[Comparative analysis of the results of decompressive interventions in elderly patients with cauda equine syndrome caused by lumbar spinal stenosis.]

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.

[Evaluation of the results of using the accelerated recovery program after performing two-level lumbar spinal fusion in patients of an older age group.]

The aim of the study was to evaluate the results of using the accelerated recovery program after performing two-level lumbar spinal fusion in patients of an older age group. The results of surgical treatment of 29 patients older than 65 years with multisegmental degenerative diseases of the lumbar region, who performed minimally invasive two-level rigid stabilization using the concept of «accelerated recovery program¼ (PAR), were retrospectively studied. We studied the technical features of surgical interventions, the specificity of the postoperative period, the number of adverse outcomes of anesthetic benefits and perioperative surgical complications, the frequency of repeated hospitalizations for 90 days. Clinical parameters were used to evaluate the effectiveness of PAR: the level of pain in the area of operation according to the visual analogue scale (VAS) during hospitalization, the quality of life of patients on the SF-36 questionnaire, and patient satisfaction with the result of treatment using the Macnab scale. As a result, it was established that the introduced PAR after performing two-level lumbar spinal fusion in patients of an older age group provides the minimum number of adverse consequences of anesthesiological aid and perioperative surgical complications, a significant restoration of the quality of life and high patient satisfaction with the treatment.

[Possibilities and advantages of minimally invasive dorsal decompressive-stabilizing interventions in the treatment of degenerative spondylolisthesis of the elderly patients.]

The purpose of the study was a comparative analysis of the clinical and radiographic efficacy of minimally invasive rigid stabilization techniques and the traditional open interbody fusion with transpedicular fixation in the treatment of degenerative spondylolisthesis in elderly patients. The study included 65 elderly patients (over 60 years old) divided into 2 groups: the 1st group (MIS-TLIF, n=31), who underwent minimally invasive transforaminal interbody fusion, unilateral open contralateral transcutaneous transpedicular stabilization; the 2nd group (O-TLIF, n=34), operated using rigid stabilization from the median approach. For the comparative analysis, gender characteristics (gender, age), constitutional features (height, weight, body mass index), ASA physical status, intraoperative parameters of interventions and specificity of postoperative management of patients, clinical data, radiographic outcomes, complications were used. Dynamic evaluation was performed at the time from 24 to 48 months after the operation (median 32 months). As a result, it has been established that the use of minimally invasive dorsal decompressive-stabilizing interventions allows achieving better clinical outcomes and fewer perioperative complications than open transforaminal interbody spondylodesis and transpedicular stabilization with similar radiographic results of fusion formation and reduction of abnormal vertebral displacement. Low traumatic surgery in the main study group makes it possible to use a technique for treating degenerative spondylolisthesis in elderly patients.