Long-term clinical outcomes and development of degenerative diseases of the adjacent proximal segment during personalized lumbar transforaminal fusion: A multicenter prospective study
- Authors: Spiridonov A.V.1,2, Pestryakov Y.Y.1,2, Kalinin A.A.1,3, Byvaltsev V.A.1,3,4
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Affiliations:
- Irkutsk State Medical University
- Regional Clinical Hospital of Krasnoyarsk
- Railway Clinical Hospital
- Irkutsk State Medical Academy of Postgraduate Education – branch of the Federal State Budgetary Educational Institution DPO RMANPO of the Ministry of Health of the Russian Federation
- Issue: Vol 26, No 3 (2024)
- Pages: 399-410
- Section: Research paper
- Submitted: 21.03.2024
- Accepted: 06.06.2024
- Published: 06.09.2024
- URL: https://journals.eco-vector.com/1682-7392/article/view/629309
- DOI: https://doi.org/10.17816/brmma629309
- ID: 629309
Cite item
Abstract
Long-term clinical outcomes and incidence of degenerative diseases of the adjacent proximal segment during personalized lumbar transforaminal fusion were prospectively assessed. According to the created register, the observational prospective multicenter study included 209 patients who underwent primary open transforaminal lumbar fusion according to generally accepted indications at the LIV–SI vertebral level between 2015 and 2019, and in these patients, adjacent vertebral motion segment had initial degeneration of the adjacent segment in varying severity levels. The risk of developing degenerative adjacent segment disease on the proximal spinal motion segment was assessed using an original method (Patent 2762496 of the Russian Federation, December 21, 2021, Bulletin No. 36). The surgical technique in relation to the adjacent spinal motion segment was determined according to the algorithm for personalized implementation of open transforaminal lumbar fusion. Instrumental parameters were studied in the preoperative period, and development of degenerative adjacent segment disease in the long-term postoperative follow-up was examined at 65 (60–74) months. After a comprehensive assessment of the risk of developing a degenerative adjacent segment disease, monosegmental open transforaminal lumbar fusion was performed in 75 patients, open transforaminal lumbar fusion with interspinous stabilization of the adjacent vertebral motion segment in 69, and involvement of the adjacent vertebral motion segment in rigid stabilization in 65. The incidence of degenerative adjacent segment disease was 4.9% (n = 10). Thus, a comprehensive assessment of the risk of developing degenerative adjacent segment disease and a personalized algorithmic approach to performing open transforaminal lumbar fusion can significantly improve long-term clinical results and reduce the incidence of this degenerative disease in a minimum 5-year follow-up period.
About the authors
Alexey V. Spiridonov
Irkutsk State Medical University; Regional Clinical Hospital of Krasnoyarsk
Email: av_spiridonov@bk.ru
ORCID iD: 0000-0003-3244-4688
SPIN-code: 4676-9573
graduate student
Russian Federation, Irkutsk; KrasnoyarskYuri Ya. Pestryakov
Irkutsk State Medical University; Regional Clinical Hospital of Krasnoyarsk
Email: pestryakov-nho@mail.ru
ORCID iD: 0000-0001-7076-571X
SPIN-code: 8933-1410
MD, Cand. Sci. (Med.)
Russian Federation, Irkutsk; KrasnoyarskAndrei A. Kalinin
Irkutsk State Medical University; Railway Clinical Hospital
Email: andrei_doc_v@mail.ru
ORCID iD: 0000-0002-6059-4344
SPIN-code: 9707-8291
MD, Cand. Sci. (Med.), associate professor, Department of Neurosurgery
Russian Federation, Irkutsk; IrkutskVadim A. Byvaltsev
Irkutsk State Medical University; Railway Clinical Hospital; Irkutsk State Medical Academy of Postgraduate Education – branch of the Federal State Budgetary Educational Institution DPO RMANPO of the Ministry of Health of the Russian Federation
Author for correspondence.
Email: byval75vadim@yandex.ru
ORCID iD: 0000-0003-4349-7101
SPIN-code: 5996-6477
MD, Dr. Sci. (Med.), professor, Department of Neurosurgery
Russian Federation, Irkutsk; Irkutsk; IrkutskReferences
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