Analysis of long-term functional results of surgical treatment of spondylolisthesis in middle-aged and elderly patients

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Abstract

BACKGROUND: Insufficient attention has been paid to the analysis of the use of instrumental methods of examination in assessment the long-term results of surgical treatment of spondylolisthesis in middle-aged and elderly patients.

AIM: To show the peculiarities of strength characteristics of lower limb muscles and temperature and pain sensitivity in the dermatomes of the cauda equina roots in middle-aged and elderly patients in the distant terms after surgical treatment of spondylolisthesis depending on the etiology of the disease.

MATERIALS AND METHODS: An analysis of the results of functional studies of 21 patients with spondylolisthesis aged 41 to 74 years (12 with degenerative, 9 with isthmic) is presented. The research done before treatment and 75–99 months after surgery. The following research methods were used: analysis clinical (neurological status), visual analog scale (VAS), Oswestry Disability Index (ODI), radiology (functional X-ray examination), magnetic resonance imaging, anthropometry, the lower limb muscles dynamometry, esthesiometry, statistical.

RESULTS: In the long term after surgical treatment, patients with isthmic spondylolisthesis had a predominant increase in the moment of force in all muscle groups (39–75% of cases). Negative dynamics prevailed in the group of patients with degenerative spondylolisthesis — a decrease in muscle strength characteristics in 50–94% of cases. According to esthesiometry, more pronounced negative changes in the values of temperature and pain sensitivity thresholds were observed in patients with degenerative spondylolisthesis.

CONCLUSION: The analysis of muscle strength characteristics and esthesiometry data determined a different degree of compensation and recovery during surgical treatment of patients with spondylolisthesis, depending on the etiology of the disease.

About the authors

Nikita S. Gvozdev

National Ilizarov Medical Research Centre for Orthopaedics and Traumatology

Author for correspondence.
Email: nikitozgvozdev@mail.ru
ORCID iD: 0000-0003-3428-3742
SPIN-code: 1412-5077

traumatologist-orthopedist

Russian Federation, Kurgan

Elena N. Shchurova

National Ilizarov Medical Research Centre for Orthopaedics and Traumatology

Email: elena.shurova@mail.ru
SPIN-code: 6919-1265

Dr. Sci. (Biol.), leading researcher

Russian Federation, Kurgan

Oksana G. Prudnikova

National Ilizarov Medical Research Centre for Orthopaedics and Traumatology

Email: pog6070@gmail.com
ORCID iD: 0000-0003-1432-1377
SPIN-code: 1391-9051

MD, Dr. Sci. (Med.), traumatologist-orthopedist

Russian Federation, Kurgan

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2. Fig. Dynamics of indicators of the absolute maximum moment of force of the muscles of the lower extremities (%): positive (a) and negative (b).

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