Analysis of long-term functional results of surgical treatment of spondylolisthesis in middle-aged and elderly patients

N. Gvozdev, E. N. Shchurova, O. Prudnikova
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Abstract

BACKGROUND: Insufficient attention has been paid to the analysis of the use of instrumental methods of examination in assessment the long-term results of surgical treatment of spondylolisthesis in middle-aged and elderly patients. AIM: To show the peculiarities of strength characteristics of lower limb muscles and temperature and pain sensitivity in the dermatomes of the cauda equina roots in middle-aged and elderly patients in the distant terms after surgical treatment of spondylolisthesis depending on the etiology of the disease. MATERIALS AND METHODS: An analysis of the results of functional studies of 21 patients with spondylolisthesis aged 41 to 74 years (12 with degenerative, 9 with isthmic) is presented. The research done before treatment and 7599 months after surgery. The following research methods were used: analysis clinical (neurological status), visual analog scale (VAS), Oswestry Disability Index (ODI), radiology (functional X-ray examination), magnetic resonance imaging, anthropometry, the lower limb muscles dynamometry, esthesiometry, statistical. RESULTS: In the long term after surgical treatment, patients with isthmic spondylolisthesis had a predominant increase in the moment of force in all muscle groups (3975% of cases). Negative dynamics prevailed in the group of patients with degenerative spondylolisthesis a decrease in muscle strength characteristics in 5094% of cases. According to esthesiometry, more pronounced negative changes in the values of temperature and pain sensitivity thresholds were observed in patients with degenerative spondylolisthesis. CONCLUSION: The analysis of muscle strength characteristics and esthesiometry data determined a different degree of compensation and recovery during surgical treatment of patients with spondylolisthesis, depending on the etiology of the disease.
中老年腰椎滑脱手术治疗的远期功能效果分析
背景:在评估中老年椎体滑脱手术治疗的远期效果时,仪器检查方法的应用分析一直不够重视。目的:观察中老年患者脊柱滑脱手术治疗后下肢肌肉力量特征及马尾根皮节温度和疼痛敏感性的不同病因。材料与方法:对21例41 ~ 74岁的滑脱患者(退行性12例,峡性9例)的功能研究结果进行分析。这项研究在治疗前和手术后7599个月进行。采用以下研究方法:临床分析(神经系统状态)、视觉模拟量表(VAS)、Oswestry残疾指数(ODI)、放射学(功能x线检查)、磁共振成像、人体测量、下肢肌肉动力测量、美学测量、统计学。结果:手术治疗后长期,峡部滑脱患者各肌群的力力矩明显增加(占病例总数的3975%)。负动力在退行性椎体滑脱患者组中普遍存在,5094%的病例中肌肉力量特征下降。根据感觉测量,退行性椎体滑脱患者的温度和疼痛敏感阈值的负变化更为明显。结论:对脊柱滑脱患者的肌肉力量特征和感觉测量数据的分析确定了手术治疗中不同病因患者的代偿和恢复程度。
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