverse outcomes.

scholarly journals Clinical Outcomes and Quality of Life Following Surgical Treatment for Refractory Epilepsy

Medicine ◽  
2015 ◽  
Vol 94 (6) ◽  
pp. e500 ◽  
Author(s):  
Shi-Yong Liu ◽  
Xiao-Lin Yang ◽  
Bing Chen ◽  
Zhi Hou ◽  
Ning An ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Refractory Epilepsy

Comorbid PTSD in Bipolar Patients: Clinical Outcomes and Quality of Life

2009 ◽  
Author(s):  
Lucas Quarantini ◽  
Angela Miranda-Scippa ◽  
Monica Nascimento ◽  
Flavio Kapczinski ◽  
Karestan Koenen
Keyword(s):  
Quality Of Life ◽  
Clinical Outcomes ◽  
Bipolar Patients

Health-related quality of life one year after surgical treatment of the type I chronic aortic dissection

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Oksana Kamenskaya ◽  
Asya Klinkova ◽  
Irina Loginova ◽  
Alexander Chernyavskiy ◽  
Dmitry Sirota ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Aortic Dissection ◽  
Type I ◽  
Health Related Quality ◽  
Chronic Aortic Dissection ◽  
Related Quality ◽  
Health Related ◽  
One Year
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