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1.
Adv Gerontol ; 36(2): 219-226, 2023.
Artigo em Russo | MEDLINE | ID: mdl-37356098

RESUMO

The purpose of the study was to compare the clinical and radiological efficacy of 2-level anterior cervical discectomy and fusion (ACDF) and 1-level anterior cervical corpectomy and fusion (ACCF) in the treatment of two-segment degenerative stenosis of the cervical spine in elderly patients. The retrospective study included 74 elderly patients (over 60 years old), two cohorts were identified: the 1st (n=38) - patients who underwent staged 2-level ACDF; the 2nd (n=36) - patients operated on using the technique of 1-level ACCF. For comparative analysis, we used general information about patients (gender, age, body mass index, physical status according to ASA), characteristics of surgical interventions (time of surgery, volume of blood loss), features of the postoperative period, clinical data, radiological outcomes, and the presence of complications. Analysis of the results was carried out in a minimum period of 36 months. As a result, it was found that 2-level ACDF in the treatment of two-segment degenerative stenosis of the cervical spine in older patients is associated with less blood loss and the level of local pain syndrome. At the same time, better clinical outcomes and fewer revision interventions after 1-level ACCF were recorded in the long-term postoperative period.


Assuntos
Fusão Vertebral , Espondilose , Humanos , Idoso , Estudos Retrospectivos , Resultado do Tratamento , Constrição Patológica/complicações , Espondilose/complicações , Espondilose/cirurgia , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Descompressão
2.
Adv Gerontol ; 35(4): 529-537, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36401862

RESUMO

The aim of the study was to evaluate the results of surgical treatment and the effectiveness of clinical recovery in elderly patients with cauda equina syndrome (CES) caused by degenerative spinal canal stenosis after isolated open and minimally invasive decompression. A retrospective analysis of the results of surgical treatment of 50 patients over 60 years of age who underwent isolated open (n=21) and minimally invasive (n=29) decompressive interventions for CES caused by lumbar spinal stenosis was performed. For comparative analysis, we used the technical features of the intervention, the specificity of postoperative management of patients, clinical parameters, and the number of perioperative complications. As a result, the advantages of minimally invasive isolated decompression compared to open decompression due to a smaller volume of blood loss and duration of hospitalization, low need for postoperative pain relief, a minimum number of perioperative surgical complications, as well as the dynamics of neurological symptoms, better efficiency of clinical recovery of functional state indicators according to ODI and quality life according to SF-36 in the late postoperative period.


Assuntos
Estenose Espinal , Cavalos , Animais , Estenose Espinal/complicações , Estenose Espinal/diagnóstico , Estudos Retrospectivos , Descompressão Cirúrgica/efeitos adversos , Descompressão Cirúrgica/métodos , Vértebras Lombares/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Resultado do Tratamento
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