ANTERIOR EXTRAPERITONEAL AND POSTERIOR TRANSFORAMINAL SPONDYLOSIS IN THE SURGICAL TREATMENT OF SINGLE-LEVEL L5-S1 INTERVERTEBRAL DISC LESIONS IN OBESE PATIENTS. COMPARATIVE ANALYSIS

Grebenyuk Yaroslav Dmitrievich, Zhukov Denis Igorevich, Kim Eduard Anatolievich, Kokoreva Anastasia Yuryevna

Purpose of the study. Comparative analysis of clinical efficacy and safety of indirect decompression of spinal cord roots and interbody spondylodesis from anterior extraperitoneal and posterior transforaminal spondylodesis in surgical treatment of unisegmental lesion of L5-S1 intervertebral disc in obese patients. Material and Methods. A retrospective comparative analysis of the treatment of 87 patients with obesity and unisegmental lesion of the intervertebral disc L5-S1 was performed. Anterior lumbar interbody fusion (ALIF) was performed in 35 cases, transforaminal lumbar interbody fusion (TLIF) with transpedicular fixation by 4-screw system - in 52 cases. Results: postoperatively, patients in both groups had a significant reduction in pain according to the NRS scale. The ODI quality of life assessment also showed a positive dynamics in both groups. However, the ALIF group showed a lower level of back pain and lower ODI scores in the early postoperative period, as well as a statistically confirmed advantage over TLIF in the NRS score. Long-term surgical results demonstrate comparable efficacy of the techniques. Patients operated with ALIF compared to TLIF have a comparable number of postoperative complications. Conclusions: Anterior extraperitoneal spondylodesis is an effective and safe method of surgical treatment of single-level lesions of the L5-S1 intervertebral disc in obese patients. This technique allows to reduce the traumatic nature of surgery and the severity of pain syndrome in the early postoperative period. Further multicenter randomized studies are necessary for comprehensive evaluation of the long-term results.

Keywords:Anterior extraperitoneal spondylosis, posterior transthoracic spondylosis, spine surgery