Анализ неудовлетворительных результатов межостистой динамической стабилизации при дегенеративных заболеваниях поясничного отдела позвоночника

Objective . To analyze the causes of interspinous dynamic stabilization failures in patients with lumbar spine degenerative disorders. Material and Methods. Retrospective analysis of 155 cases of interspinous dynamic stabilization using DIAM device was performed. Twenty three cases with poor results were selected for detailed analysis. Results. It was revealed that reoperation rate for this method was 15 %, but only 8 % of failures were related to the technology itself. Main complications associated with interspinous stabilization devices included fracture and erosion of the spinous processes, destruction and migration of implants, and infection. In nine cases poor results were associated with surgeon’s mistake in planning or performing of the procedure. Conclusion. Decision making for performing interspinous stabilization should be based on evaluation of indications and factors, which adversely affect its prognosis. These factors include elderly age of a patient, decreased bone quality, narrow and short interspinous gap, significant deformation and hypertrophy of the articular processes, significant slope of the spinous process, and essential amount of the planned bone decompression.