Year 2015 Vol. 23 No 2

NEUROSURGERY

E.L. TSITKO ¹, A.F. SMEYANOVICH ², .S. ASTAPOVICH³, .V. TSITKO4

ROENTGENOMETRIC ANALYSIS OF THE KINEMATICS L4-L5 AND
L5S1 SPINE SEGMENTS AT THE THIRD STAGE OF THE DEGENERATIVE PROCESS

E "Gomel Regional Clinical Hospital"¹,
SE "Republican Scientific and Practical Center of Neurology and Neurosurgery"²,
EE "Gomel State Medical University"³,
SME "Gomel City Clinical Hospital 3"4

Objectives. To study kinematics of the lumbosacral spine according to radiometric parameters of the intervertebral joints in patients at the third stage of degenerative-dystrophic process.
Methods. 25 patients with spinal osteochondrosis at the third stage were enrolled in the study. According to the level of localization of the intervertebral discs hernia the main group was divided into two subgroups. In the 1st subgroup 14 (56%) patients with hernia at the level of L4-L5 were included, in the 2nd subgroup 11 (44%) patients with lesions of the segment L5-S1. The control group consisted of 12 persons without clinical and anamnestic data about the degenerative process. To study kinematics of the lumbosacral spinal level (LSL) the roentgenography in the lateral projection in the horizontal and vertical position has been performed.
Results. In the 1st subgroup in assessing of radiometric indicators of the intervertebral joints the height reduction of the anterior and posterior sections of the intervertebral disc (IVD) at the level L4-L5 (p<0,05), and the wedge angle of IVD from 9,60 (3,10; 11,10)º to 6,15 (3,10; 9,30)º as well as in the horizontal and vertical positions have been registrered. In the 2nd subgroup the values of the wedge angle of IVD L5-S1 in the horizontal position is significantly lower than in the control group (p=0,04), and verticalization the height of the ventral part of IVD L5-S1 (p<0,05) decreases. Analysis of differences of mean values of the parameters studied showed a reduction of the anterior size of IVD and an increase of interspinous angles in the 1st subgroup at L4-L5 and L5-S1 (p=0,03 and p<0,006, respectively), and in the 2nd subgroup at L5-S1 (p=0,001 and p=0,04, respectively).
Conclusion. In patients with spinal osteochondrosis in the III stage of the degenerative process the decrease of height was established as well as of the wedge angle of IVD at the the required level. The radiometric patterns of biomechanics disturbances were determined at the radiography of LSL in horizontal and vertical positions.

Keywords: analysis of kinematics, the degenerative process, herniated disc, violations of biomechanics, spinal motion segment, lumbar osteochondrosis, radiography
p. 202-208 of the original issue
References
  1. Akshulakov SK, Kerimbaev TT, Aleinikov VG. Sovremennye problemy khirurgicheskogo lecheniia degenerativno-distroficheskikh zabolevanii pozvonochnika [Modern problems of surgical treatment of degenerative diseases of the spine]. Neirokhirurgiia i Nevrologiia Kazakhstana. 2013;1(30):7-16.
  2. Krut'ko AV, Baikov ES. Analiz kriteriev prognozirovaniia rezul'tatov khirurgicheskogo lecheniia gryzh mezhpozvonkovykh diskov: obzor literatury [Criteria analysis forecasting results of surgical treatment of intervertebral disc hernia: a literature review]. Genii Ortopedii. 2012;(1):140-45.
  3. Usikov VD, Ptashnikov DA, Mikhailov DA. Sposoby maloinvazivnoi khirurgii v lechenii degenerativno-distroficheskikh zabolevanii pozvonochnika [Methods of minimally invasive surgery in the treatment of degenerative diseases of the spine]. Travmatologiia i Ortopediia Rossii. 2009;3 (53):78-84.
  4. Zucherman JF, Hsu KY, Hartjen CA, Mehalic TF, Implicito DA, Martin MJ, Johnson DR 2nd, Skidmore GA, Vessa PP, Dwyer JW, Puccio S, Cauthen JC, Ozuna RM. A prospective randomized multi-center study for the treatment of lumbar spinal stenosis with the X STOP interspinous implant: 1-year results. Eur Spine J. 2004 Feb;13(1):22-31.
  5. Bocharov MI. Chastnaia biomekhanika s fiziologiei dvizheniia [Private biomechanics physiology of movement]. Ukhta, RF: UGTU, 2010. 235 p.
  6. Shchedrenok VV, Sebelev KI., Anikeev NV, Tiul'kin ON, Kaurova TA, Moguchaia OV. Izmeneniia dugootrostchatykh sustavov pri travme i degenerativno-distroficheskikh zabolevaniiakh poiasnichnogo otdela pozvonochnika [Changes of facet joints in trauma and degenerative diseases of the lumbar spine]. Travm i Ortopediia Rossii. 2011;2 (60):114-17.
  7. Li W, Wang S, Xia Q, Passias P, Kozanek M, Wood K, Li G.Lumbar facet joint motion in patients with degenerative disc disease at affected and adjacent levels: an in vivo biomechanical study. Spine (Phila Pa 1976). 2011 May 1;36(10):E629-37. doi: 10.1097/BRS.0b013e3181faaef7.
  8. Akhmedov ShCh, Sattorov AR, Kobilov AK. Statika i biomekhanika pozvonochnika v norme: obzor [Statics and biomechanics of the spine in a norm: a review]. Nevrologiia. 2013;3 (59):44-49.
  9. Kalichman L, Suri P, Guermazi A, Li L, Hunter DJ. Facet orientation and tropism: associations with facet joint osteoarthritis and degeneratives. Spine (Phila Pa 1976). 2009 Jul 15;34(16):E579-85. doi: 10.1097/BRS.0b013e3181aa2acb.
Address for correspondence:
246012, Respublika Belarus,
g. Gomel, ul. Bratev Lizyukovyih, d. 5,
U "Gomelskaya oblastnaya klinicheskaya bolnitsa",
neyrokhirurgicheskoe otdelenie,
tel. office: 375 232 48-55-66,
e-mail: fedor30@tut.by,
Tsitko Evgeniy Leonidovich
Information about the authors:
Tsitko E.L. PhD, neurosurgeon of E "Gomel Regional Clinical Hospital".
Smeyanovich A.F. MD, professor, academician of NAS of Belarus, Honored Worker of Belarus, a head of the neurosurgical department of SE "RSPC of Neurology and Neurosurgery".
Astapovich E.S. A 6-year student, EE "Gomel State Medical University".
Tsitko E.V. PhD, Deputy Chief Physician on medical affairs of SME "Gomel City Clinical Hospital 3".
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