RESULTS OF INTERVERTEBRAL DISC REPLACEMENT FOR DISEASES OF THE ADJACENT SEGMENT OF THE LUMBAR SPINE

The study included 20 patients with adjacent segment disease who were re-operated using the ALIF technique from 2019 to 2022. All patients were divided into two groups depending on the surgical technology. The first group included 11 patients aged from 30 to 60 years (M ± SD = 48.0:11.9 years) who underwent surgery using ALIF technology using interbody implants. There were 6 men (54.6%), 5 women (45.4%). The second included 9 patients aged 35 to 55 years (M ± SD = 42.4:8.6 years), operated on with ALIF technology using an M6 intervertebral disc prosthesis. The ratio of men to women in this group was 5 (55.5%):4 (44.5%). In group I, anterior decompression of the spinal canal using the ALIF method with the use of interbody implants, statistically significant results were observed: VAS before surgery 7.5 ± 0.9 – after 2.2 ± 1.3 p < 0.001, ODI index before surgery 52.4 ± 8.8 – after 14.5 ± 6.9 p <0.001. In ALIF group II using M6 intervertebral disc endoprosthesis, significant results were also noted: VAS before surgery 8.1 ± 0.9 – after surgery 1.2 ± 0.2 p <0.001, ODI before surgery 63.6 ± 9.9 – after 11.5 ± 4.2 p <0.001. However, ODI indicators in the second group in a comparative analysis are better than in group I, p <0.05. Thus, the long fixation lever, the level of spinal fusion, influences the development of diseases of the adjacent segment. In the present study, we performed a comparative analysis using ALIF technology using a conventional titanium cage and an endoprosthesis. We came to the conclusion that by using an intervertebral endoprosthesis as an alternative to spinal fusion, it is possible to reduce the risk of progression of degenerative changes in adjacent segments and the development of diseases at adjacent levels.