电邮这篇文章 Surgical treatment of patients with sagittal imbalance of degenerative etiology: a comparison of two methods
- 作者: Baykov E.S.1, Peleganchuk A.V.1, Sanginov A.J.1, Leonova O.N.1, Krutko A.V.1
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隶属关系:
- Ya.L. Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
- 期: 卷 27, 编号 3 (2020)
- 页面: 16-26
- 栏目: Original study articles
- URL: https://ogarev-online.ru/0869-8678/article/view/34935
- DOI: https://doi.org/10.17816/vto202027316-26
- ID: 34935
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Purpose. Compare the clinical and radiological results of treatment of patients with spinal deformities operated on using the PSO method and corrective fusion in the lumbar spine.
Materials and methods. Retrospective monocenter cohort study. The data of 42 patients were analyzed. PSO (group I) was performed in 12 patients; 30 patients had a combination of surgical methods (group II) with mandatory ventral corrective spinal fusion at levels L4-L5, L5-S1. Clinical and radiological parameters were evaluated during hospitalization and at least 1 year later.
Results. Postoperative hospitalization in group I — 32.5 ± 7.4 days, 27.1 ± 7.4 in group II (p = 0.558758). The duration of the operation in group I was 402.5 ± 55.6 minutes, in group II 526.0 ± 116.2 minutes (p = 0.001124); blood loss 1862.5 ± 454.3 ml versus 1096.0 ± 543.3 ml (p = 0.000171). In both groups, significantly improved clinical and radiological parameters after surgery and after 1 year (p < 0.05). In group II, as compared with group I after surgery and more than 1 year: lower back pain according to VAS (p = 0.015424 and p = 0.015424); below ODI after 1 year was (p = 0.000001). In group I, compared with group II after surgery and after 1 year, SVA is less (p = 0.029879 and p = 0.000014), lumbar lordosis is higher (p = 0.045002 and p = 0.024120), LDI is restored more optimally (p = 0.000001 and p = 0.000002), the GAP is lower (p = 0.005845 and p = 0.002639). The ideal Russoly type is restored more often in patients of group II (p = 0,00032). Complications in group I were noted in 12 (100%) patients, in group II — in 13 (43.3%) patients (p = 0.001).
Conclusions. In multistep surgical treatment compared with PSO, the anterior corrective interbody fusion L4-L5, L5-S1 reliably better and more harmoniously restores the sagittal balance parameters, has significantly lower volume of intraoperative blood loss, fewer perioperative complications and significantly improves the quality of life of patients.
作者简介
Evgenii Baykov
Ya.L. Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
编辑信件的主要联系方式.
Email: evgen-bajk@mail.ru
ORCID iD: 0000-0002-4430-700X
SPIN 代码: 5367-5438
Scopus 作者 ID: 57189456380
MD, PhD, Head of the Department of Neurosurgery No. 2
俄罗斯联邦, Frunze str., 17, Novosibirsk, 630091Alexey Peleganchuk
Ya.L. Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
Email: APeleganchuk@mail.com
ORCID iD: 0000-0002-4588-428X
Scopus 作者 ID: 57203729190
MD, PhD, Department of Neurosurgery No. 2
俄罗斯联邦, Frunze str., 17, Novosibirsk, 630091Abdugafur Sanginov
Ya.L. Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
Email: Dr.sanginov@gmail.com
ORCID iD: 0000-0002-4744-4077
Scopus 作者 ID: 57202849091
MD, PhD, Department of Neurosurgery No. 2
俄罗斯联邦, Frunze str., 17, Novosibirsk, 630091Olga Leonova
Ya.L. Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
Email: onleonova@gmail.com
ORCID iD: 0000-0002-9916-3947
MD, PhD, Research scientist
俄罗斯联邦, Frunze str., 17, Novosibirsk, 630091Aleksandr Krutko
Ya.L. Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics
Email: AKrutko@niito.ru
ORCID iD: 0000-0002-2570-3066
Scopus 作者 ID: 54795500200
MD, PhD, Head of the Department of Neurovertebrology
俄罗斯联邦, Frunze str., 17, Novosibirsk, 630091参考
- Schwab F, Patel A, Ungar B, et al. Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery. Spine (Phila Pa 1976). 2010;35(25):2224-2231. https://doi.org/10.1097/BRS.0b013e3181ee6bd4.
- Aebi M. The adult scoliosis. Eur Spine J. 2005;14(10):925-948. https://doi.org/10.1007/s00586-005-1053-9.
- Glassman SD, Bridwell K, Dimar JR, et al. The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976). 2005;30(18):2024-2029. https://doi.org/10.1097/01.brs.0000179086.30449.96.
- Михайлов Д.А., Пташников Д.А., Усиков В.Д., и др. Актуальные вопросы лечения дегенеративного сколиоза на современном этапе (обзор зарубежной литературы). Травматология и ортопедия России. 2014;(4):127-134. [Mikhaylov DA, Ptashnikov DA, Usikov VD, et al. Topical issues of treatment of degenerate scoliosis at adults at the present stage (review). Travmatologiya i ortopediya Rossii. 2014;(4):127-134. (In Russ.)]
- Le Huec JC, Hasegawa K. Normative values for the spine shape parameters using 3D standing analysis from a database of 268 asymptomatic Caucasian and Japanese subjects. Eur Spine J. 2016;25(11):3630-3637. https://doi.org/10.1007/s00586-016-4485-5.
- Васильев А.И. Дегенеративный сколиоз: обзор мировой литературы. Хирургия позвоночника. 2016;13(4):56-65. [Vasilyev AI. Degenerative scoliosis: literature review. Hirurgiâ pozvonočnika (Spine Surgery). 2016;13(4):56-65. (In Russ.)] https://doi.org/10.14531/ss2016.4.56-65.
