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- 저자 : Oleg Smekalenkov (검색결과 2 건)
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Risk Factors for Adjacent Segment Disease Development after Lumbar Fusion
Sergei Masevnin,Dmitry Ptashnikov,Dmitry Michaylov,Hao Meng,Oleg Smekalenkov,Nikita Zaborovskii 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.2
Study Design: Retrospective cohort study. Purpose: To identify factors which may be important in the occurrence of symptomatic adjacent segment disease (ASD) after lumbar fusion. Overview of Literature: Many reports have been published about the risk factors for ASD after lumbar fusion. Despite on the great numbers of risk factors identified for ASD development, study results have been inconsistent and there is controversy regarding which are the most important. Methods: This study evaluated 120 patients who underwent 360° fusion lumbar surgery from 2007 to 2012. We separated the population into two groups: the first group included 60 patients with long lumbar fusion (three or more levels) and the second group included 60 patients with short lumbar fusion (less than three levels). Results: In the first group, symptomatic ASD was found in 19 cases during the one year follow-up. There were 14 cases with sagittal imbalance and 5 cases at the incipient stage of disc degeneration according to the preoperative magnetic resonance imaging. At the three year follow-up, symptomatic ASD was diagnosed in 31 cases, of which 17 patients had postoperative sagittal balance disturbance. In the second group, 10 patients had ASD at the one year follow-up. Among these cases, preoperative disc degenerative changes were identified in 8 patients. Sagittal imbalance was found only in 2 cases with symptomatic ASD at the one year followup. At the three year follow-up, the number of patients with symptomatic ASD increased to 14. Among them, 13 patients had initial preoperative adjacent disc degenerative changes. Conclusions: Patients with postoperative sagittal imbalance have a statistically significant increased risk of developing symptomatic ASD due to an overloading the adjacent segments and limited compensatory capacities due to the large number of fixed mobile segments. In the case of a short fixation, preoperative degenerative changes are more important factors in the development of ASD.
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Hardware Failure in Spinal Tumor Surgery: A Hallmark of Longer Survival?
Nikita Zaborovskii,Adam Schlauch,Dmitrii Ptashnikov,Dmitrii Mikaylov,Sergei Masevnin,Oleg Smekalenkov,John Shapton,Dimitriy Kondrashov 대한척추신경외과학회 2022 Neurospine Vol.19 No.1
Objective: Instrumentation failure in spine tumor surgery is a common reason for revision operation. Increases in patient survival demand a better understanding of the hardware longevity. The study objective was to investigate risk factors for instrumentation failure requiring revision surgery in patients with spinal tumors. Methods: A retrospective cohort from a single tertiary care specialty hospital from January 2005 to January 2021, for patients with spinal primary or metastatic tumors who underwent surgical intervention with instrumentation. Demographic and treatment data were collected and analyzed. Kaplan-Meier analysis was performed for overall survival, and separate univariate and multivariate regression analysis was performed. Results: Three hundred fifty-one patients underwent surgical intervention for spinal tumor, of which 23 experienced instrumentation failure requiring revision surgery (6.6%). Multivariate regression analysis identified pelvic fixation (odds ratio [OR], 10.9), spinal metastasis invasiveness index (OR, 1.11), and survival of greater than 5 years (OR, 3.6) as significant risk factors for hardware failure. One- and 5-year survival rates were 57% and 8%, respectively. Conclusion: Instrumentation failure after spinal tumor surgery is a common reason for revision surgery. Our study suggests that the use of pelvic fixation, invasiveness of the surgery, and survival greater than 5 years are independent risk factors for instrumentation failure.
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