THE APPLICATION OF COMPUTER CALCULATION OF MINIMALLY SUFFICIENT AREAS OF BONE RESECTION IN MICROSURGERY OF LUMBAR COMPRESSIVE SYNDROMES
https://doi.org/10.51523/2708-6011.2016-13-2-10
Abstract
Objective: to define the main types of bone resection and geometric shapes of the bone window made by means of computer calculation, to estimate the effectiveness of the proposed method in the early postoperative period using the visual analog scale (VAS). Material and methods . 31 patients with compressive pathology of the lumbosacral spine were operated using the invented method of calculation in the years 2015-2016. The patients were surveyed, the case histories, protocols of X-ray computed tomography (X-ray CT) and magnetic resonance imaging (MRI) were analyzed. Results. Due to the application of the method, the intensity of radicular pains in the early postoperative period decreased in all the studied subgroups. According to the VAS scale, the pains in the subgroup of patients with herniated discs without sequestration decreased from 7.50 (6.00; 9.00) to 2.00 (1.00; 3.50) - p = 0.001, in the subgroup of herniated discs with sequestration - from 9.50 (7.25; 10.00) to 2.5 (1.25; 3.75) - p = 0.011, in the subgroup of herniated discs in combination with stenosis - from 8.00 (5.00; 9.50) to 2.00 (1.00; 3.50) - p = 0.008. Conclusion. The developed method of calculation of minimally sufficient areas of bone resection made it possible to perform economical, reasonable resection of the posterior supportive complex bone structures, besides it was used in different types of the compressive spine pathology.
About the Authors
P. S. Remov
Gomel State Medical University
Belarus
Belarus
M. V. Olizarovich
Gomel State Medical University
Belarus
Belarus
References
1. Minimally Invasive Lumbar Decompression for Spinal Stenosis / T. Deer [et al.] // J. Neuroscience R. - 2011. - 1(1). - P. 29-32.
2. The efficacy of minimally invasive discectomy compared with open discectomy: a meta-analysis of prospective randomized controlled trials / H. Dasenbrock [et al.] // Neurosurg Spine J. - 2012. - Vol. 16(5). - P. 452-462.
3. Minimally invasive discectomy versus microdiscectomy/open discectomy for symptomatic lumbar disc herniation / M. Rasouli [et al.] // U.S. National Library of Medicine. [Electronic resource]. - 2014. - Mode of access: http://www.ncbi.nlm.nih.gov/pubmed/25184502. - Date of access: 08.01.2015.
4. Multimodal intraoperative monitoring (MIOM) during surgical decompression of thoracic spinal stenosis in 36 patients / A. Eggspuehler [et al.] // Eur. Spine J. - 2007. - Vol. 16(2). - P. 216-220.
5. Comparison of Magnetic Resonance Imaging and Computed Tomography-Myelography for Quantitative Evaluation of Lumbar Intracanalar Cross-Section / H. Ogura [et al.] // Jonsei Med. J. - 2011. - 52(1). - P. 137-144.
6. An anatomic study of the interspinous space of the lumbosacral spine / Albietz [et al.] // Eur. Spine J. - 2012. - Vol. 21(1). - P. 145-148.
7. Ремов, П. С. Метод определения минимально достаточных зон костной резекции при компрессионных синдромах на поясничном уровне / П. С. Ремов, М. В. Олизарович // Актуальные проблемы медицины. Сб. науч. статей Респ. науч.-практ. конф. с межд. участием, посвящ. 25-летию основания учреждения образования «Гомельский гос. мед. унив.» (5-6 ноября 2015 года). [Электронный ресурс]. - 2016. - Режим доступа: http://www.gsmu.by/ file/konferen/sbornik.pdf. - Дата доступа: 01.02.2016.
8. Олизарович, М. В. Мобильная система виртуального сопровождения операций при дистрофической патологии поясничного отдела позвоночника / М.В. Олизарович // Актуальные проблемы медицины. Сб. науч. статей Респ. науч.-практ. конф. и 23-й итоговой научной сессии Гомельского государственного медицинского университета (13-14 ноября 2014 года) - Гомель, ГомГМУ, 2014. - т.3 - С. 122-125.
9. Lumbar spinal stenosis in elderly patients: is a unilateral microsurgical approach sufficient for decompression? / M. H. Morgalla [et al.] // Neurosurg. Spine J. - 2011. - Vol. 14. - P. 305-312.
10. Enduring improvement in Oswestry Disability Index outcomes following lumbar microscopic interlaminar decompression: An appraisal of prospectively collected patient outcomes / M. Babar [et al.] // J. Craniovertebr. Junction Spine. - 2015. - 6(4). - P. 195-199.
11. Comparison of outcomes between conventional lumbar fenestration discectomy and minimally invasive lumbar discectomy: an observational study with a minimum 2-year follow-up / S. Majeed [et al.] // Journal of Orthopaedic Surgery and Research [Electronic resource]. - 2013. - Mode of access: http://www.josr-online.com/ content/8/1/34. - Date of access: 02.02.2016.
12. Does minimally invasive lumbar disc surgery result in less muscle injury than conventional surgery? A randomized controlled trial / M. Arts [et al.] // Eur. Spine J. - 2011. - 20(1). - P. 51-57.
13. Holly, L. Intraoperative spinal navigation / L. Holly, K. Foley // Spine. -2003. - 28 (15). - P. 54-61.
Review
For citations:
Remov P.S., Olizarovich M.V. THE APPLICATION OF COMPUTER CALCULATION OF MINIMALLY SUFFICIENT AREAS OF BONE RESECTION IN MICROSURGERY OF LUMBAR COMPRESSIVE SYNDROMES. Health and Ecology Issues. 2016;(2):48-53. (In Russ.) https://doi.org/10.51523/2708-6011.2016-13-2-10
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