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Сочетание дегенеративного стеноза позвоночного канала с деформацией позвоночника на поясничном уровне. Обзор литературы

https://doi.org/10.17650/1683-3295-2018-20-3-91-103

Полный текст:

Аннотация

Цель исследования – провести анализ данных литературы, посвященной вопросам деформации позвоночника у больных с дегенеративным стенозом позвоночного канала на поясничном уровне.

Материалы и методы. Изучены 90 научных источников, опубликованных в 1980–2017 гг.

Результаты. Описаны параметры, используемые для оценки деформации позвоночника, рассмотрена их роль в прогнозировании течения дегенеративной болезни позвоночника. Приведены результаты современных исследований влияния деформации позвоночника на исход хирургического лечения больных с дегенеративным стенозом позвоночного канала на поясничном уровне. Определены факторы риска прогрессирования сколиоза: клиновидная форма межпозвонкового диска во фронтальной плоскости, низкое прохождение межгребневой линии, латеральный спондилолистез, маленький размер тела позвонка L , ротация позвонков, угол Кобба более 20°, нарушение сагиттального баланса.

Заключение. При отсутствии факторов риска прогрессирования сколиоза и наличии только корешковой симптоматики (без выраженной боли в поясничной области) у пациентов с дегенеративным стенозом позвоночного канала на поясничном уровне и деформацией позвоночника рекомендовано выполнение декомпрессивных вмешательств с сохранением дугоотростчатых суставов. При отсутствии факторов риска прогрессирования сколиоза, наличии корешковой симптоматики и боли в поясничной области целесообразно сочетать декомпрессию с короткой фиксацией. При наличии факторов риска декомпрессию необходимо дополнить длинной фиксацией, превышающей длину дуги сколиоза.

Об авторах

А. С. Никитин
ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России
Россия
127473 Москва, ул. Делегатская, 20, стр. 1


А. А. Гринь
ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России; ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского Департамента здравоохранения г. Москвы»
Россия

Андрей Анатольевич Гринь 

127473 Москва, ул. Делегатская, 20, стр. 1



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Для цитирования:


Никитин А.С., Гринь А.А. Сочетание дегенеративного стеноза позвоночного канала с деформацией позвоночника на поясничном уровне. Обзор литературы. Нейрохирургия. 2018;20(3):91-103. https://doi.org/10.17650/1683-3295-2018-20-3-91-103

For citation:


Nikitin A.S., Grin A.A. Combination of degenerative lumbar spinal stenosis and spinal deformity. Literature review. Russian journal of neurosurgery. 2018;20(3):91-103. (In Russ.) https://doi.org/10.17650/1683-3295-2018-20-3-91-103

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ISSN 1683-3295 (Print)
ISSN 2587-7569 (Online)