Revision surgery for patients with pseudoarthrosis and adjacent segment disease in degenerative dystrophic diseases of lumbosacral spine [Ревизионная хирургия у пациентов с псевдартрозом и заболеванием смежного сегмента при дегенеративно-дистрофических заболеваниях поясничнокрестцового отдела позвоночника]

Objective − to conduct a comparative analysis of results of revision surgery in pseudoarthrosis and adjacent segment disease after decompressive stabilizing interventions. Materials and methods. There were 44 patients with pseudoarthrosis and adjacent segment disease who received revision surgery in 2017-2020. The patients were distributed into two groups depending on pathology. The group 1 included 20 patients with pseudoarthrosis at the age of 36-68 (M ± SD = 55.6: 9.9). The group 2 included 24 patients at the age of 38-79 (M ± SD = 58.9: 12.1), with adjacent segment disease. Results. The mean VAS and ODI was 7.3 and 55.4 in the group 1 before and after revision surgery, correspondingly, and it improved to 1.4 and 11.8 at the moment of final follow-up (p = 0.001). The mean VAS and ODI was 6.7 and 48.4 in the group 2 before and after revision surgery, correspondingly, and it improved to 17.2 and 2.7 at the moment of final follow-up (p = 0.001). Therefore, the mean VAS and ODI improved in both groups. There were statistically significant differences in VAS between two groups (p < 0.001), but ODI points were much more worse in the group 2. Conclusion. In our study, the patients with revision surgery for pseudoarthrosis showed better clinical and radiologic results than the patients with adjacent segment disease. The patients with excessive body mass and obesity, with presurgical disk degeneration in the adjacent segment, should be completely informed about the risk of adjacent segment disease. ALIF is the theoretically substantiated and acceptable variant in treatment of pseudoarthrosis and achievement of sagittal balance by means of preservation of lumbar lordosis, resulting in decrease in the risk of adjacent segment disease. © 2020 The Charity Fund of Clinical Center of Miners' Health Protection. All rights reserved.