Fixation of the spine with spondylolisthesis, lowering the height of the intervertebral disc - Causes, symptoms and treatment. MF.

Spine fixation in spondylolisthesis, lowering of intervertebral disc height - spondylodesis of with bone allo or autografts is a neurosurgical operation performed to create immobility between adjacent vertebrae in case of ineffective conservative treatment of degenerative-dystrophic intervertebral disk pathology, spinal segment instability, spinal deformity, spondylolisthesis.

The intervertebral disc performs the function of "damping" movements. When it is removed, biomechanics of the spine is disrupted, there is a risk of development of instability and pain syndrome. If the mobility in the segment is more than the permissible value by 5-7%, this segment is unstable and can provoke the infringement of the nervous and muscular structures, increase pressure on the joints, leading to degeneration and arthrosis - pain syndrome. Spondylolisthesis - "slipping", displacement of the body of the overlying vertebra.

Spondylodesis

Spondylodesis stabilizes the vertebrae and discs by creating a joint - fusion of adjacent vertebrae. This excludes any movement between the fixed vertebrae. In case of spinal fusion in one segment, the patient does not feel a restriction of mobility.

Different methods and methods of surgical technique for performing such operations at different levels of the spine have been developed.
Preparation for operations - standard - general clinical tests, somatic examination, X-ray examinations of the spine - x-rays with functional tests, computer and magnetic resonance tomography, discography.
Rear spondylodesis is performed with deformity of the spine - scoliosis, kyphosis, spondylolisthesis.

Keiji from REEK ceramics for thoracic and lumbar spine

Transforominal lumbar intercorporal spondylodesis is carried out through the rear access, special screws are screwed into the vertebra, the intervertebral disc is removed, a spacer with an implant( possibly taken from the pelvic bone of the patient) is inserted in its placeIn the lateral grooves of the vertebrae, bone implants are installed. Screws are attached to the rods and the wound is sutured. Over time, the bone implant "takes root" and there is a fusion of the vertebrae - fixed fusion.

Stay in the hospital - individually - 3-5 days. In the future, it is recommended that corsetting, restriction of loads, rehabilitation - an average of 6 weeks.

For operations with degenerative changes of intervertebral discs in combination with spondylolisthesis at lumbar level - L2-S1, with prolonged pain syndrome and inefficiency of conservative therapy, it is possible to use a B-Twin implant. This operation can be performed by an open method - through anterior or posterior access or through posterolateral access percutaneously.

Based on the results of the examination, the physician chooses the method of operation and access, the size of the implant is selected. A discectomy is performed, the implant is inserted into the intervertebral space in the folded form and is expanded.

Contraindications to the use of the implant are quite extensive and the possibility of its use is solved by a neurosurgeon. Metabolic damage to the bones, neurofibromatosis, osteoporosis, tuberculosis, immunodeficiency, malignant formations is far from being the whole list of contraindications. The doctor should be informed about the transferred diseases, the previous treatment( for any reason), the duration of hormones, calcitonin, vitamin D. .., the presence of drug allergies and allergies to metals.

Complications - complications of anesthesia - allergic reactions, damage to nerve structures, infectious complications, unsatisfactory ligation of the vertebrae, the need for repeated surgery, ongoing pain.

Transpedicular system TangoRS L3-L5 and spondylodesis with Pezo-T cages in segment L4-L5 .

Anterior spondylodesis of cages and stabilization of the spine by the TangoRS system at the level of L2-S1 in degenerative scoliosis of the lumbar spine of .

Obelisc - implants for replacement of defects of thoracic and lumbar vertebrae in traumas, tumors, infectious and degenerative processes .

Fracture of the body L2 .

Anterior spinal fusion of L1-L3 with replacement of L2 body with Obelisc implant.

Spondyloptosis L5.Two-stage operation - resection of the body L5 and fixation of the lumbosacral section( L3-L4-S1) by the CDI and TSRH system, interbody spondylodesis L4-S1 by Interfix cages.

Rear spondylodesis.

Reconstructive system Vertex Select

The Vertex Select reconstructive system is used for operations on the cervical spine to fix the vertebrae and the occipital bone.

Body replacement implant C4 - C5 ADD plus .

An alternative to immovable fusion of vertebral bodies is the technique of an artificial intervertebral disc. With this operation, the movement between the vertebrae is restored. The operation is carried out through transabdominal access, the contents of the abdominal cavity are moved aside, the affected disc is removed, two plates are placed instead, and a plastic "support" is placed between them, which ensures the mobility of the vertebrae.

Implant Motion6 - prosthesis of the intervertebral disc C6 is used to replace the disc at the cervical level - C6 and provides mobility of the cervical spine.

Intradiscal electrothermal therapy( IDET) is a method of electrocoagulation of a disc, its strengthening, "stitching".A catheter with an electrode is inserted into the damaged disc, an electric current is applied.

Operative treatment achieves stable fixation of spinal structures, decompression of nerve structures, restoration of biomechanics of the spine, prevention of irreversible changes in the affected segment, early activation, shortening of hospitalization and rehabilitation.

Doctor neurologist Kobzeva S.V.