- Schwab F, Blondel B, Chay E, et al. The comprehensive anatomical spinal osteotomy classification. Neurosurgery. 2015;76(Suppl 1):S33-41; discussion S41. https://doi.org/10.1227/01.neu.0000462076.73701.09.
- Пантелеев А.А. Эффективность применения педикулярной субтракционной остеотомии в целях коррекции сагиттального баланса у пациентов с ригидными деформациями позвоночника: Дисс. … кан. мед. наук. М.; 2019. 168 c. [Panteleev AA. Effektivnost’ primeneniya pedikulyarnoi subtraktsionnoi osteotomii v tselyakh korrektsii sagittal’nogo balansa u patsientov s rigidnymi deformatsiyami pozvonochnika. [dissertation] Moscow; 2019. 168 p. (In Russ.).] Available at: https://www.sechenov.ru/upload/medialibrary/055/DISSERTATSIYA-Panteleev.pdf
- Berjano P, Aebi M. Pedicle subtraction osteotomies (PSO) in the lumbar spine for sagittal deformities. Eur Spine J. 2015;24(Suppl 1):S49-57. https://doi.org/10.1007/s00586-014-3670-7.
- Auerbach JD, Lenke LG, Bridwell KH, et al. Major complications and comparison between 3-column osteotomy techniques in 105 consecutive spinal deformity procedures. Spine (Phila Pa 1976). 2012;37(14):1198-1210. https://doi.org/10.1097/BRS.0b013e31824fffde.
- Oʼneill KR, Lenke LG, Bridwell KH, et al. Clinical and radiographic outcomes after 3-column osteotomies with 5-year follow-up. Spine (Phila Pa 1976). 2014;39(5):424-432. https://doi.org/10.1097/BRS.0000000000000156.
- Saigal R, Mundis GM Jr, Eastlack R, et al. Anterior column realignment (ACR) in adult sagittal deformity correction: technique and review of the literature. Spine (Phila Pa 1976). 2016;41(Suppl 8):S66-73. https://doi.org/10.1097/BRS.0000000000001483.
- Pizones J, Moreno-Manzanaro L, Sánchez Pérez-Grueso FJ, et al. ESSG European Spine Study Group. Restoring the ideal Roussouly sagittal profile in adult scoliosis surgery decreases the risk of mechanical complications. Eur Spine J. 2020;29(1):54-62. https://doi.org/10.1007/s00586-019-06176-x.
- Yilgor C, Sogunmez N, Yavuz Y, et al. European Spine Study Group. Relative lumbar lordosis and lordosis distribution index: individualized pelvic incidence–based proportional parameters that quantify lumbar lordosis more precisely than the concept of pelvic incidence minus lumbar lordosis. Neurosurg Focus. 2017;43(6):E5-E9. https://doi.org/10.3171/2017.8.FOCUS17498
- Yuksel S, Ayhan S, Nabiyev V, et al. European Spine Study Group (ESSG). Minimum clinically important difference of the health-related quality of life scales in adult spinal deformity calculated by latent class analysis: is it appropriate to use the same values for surgical and nonsurgical patients? Spine J. 2019;19(1):71–78. https://doi.org/10.1016/j.spinee.2018.07.005.
- Yagi M, Akilah KB, Boachie-Adjei O. Incidence, risk factors and classification of proximal junctional kyphosis: surgical outcomes review of adult idiopathic scoliosis affiliations. Spine (Phila Pa 1976). 2011;36(1):E60-68. https://doi.org/10.1097/BRS.0b013e3181eeaee2.
- Mundis GM Jr, Turner JD, Kabirian N, et al. International Spine Study Group. Anterior column realignment has similar results to pedicle subtraction osteotomy in treating adults with sagittal plane deformity. World Neurosurg. 2017;105:249-256. https://doi.org/10.1016/j.wneu.2017.05.122.
- Pizones J, Moreno-Manzanaro L, Perez-Grueso FJS, et al. ESSG European Spine Study Group.Effect of lumbar pedicle subtraction osteotomy level on lordosis distribution and shape. Eur Spine J. 2020;29(6):1388-1396. https://doi.org/10.1007/s00586-020-06421-8.
- Leveque JC, Yanamadala V, Buchlak QD, Sethi RK. Correction of severe spinopelvic mismatch: decreased blood loss with lateral hyperlordotic interbody grafts as compared with pedicle subtraction osteotomy. Neurosurgical Focus. 2017;43(2):E15. https://doi.org/10.3171/2017.5.FOCUS17195.
- Daubs MD, Brodke DS, Annis P, Lawrence BD. Perioperative complications of pedicle subtraction osteotomy. Global Spine J. 2016;6(7):630-635. https://doi.org/10.1055/s-0035-1570088.
- Gupta MC, Ferrero E, Mundis G, et al. International Spine Study Group. Pedicle subtraction osteotomy in the revision versus primary adult spinal deformity patient: is there a difference in correction and complications? Spine (Phila Pa 1976). 2015;40(22):E1169-1175. https://doi.org/10.1097/BRS.0000000000001107.
- Schwab FJ, Blondel B, Bess S, et al. International Spine Study Group (ISSG). Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. Spine (Phila Pa 1976). 2013;38(13):E803-812. https://doi.org/10.1097/BRS.0b013e318292b7b9.
- Tarawneh AM, Venkatesan M, Pasku D, et al. Impact of pedicle subtraction osteotomy on healthrelated quality of life (HRQOL) measures in patients undergoing surgery for adult spinal deformity: a systematic review and meta-analysis. Eur Spine J. 2020. (Forthcoming). https://doi.org/10.1007/s00586-020-06439-y.
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