TY - JOUR

T1 - Syndromic assessment of degenerative disorders of the lumbar spine in elderly patients

AU - Klimov, Vladimir

AU - Khalepa, Roman

AU - Amelina, Evgeniya

AU - Evsukov, Alexei

AU - Krivoshapkin, Alexei

AU - Ryabykh, Sergei

N1 - Климов В.С., Халепа Р.В., Амелина Е.В., Евсюков А.В., Кривошапкин А.Л., Рябых С.О. Синдромальная оценка дегенеративной патологии поясничного отдела позвоночника у пациентов пожилого и старческого возраста // Травматология и ортопедия России. - 2023. - Т. 29. - № 3. - C. 31-45. Публикация для корректировки.

PY - 2023

Y1 - 2023

N2 - Background. The choice of the method and options for surgical treatment of degenerative pathology of the lumbar spine is difficult due to the lack of clear clinical and radiological criteria for diagnosis and a direct correlation between the severity of the radiological manifestations of the disease and clinical symptoms. The purpose of this study was to analyze the clinical and neurological characteristics of elderly patients with degenerative disorders of the lumbar spine and to identify the dominant clinical and radiologic syndromes. Patients and Methods. Сohort of 1013 patients were operated using MIS technologies (decompression alone, TLIF, LLIF, ALIF) in the period 20132017 (367 male/646 female). The age range is 60-89 years (mean 66 years). The criteria for identifying the leading syndromes: leg pain/back pain with a threshold value of 5 points according to VAS, X-ray criteria for clinical instability by A.A. White and M.M. Panjabi (value 5 points), Cobb angle 10, markers of sagittal imbalance: Index Barrey (II and III), PT increase above target values, L4-S1 and LL deficiency. Results. Symptoms of compression were identified in 97% of patients. Radiculopathy syndrome was detected in 665 (66%) patients with mean leg pain 7 points, neurogenic intermittent claudication - in 319 (31%) patients. Degenerative spondylolisthesis according to radiological criteria was detected in 428 (42%) patients. Degenerative scoliotic deformity had 91 (9%) patients. In accordance with the proposed criteria, the dominant compression syndrome was determined in 624 patients (62%), clinical instability syndrome - in 338 (33%), sagittal imbalance syndrome due to degenerative scoliosis - in 51 (5%). Conclusion. Syndromic assessment of clinical, neurological and radiological manifestations of degenerative disorders provides the possibility of identifying the dominant syndrome requiring operative surgical treatment and a differentiated approach to choosing the optimal surgical option.

AB - Background. The choice of the method and options for surgical treatment of degenerative pathology of the lumbar spine is difficult due to the lack of clear clinical and radiological criteria for diagnosis and a direct correlation between the severity of the radiological manifestations of the disease and clinical symptoms. The purpose of this study was to analyze the clinical and neurological characteristics of elderly patients with degenerative disorders of the lumbar spine and to identify the dominant clinical and radiologic syndromes. Patients and Methods. Сohort of 1013 patients were operated using MIS technologies (decompression alone, TLIF, LLIF, ALIF) in the period 20132017 (367 male/646 female). The age range is 60-89 years (mean 66 years). The criteria for identifying the leading syndromes: leg pain/back pain with a threshold value of 5 points according to VAS, X-ray criteria for clinical instability by A.A. White and M.M. Panjabi (value 5 points), Cobb angle 10, markers of sagittal imbalance: Index Barrey (II and III), PT increase above target values, L4-S1 and LL deficiency. Results. Symptoms of compression were identified in 97% of patients. Radiculopathy syndrome was detected in 665 (66%) patients with mean leg pain 7 points, neurogenic intermittent claudication - in 319 (31%) patients. Degenerative spondylolisthesis according to radiological criteria was detected in 428 (42%) patients. Degenerative scoliotic deformity had 91 (9%) patients. In accordance with the proposed criteria, the dominant compression syndrome was determined in 624 patients (62%), clinical instability syndrome - in 338 (33%), sagittal imbalance syndrome due to degenerative scoliosis - in 51 (5%). Conclusion. Syndromic assessment of clinical, neurological and radiological manifestations of degenerative disorders provides the possibility of identifying the dominant syndrome requiring operative surgical treatment and a differentiated approach to choosing the optimal surgical option.

UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-85175015048&origin=inward&txGid=604902372f2bcb83c39142f2e3d142f2

UR - https://www.elibrary.ru/item.asp?id=54685896

UR - https://www.mendeley.com/catalogue/956aec02-d7e0-3040-8e73-a2b1b97af53a/

U2 - 10.17816/2311-2905-12024

DO - 10.17816/2311-2905-12024

M3 - Article

VL - 29

SP - 31

EP - 45

JO - Traumatology and Orthopedics of Russia

JF - Traumatology and Orthopedics of Russia

SN - 2311-2905

IS - 3

ER -