INTRAOPERATIVE DETERMINATION OF THE INSTABILITY OF THE FUNCTIONAL SPINAL UNITS OF THE LUMBAR SPINE IN MIDDLE-AGED AND ELDERLY PATIENTS

Piontkovskiy V. K.

METHODS AND METHODOLOGIES

Scentific article

The author proposes a new method of intraoperative determination of the instability of the functional spinal units in middle-aged and elderly patients based on the measurement of distraction interosseous distance. The study was carried out in 2 groups of patients: the first group consisted of patients with the diagnosed instability of the functional spinal units in the preoperative period according to functional radiographs; the second group consisted of patients without the instability of the functional spinal units in the preoperative period according to functional radiographs. In the group of patients with the stable forms of osteochondrosis it was revealed that the value of the distraction of the interosseous spaces didn’t exceed 4 mm and during the laminectomy at the same level with resection of the supraosseous and interosseous ligaments it didn’t exceed 7 mm. In the group of patients with the unstable forms of osteochondrosis it was revealed that the value of the distraction of the interosseous spaces exceeded 4 mm and in patients with laminectomy at 1 level it exceeded 7 mm. The interosseous hypermobility (and therefore instability), increases in direct proportion to the loss of the substance of the disc and increases dramatically with a loss of >1.8-2 cubic centimetres. Another factor that affected the interstitial distraction distance was the volume of posterior decompression, which increased especially sharply during the unilateral and bilateral facetectomy. In conclusion, this study demonstrates that in patients with severe pain syndrome when is impossible to carry out functional radiography in the preoperative period, it is possible to diagnose the presence of instability by means of a distraction interosseous test.

insability of the functional spinal units

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«Bulletin of problems biology and medicine» Issue 1 Part 1 (148), 2019 year, 237-240 pages, index UDK 616.711-018.3:617-08-036.868

10.29254/2077-4214-2019-1-1-148-237-240