ANALYSIS OF RESULTS OF THE INTERVERTEBRAL TOTAL DISK ARTHROPLASTY OF THE LUMBAR SPINE BY M6-L PROSTHESIS: A MULTICENTER STUDY

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Abstract

Background: Pain in the lower back is an urgent health issue in industrialized countries. The dominant cause of pain in the lumbosacral spine is the degeneration of the inter vertebral discs (I VD). The total prosthetics I VD is a modern method of surgical treatment of I VD degenerative diseases, an alternative method of rigid stabilization.

Aim: To analyze the results of surgical inter vention (I VD prosthesis M6-L implantation) in patients with I VD degeneration of lumbar spine at the 6, 12, 24, and 36 months after the surger y.

Materials and methods: The study included 156 patients (92 men, 64 women) aged 23 to 45 years who under went a single-level discectomy with implantation of an artificial IVD prosthesis M6-L  at the bases of three neurosurgical centers. For dynamic assessment, clinical parameters (pain intensity from the visual analogue pain scale (VAS), quality of life according to the Oswestry index, subjective satisfaction with the result of surgical treatment on the Macnab scale) and instrumental data (amplitude of movements in the operated spinal-motor segment, degree of heterotopic ossification according to McAfeeSuchomel classification) were applied at 6, 12, 24, and 36 months after surger y.

Results: The mean value of the quality of life for the Oswestr y index before surger y was 40.2±6.9%, after ― 12.3±6.1% (t-test, p<0.001). The mean value of the level of pain according to VAS before surger y was 6.9±1.6 cm; after surger y ― 1.3±1.2 cm (t-test, p<0.001). The average range of motion in the operated segment at baseline was 36.8±2.6°, within 36 months after the operation increased up to 41.2±2.9°. During the entire period of obser vation the initial (13.4%) or moderate (10.2%) signs of heterotopic ossification were revealed. Conclusions: The use of prosthetic I VD M6-L can significantly reduce the level of pain, improve the life quality, and maintain the physiological range of motion in the operated spinal motion segment with a low level of adverse outcomes.

About the authors

V. A. Byvaltsev

Irkutsk State Medical University; Railway Clinical Hospital on the station Irkutsk-Passazhirskiy of Russian Railways Ltd.; Irkutsk Scientific Center of Surgery and Traumatology; Irkutsk State Academy of Postgraduate Education

Author for correspondence.
Email: byval75vadim@yandex.ru
ORCID iD: 0000-0003-4349-7101

Главный нейрохирург Департамента  здравоохранения ОАО «РЖД»; руководитель Центра нейрохирургии ДКБ на ст. ИркутскПассажирский ОАО «РЖД»; заведующий курсом нейрохирургии ИГМУ;  заведующий научно-клиническим отделом нейрохирургии и ортопедии  ИНЦХТ; профессор кафедры травматологии, ортопедии  и нейрохирургии ИГМАПО.

664082, Иркутск, ул. Боткина, д. 10, тел.: +7 (3952) 63-85-28.

SPIN-код: 5996-6477

Россия

A. A. Kalinin

Irkutsk State Medical University; Railway Clinical Hospital on the station Irkutsk-Passazhirskiy of Russian Railways Ltd.; Irkutsk Scientific Center of Surgery and Traumatology

Email: andrei_doc_v@mail.ru
ORCID iD: 0000-0001-9039-9147

Кандидат  медицинских наук, Доцент курса нейрохирургии Иркутского  государственного медицинского университета,  врач-нейрохирург Центра нейрохирургии ДКБ на ст. Иркутск-Пассажирский ОАО «РЖД».

664003, Иркутск, ул. Красного  Восстания, д. 14, тел.: +7 (3952) 63-85-28.

SPIN-код: 9707-8291 Россия

A. Y. Pestryakov

Regional Clinical Hospital

Email: pestryakov-nho@mail.ru
ORCID iD: 0000-0003-2633-7149

Krasnoyarsk

Россия

V. V. Shepelev

1 Naval Clinical Hospital

Email: shepelev.dok@mail.ru
ORCID iD: 0000-0001-5135-8115

Vladivostok

Россия

I. A. Stepanov

Irkutsk State Medical University

Email: edmoilers@mail.ru
ORCID iD: 0000-0001-9039-9147

Аспирант  курса нейрохирургии.

664003, Иркутск, ул. Красного  Восстания, д. 14, тел.: +7 (951) 632-66-35.

SPIN-код: 5485-5316

Россия

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