Use of Nitinol Rods for Lumbosacral Spine Fixation (Prospective Randomized Clinical Study)



Cite item

Full Text

Abstract

One hundred thirty operations were performed in patients (57 males, 73 females) with degenerative lumbar spine diseases during the period from 2010 to 2012. Mean age of patients made up 57 (45-82) years. Depending on the type of intervention all patients were divided into 2 groups: in 60patients (1 st group) dynamic stabilization with nitinol rods without fusion and in 70patients (2 nd group) rigid fixation of lumbar spine with titanium rods was performed. Outcomes were analyzed in 1.5 years after surgery. VAS, ODI and SF36 questionnaires showed improvement of patients’ condition in both groups. Restoration of lordosis was from 22 to 35° and from 23 to 37° in 1 st and 2 nd groups, respectively. No screw instability, bone tissue resorption around the screws and adjacent segment pathology was noted in group 1. Functional X-rays showed preservation of mobility (5+1.2°). In 2 nd group formation of pseudarthrosis was recorded in 5patients, adjacent segment pathology - in 20 including 5 patients who required repeated surgical intervention. Transpedicular lumbosacral spine fixation using nitinol rods is an effective technique that enables to preserve movements in lumbosacral spine in combination with stable fixation

About the authors

S. V Kolesov

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov, Moscow, Russia

V. V Shvets

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov, Moscow, Russia

D. A Kolobovskiy

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov, Moscow, Russia

A. I Kaz’min

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov, Moscow, Russia

Email: kazmin.cito@mail.ru

N. S Morozova

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov, Moscow, Russia

References

  1. Weinstein J.N., Lurie J.D., Olson P.R., Bronner K.K., Fisher E.S. United States“ trends and regional variations in lumbar spine surgery: 1992 - 2003. Spine (Phila Pa 1976) 2006; 31: 2707-14.
  2. Deyo R.A., Mirza S.K., Martin B.I. Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002. Spine. 2006; 31: 2724-7.
  3. Cassidy J.D., Carroll L.J., Cote P. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine. 1998; 23: 1860-6.
  4. Deyo R.A., Tsui-Wu Y.J. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine. 1987; 12: 264-8.
  5. Katz J.N. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J. Bone Joint Surg. Am. 2006; 88 (suppl 2): 21-4.
  6. Luo X., Pietrobon R., Sun S.X., Liu G.G., Hey L. Estimates and patterns of direct health care expenditures among individuals with back pain in the United States. Spine. 2004; 29: 79-86.
  7. Hart L.G., Deyo R.A., Cherkin D.C. Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey. Spine. 1995; 20: 11-9.
  8. Friedman B.W., Chilstrom M., Bijur P.E., Gallagher E.J. Diagnostic testing and treatment of low back pain in the United States Emergency Departments: A national perspective. Spine. 2010; 35 (24): E1406-11.
  9. Zagra A., Minoia L., Archetti M., Corriero A.S., Ricci K., Teli M, Giudici F. Prospective study of a new dynamic stabilisation system in the treatment of degenerative discopathy and instability of the lumbar spine. Eur. Spine J. 2012; 21 (Suppl 1): 83-9.
  10. Panjabi M. The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J. Spinal Disord. 1992: 1992; 5: 390-8.
  11. Швец В.В. Поясничный остеохондроз. Некоторые аспекты патогенеза, хирургическое лечение. Дис.. д- ра мед. наук. М.; 2008.
  12. White A.A., Panjabi M.M. Clinical biomechanics of the spine. Philadelphia: J.B. Lippincott; 1990.
  13. Friberg O. Lumbar instability: a dynamic approach by traction-compression radiography. Spine. 1987; 12 (2): 119-29.
  14. Boos N., Webb J.K. Pedicle screw fixation in spinal disorders: a European view. Eur. Spine J. 1997; 6: 2-18.
  15. Cheh G., Bridwell K.H., Lenke L.G., Buchowski J.M., Daubs M.D., Kim Y., Baldus C. Adjacent segment disease following lumbar/thoracolumbar fusion with pedicle screw instrumentation: a minimum 5-year follow-up. Spine. 2007; 32: 2253-7.
