RISK FACTORS OF PEDICLE FIXATION INSTABILITY AT PATIENTS WITH DEGENERATIVE LUMBAR SPINE PATHOLOGY

A. E. Bokov, S. G. Mlyavykh, A. Ya. Aleynik, A. A. Bulkin, M. V. Rasteryaeva
2016 Bûlleten' Sibirskoj Mediciny  
Приволжский федеральный медицинский исследовательский центр, г. Нижний Новгород РЕЗЮМЕ Цель исследования -оценить факторы риска дестабилизации транспедикулярного инструментария после выполнения декомпрессивно-стабилизирующих вмешательств у пациентов с дегенеративной патологией поясничного отдела позвоночника. КЛЮЧЕВЫЕ СЛОВА: транспедикулярная фиксация, нестабильность имплантов, компьютерная томография, дегенеративные заболевания поясничного отдела позвоночника. Бюллетень сибирской медицины,
more » ... рской медицины, 2016, том 15, № 2, с. 13-19 Оригинальные статьи Results. Radiodensity of vertebra body cancellous bone getting decreased, the increase number of fixed levels and extensiveness of facet joints and ligaments resection are associated with the increased risk of a screw loosening development. Laminectomy, interbody fusion, altered biomechanics associated with incomplete vertebra body reduction and L5-S1 segment included into fixed zone did not have a significant influence on pedicle screws loosening rate. Bias related to heterogeneity of studied group was also insignificant. Goodness-of-fit of estimated general logistic regression model: ¹ 2 = 67,57851; p < 0,0001. This model classified correctly 81,5% cases with sensitivity and specificity of 77,4% and 85,3% respectively. Conclusion. Radiodensity of a vertebra cancellous bone, number of fixed levels and extensiveness of facet joints and ligaments resection during decompression are significant predictors for pedicle screws loosening development. The detected risk factors should be taken into account in preoperative planning especially in elderly patients. KEY WORDS: pedicle screw fixation, implant instability, computed tomography, degenerative lumbar spine diseases.
doi:10.20538/1682-0363-2016-2-13-19 fatcat:xbje43jmijfybfslafk3ptypyy