Degenerative changes in the spinal motion segment following surgical treatment of thoracic and lumbar spine fractures
https://doi.org/10.56618/2071-2693_2025_17_3_43
EDN: JSSNFY
Abstract
AIM. To compare degenerative changes in facet joints (FJ) and intervertebral discs (IVD) following different surgical approaches for uncomplicated thoracolumbar spine fractures.
MATERIALS AND METHODS. This (2009–2022) retrospective single-center study analyzed 108 patients with A2-C type fractures (AOSpine classification). Outcomes of percutaneous/open transpedicular fixation (TPF) with/without decompression, anterior and combined fusion were evaluated. Degenerative changes in FJ and IVD were graded using Pathria and Park classification systems.
RESULTS. Ankylosis occurred in 67.9% of cases at fracture level, more frequently with open TPF (OR=3.17). Anterior fusion showed 40.9 % ankylosis rate at adjacent upper level (OR=15.87 vs TPF). Adjacent segments: Long-segment TPF increased ankylosis risk 5-fold (OR=5.11).
CONCLUSION. Percutaneous TPF minimizes FJ ankylosis and is preferable for temporary fixation. Open TPF with FJ decortication promotes spontaneous fusion. Anterior fusion carries higher risk of adjacent segment degeneration. Implant removal should be considered within 2 years post-TPF.
About the Authors
A. A. Grin
Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Andrey A. Grin – Corresponding Member of the Russian Academy of Sciences, Chief Freelance Neurosurgeon, Head at the Scientific Department of Emergency Neurosurgery
3 Bolshaya Sukharevskaya square, Moscow, 129090
A. E. Talipov
Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Alexander E. Talipov – Dr. of Sci. (Med.), Leading Researcher at the Department of Neurosurgery, Sklifosovsky Research Institute for Emergency Medicine; Professor at the Department of Fundamental Neurosurgery, Pirogov National Research Medical University
3 Bolshaya Sukharevskaya square, Moscow, 129090
В. A. Karanadze
Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Vasily A. Karanadze – Cand. of Sci. (Med.), Neurosurgeon, Head at the Neurosurgical Department for the Treatment of Patients with Vascular Diseases of the Brain
3 Bolshaya Sukharevskaya square, Moscow, 129090
A. Yu. Kordonsky
Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Anton Yu. Kordonsky – Cand. of Sci. (Med.), Researcher at the Department of Emergency Neurosurgery
3 Bolshaya Sukharevskaya square, Moscow, 129090
R. I. Abdrafiev
Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Rinat I. Abdrafiev – Neurosurgeon at the Neurosurgical Department for the Treatment of Patients with Vascular Diseases of the Brain
3 Bolshaya Sukharevskaya square, Moscow, 129090
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Review
For citations:
Grin A.A., Talipov A.E., Karanadze A., Kordonsky A.Yu., Abdrafiev R.I. Degenerative changes in the spinal motion segment following surgical treatment of thoracic and lumbar spine fractures. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2025;17(3):43-43. (In Russ.) https://doi.org/10.56618/2071-2693_2025_17_3_43. EDN: JSSNFY
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