  16. Martin B. I., Mirza S. K., Comstock B. A., Gray D. T., Kreuter W., Deyo R. A. Reoperation rates following lumbar spine surgery and the influence of spinal fusion procedures. Spine. 2007; 32 (3): 382-7.
  17. Kaner T., Sasani M., Oktenoglu T., Ozer A. F. Dynamic stabilization of the spine: a new classification system Turk. Neurosurg. 2010; 20 (2): 205-15.
  18. Kaner T., Sasani M., Oktenoglu T., Cosar M., Ozer A.F. Utilizing dynamic rods with dynamic screws in the surgical treatment of chronic instability: a prospective clinical study. Turk. Neurosurg. 2009; 19 (4): 319-26.
  19. Nockels R.P. Dynamic stabilization in the surgical management of painful lumbar spine disorders. Spine. 2005; 30: S68.
  20. Panjabi M.M. Hybrid multidirectional test method to evaluate spinal adjacent-level effects. Clin. Biomech. 2007; 22: 257-65.
  21. Chou WY., Hsu C.J., Chang W.N., Wong C.Y. Adjacent segment degeneration after lumbar spine posterolateral fusion with instrumentation in elderly patients. Arch. Orthop. Trauma Surg. 2002; 122; 39-43.
  22. Esses S.I., Sachs B.L., Dreyzin V. Complications associated with the technique of pedicle screw fixation. A selected survey of ABS members. Spine. 1993; 18: 2231-9.
  23. McAfee P.C., Weiland D.J., Carlow J.J. Survivorship analysis of pedicle spinal instrumentation. Spine. 1991; 16 (suppl 8): S422-7.
  24. Schmoelz W., Huber J.F., Nydegger T., Dipl-Ing, Claes L., Wilke H.J. Dynamic stabilization of the lumbar spine its effects on adjacent segments: an in vivo experiment. J. Spinal Disord. Tech. 2003; 16: 418-23.
  25. Sengupta D.K., Herkowitz H.N. Pedicle screw-based posterior dynamic stabilization: literature review. Adv. Orthop. 2012; 2012: 424268.
  26. Kollerov M., Lukina E., Gusev D., Mason P., Wagstaff P. Impact of material structure on the fatigue behavior of NiTi leading to a modified Coffin-Manson equation. Materials Science and Engineering A. 585 (2013); 356362
  27. Левченко С.К., Древаль О.Н., Ильин А.А., Коллеров М.Ю., Рынков И.П., Басков А.В. Экспериментально-анатомическое исследование функциональной транспедикулярной стабилизации позвоночника Вопросы нейрохирургии им. Н.Н. Бурденко. 2011; 75 (1): 20-6.
  28. Левченко С.К., Древаль О.Н., Ильин А.А., Коллеров М.Ю., Рынков И.П., Басков А.В., Каримов А.А. Клинические исследования транспедикулярной конструкции со стержнем функционально-оптимального уровня жесткости из никелида титана. Вопросы нейрохирургии им. Н.Н. Бурденко. 2009; 4: 31-5.
  29. Древаль О.Н., Ильин А.А., Колеров М.Ю., Левченко С.К., Мамонов А.М., Рынков И.П. Фиксатор для позвоночника. Патент РФ №2270632, 2004.
  30. Schnake K.J., Schaeren S., Jeanneret B. Dynamic stabilization in addition to decompression for lumbar spinal stenosis with degenerative spondylolisthesis. Spine. 2006; 31: 442-9.
  31. Sangiorgio S.N., Sheikh H., Borkowski S.L., Khoo L., Warren C.R., Ebramzadeh E. Comparison of three posterior dynamic stabilization devices. Spine. 2011. 36 (19): E1251-8.
  32. Zhang Q.H., Zhou Y.L., Petit D., Teo E.C. Evaluation of load transfer characteristics of a dynamic stabilization device on disc loading under compression. Med. Eng. Phys. 2008; 31: 533-8.
  33. Haddad B., Makki D., Konan S., Park D., Khan W., Okafor B. Dynesis dynamic stabilization: less good outcome than lumbar fusion at 4-year follow-up. Acta Orthop. Belg. 2012; 78: 97-103.
  34. Park P., Garton H.J., Gala V.C., Hoff J.T., McGillicuddy J.E. Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature. Spine. 2004. 29 (17): 1938-44.
  35. Siepe C.J., Mayer H. M., Wiechert K., Korge A. Clinical results of total lumbar disc replacement with ProDisc II: three-year results for different indications. Spine. 2006. 31 (17): 1923-32

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2014 Eco-Vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-76249 от 19.07.2019.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies