neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2020-22-1-103-110neurosurgery-841Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWМежфасеточная фиксация – альтернатива задней малоинвазивной стабилизации поясничного отдела позвоночника?Facet fixation: an alternative to minimally-invasive posterior lumbar stabilization?https://orcid.org/0000-0001-8895-3196ЕпифановД. С.EpifanovD. S.

105203 Москва, ул. Нижняя Первомайская, 70

70 Nizhnyaya Pervomayskaya St., Moscow 105203

doc.neuros@gmail.comЛебедевВ. Б.LebedevV. B.

105203 Москва, ул. Нижняя Первомайская, 70

70 Nizhnyaya Pervomayskaya St., Moscow 105203

ОщепковС. К.OshchepkovS. K.

105203 Москва, ул. Нижняя Первомайская, 70

70 Nizhnyaya Pervomayskaya St., Moscow 105203

ЗуевА. А.ZuevА. А.

105203 Москва, ул. Нижняя Первомайская, 70

70 Nizhnyaya Pervomayskaya St., Moscow 105203

ФГБУ «Национальный медико-хирургический центр им. Н. И. Пирогова» Минздрава РоссииРоссияN. I. Pirogov National Medical and Surgical Center, Ministry of Health of RussiaRussian Federation202011042020221103110Copyright © Епифанов Д.С., Лебедев В.Б., Ощепков С.К., Зуев А.А., 20202020Епифанов Д.С., Лебедев В.Б., Ощепков С.К., Зуев А.А.Epifanov D.S., Lebedev V.B., Oshchepkov S.K., Zuev А.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/841

Цель исследования – провести анализ научной литературы и на основе полученных данных оценить эффективность декомпрессии нервных структур с использованием различных методик межфасеточной фиксации.

Материалы и методы

Материалы и методы. Систематический обзор выполнен согласно рекомендациям Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Критерии включения: наличие полного текста статьи на английском языке, возраст пациентов 19 и более лет, наличие оценки результатов межфасеточной фиксации, наличие у пациентов дегенеративно-дистрофического заболевания позвоночника на поясничном уровне.

Результаты

Результаты. По данной тематике в PubMed первично были найдены 198 статей. Из них критериям включения соответствовали 38 статей, из которых 33 статьи не содержали полных данных об исходах лечения пациентов с использованием исследуемых методик стабилизации. Отобранные 5 статей содержали данные о результатах лечения, частоте спондилодезов и осложнений. Многие авторы отмечают получение хорошего клинического эффекта и снижение частоты интра- и послеоперационных осложнений после межфасеточной фиксации в сравнении с таковой после декомпрессии с транспедикулярной фиксацией.

Ограничения исследования

Ограничения исследования. Отсутствие систематических обзоров, а также наличие только 1 публикации о каждой методике межфасеточной фиксации. Малый размер выборок пациентов и короткий катамнез.

Заключение

Заключение. Декомпрессия и межфасеточная фиксация в одном позвоночно-двигательном сегменте при сочетании с передним поясничным, трансфораминальным и боковым поясничным межтеловым спондилодезом, в том числе с применением малоинвазивных технологий и других методик, во многих случаях позволяет добиться хорошего клинического эффекта и надежной стабилизации.

The study objective is to analyze literature and evaluate based on the obtained data the effectiveness of decompression of neural structures using different methods of facet fixation.

Materials and methods

Materials and methods. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following inclusion criteria were used: full-text article in English, patient age above 19 years, presence of evaluation of the results of facet fixation, degenerative disease of the lumbar spine in patients.

Results

Results. First search in the PubMed database returned 198 results. Among them, 38 articles complied with the inclusion criteria, and 33 articles didn’t contain full data on patient outcomes in the context of the studied stabilization methods. The selected 5 articles contained data on treatment results, rates of fixation and complications. Many authors note good clinical effect and decreased rate of intra- and postoperative complications for facet fixation compared to transpedicular fixation.

Study limitations

Study limitations. Absence of systematic reviews and availability of only 1 article for each method of facet fixation. Small patient samples and short follow-up.

Conclusion

Conclusion. Decompression and facet fixation in a single spinal motion segment in combination with posterior lumbar, transforaminal and lateral lumbar interbody fixation including use of minimally invasive technologies and other methods in many cases allows to achieve good clinical effect and firm stabilization.

межфасеточная фиксациятрансламинарный винтзадний поясничный межтеловой спондилодезпередний поясничный межтеловой спондилодезбоковой поясничный межтеловой спондилодезтрансфораминальный поясничный межтеловой спондилодезfacet wedgetranslaminar screwposterior lumbar interbody fixationanterior lumbar interbody fixationlateral lumbar interbody fixationtransforaminal lumbar interbody fixationReferencesKing D. Internal fixation for lumbosacral fusion. Am J Surg 1944;66(3):357–61.King D. Internal fixation for lumbosacral fusion. Am J Surg 1944;66(3):357–61.Boucher H.H. A method of spinal fusion. J Bone Joint Surg Br 1959;(2):248–59.Boucher H.H. A method of spinal fusion. J Bone Joint Surg Br 1959;(2):248–59.Roy-Camille R., Demeulenaere C. OsteoSynthese durachis dorsal, lombaire et lombosacree par plaque metalliques vissees dansles pedicles vertebraux et les apophyses articulaires. Presse Medicale 1970;78:1447–8.Roy-Camille R., Demeulenaere C. 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The authors declare that there are no conflicts of interest present.