On the extent of preoperative radiological and CT examination of patients with degenerative diseases of the lumbar spine

• Main Authors: Aleksandr V. Krutko, Abdugafur J. Sanginov
• Format: Article
• Language: English
• Published: Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan" 2018-06-01
• Series: Хирургия позвоночника
• Subjects: preoperative examination; lumbar degenerative disease; planning of surgical intervention
• Online Access: https://www.spinesurgery.ru/jour/article/view/1471/1415
• ISSN: 1810-8997; 2313-1497

Objective. To specify the extent of preoperative examination of patients with lumbar degenerative diseases and to study the effect of ex- amination results on the tactics of surgical treatment. Material and Methods. The study included retrospective analysis of 1340 patients with lumbar degenerative diseases treated in the Neu- rosurgical Department No. 2 of Novosibirsk RITO n.a. Ya.L. Tsivyan during 2017. Results. The average height of the intervertebral disc as evaluated with MRI was 7.4 ± 1.8 mm, and that evaluated with MSCT – 4.9 ± 1.5 mm, with a statistically significant difference between them (p < 0.05). Immediate preoperative examination of patients with lumbar disc herniation showed reduction or lysis of the hernia fragment in some of them. Reduction of the leg pain and hernia size (by more than 50 %) and lysis of the herniated disc fragment evidenced by MRI were observed in 21 (3.2 %) patients. Comparison of the pre- planned and actually performed extent of decompression and stabilization interventions showed that tactics and/or extent of surgical treatment changed in 37.6 % of cases. Conclusion. The complex of instrumental radiological and neuroimaging studies, as well as methods of provocative procedure in the lum- bar spine performed immediately before the planned surgical treatment allow choosing the proper treatment tactics, specifying or correct- ing the volume of surgical treatment, and to prognosing its outcome in lumbar degenerative diseases.