Korzh M. O., Barkov O. O., Karpinska O. D.

RADIOMETRIC CHANGES IN ADJACENT INTERVERTEBRAL DISCS FOLLOWING TRANSPEDICULAR FIXATION OF THE LUMBAR SPINE IN THE TREATMENT OF DEGENERATIVE DISEASES

---

Show/Download

About the author:

Korzh M. O., Barkov O. O., Karpinska O. D.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Transpedicular spinal fixation disrupts the normal biomechanical relationships between the spinal-motor segments and accelerates degenerative changes. The aim was to determine the nature of changes in intervertebral discs and adjacent vertebral bodies in dynamics after transpedicular fixation at the L4-L5 level. To assess the condition of the vertebrae and discs, the disc index (Id), the disc shape index (If), and the vertebral-disc ratio (Kdp) were determined. A statistically significant change in Id over time was found, as well as a significant interaction between time and level of fixation. There was an increase in Id after surgery, a period of stability, and then a significant decrease. The index of intervertebral disc shape (If) demonstrated statistically substantial dynamics over time, regardless of the level of fixation. The interaction between time and level of fixation is not statistically significant, which indicates the same form of dynamics regardless of the anatomical level (above, at the level of, below fixation). A statistically significant change in Kdp over time and a U-shaped dynamics of the indicator were found, indicating a pronounced decrease after the initial period with subsequent partial recovery. The changes in dynamics are presented. The analysis of changes during the year after the operation showed that changes occur both above the fixation zone and below it. It was determined that in the upper adjacent segments, the first signs appear as early as 6 months after surgery, while in the segments below, only a year later, and are not so pronounced. It was noted that when assessing the destruction of the disc and vertebrae, no obvious trends in the priority of changes were identified; rather, it may depend on other reasons, such as the patient's age, the state of bone structures, features of the anatomical structure, etc. Identifying these reasons requires additional research.

Tags:

Bibliography:

1. Arim O, Alshalcy A, Shakir M, Agha O, Alhamdany H. Transpedicular Screw Fixation In Degenerative Lumbosacral Spine Disease Surgical Outcome. Georgian Med News. 2024;348:117-121.
2. Burch MB, Wiegers NW, Patil S, Nourbakhsh A. Incidence and risk factors of reoperation in patients with adjacent segment disease: A meta-analysis. J Craniovertebr Junction Spine. 2020;11(1):9-16. DOI: 10.4103/jcvjs.JCVJS_10_20.
3. Saghebdous S, Zare R, Chaurasia B, Vakilzadeh MM, Yousefi O, Boustani MR. Dynamic Rod Constructs as the Preventive Strategy against Adjacent Segment Disease in Degenerative Lumbar Spinal Disorders: A Retrospective Comparative Cohort Study. Arch Bone Jt Surg. 2023;11(6):404-413. DOI: 10.22038/ABJS.2022.68498.3239.
4.  Barkov OO, Malyk RV, Karpinska OD. Doslidzhennya navantazhennya u kryzhovo-klubovomu zchlenuvanni pry dynamichniy symulyatsiyi rukhiv u poperekovomu viddili khrebta na skeletno-myazovykh modelyakh pislya vykonannya zadnoho bisehmentarnoho spondylodezu. Travma. 2023;24(2):54-59. DOI: 10.22141/1608-1706.2.24.2023.944. [in Ukrainian].
5.  Barkov OO, Malyk RV, Karpinska OD. Doslidzhennya navantazhennya tila khrebtsya L4 pry dynamichniy symulyatsiyi rukhiv u poperekovomu viddili khrebta na skeletno-myazovykh modelyakh pislya vykonannya zadnoho bisehmentarnoho spondylodezu. Ortopediya, travmatolohiya ta protezuvannya. 2023;3:13-18. DOI: 10.15674/0030-59872023333-18. [in Ukrainian].
6.  Lin X, Zhu J, Song J, Wang L, Ge J, Sha W. The Effect of L5 Morphology on Prevention of L5-S1 Degeneration Following Floating Fusion for Degenerative Spine Disorders. Global Spine J. 2025;15(4):2300-2308. DOI: 10.1177/21925682241297934.
7.  Fuster S, Martínez-Anda JJ, Castillo-Rivera SA, Vargas-Reverón C, Tornero E. Dynamic Fixation Techniques for the Prevention of Adjacent Segment Disease: A Retrospective Controlled Study. Asian Spine J. 2022;16(3):401-410. DOI: 10.31616/asj.2020.0585.
8.  Kashkoush A, Agarwal N, Paschel E, Goldschmidt E, Gerszten PC. Evaluation of a Hybrid Dynamic Stabilization and Fusion System in the Lumbar Spine: A 10 Year Experience. Cureus. 2016;8(6):e637. DOI: 10.7759/cureus.637.
9.  Botelho RV, Bastianello R Jr, Albuquerque LD, Bernardo WM. Dynamic compared to rigid fixation in lumbar spine: a systematic review. Rev Assoc Med Bras (1992). 2014;60(2):151-5. DOI: 10.1590/1806-9282.60.02.013.
10. Herren C, Simons RM, Bredow J, Oikonomidis S, Westermann L, Sobottke R, et al. Posterior Lumbar Interbody Fusion versus Dynamic Hybrid Instrumentation: A Prospective Randomized Clinical Trial. World Neurosurg. 2018;117:e228-e237. DOI: 10.1016/j.wneu.2018.06.005.
11.  Guan J, Liu T, Li W, Zhao H, Yang K, Li C, et al. Effects of posterior lumbar nonfusion surgery with isobar devices versus posterior lumbar interbody fusion surgery on clinical and radiological features in patients with lumbar degenerative diseases: a meta-analysis. J Orthop Surg Res. 2022;17(1):116. DOI: 10.1186/s13018-022-03015-6.

Publication of the article:

«Bulletin of problems biology and medicine», Issue 2,177, 176-190 pages, index UDC 617.3/616-092

DOI:

10.29254/2077-4214-2025-2-177-176-190