Bone resorption around the annular closure device during a postoperative follow-up of 8 years.

Autor: Sanginov A; Neurosurgery Department, Novosibirsk Research Institute of Traumatology and Orthopaedics (NRITO) N.a.Ya.L.Tsivyan, Frunze Str, 17, Novosibirsk, Russia., Krutko A; Neurosurgery Department, Priorov National Medical Research Center of Traumatology and Orthopedics, Priorova Str, 10, Moscow, Russia., Leonova O; Neurosurgery Department, Priorov National Medical Research Center of Traumatology and Orthopedics, Priorova Str, 10, Moscow, Russia. onleonova@gmail.com., Peleganchuk A; Neurosurgery Department, Novosibirsk Research Institute of Traumatology and Orthopaedics (NRITO) N.a.Ya.L.Tsivyan, Frunze Str, 17, Novosibirsk, Russia.
Jazyk: angličtina
Zdroj: Acta neurochirurgica [Acta Neurochir (Wien)] 2024 Jan 27; Vol. 166 (1), pp. 40. Date of Electronic Publication: 2024 Jan 27.
DOI: 10.1007/s00701-024-05930-5
Abstrakt: Objective: Annular closure device (ACD) implantation is considered to be an effective means of preventing reherniation after microdiscectomy; however, there is an issue: the bone may resorb around the ACD. The causes of vertebral bone resorption remain unexplored; the dynamics of changes in bone resorption around the ACD have not yet been assessed or characterized.
Methods: One hundred thirty-three patients underwent ACD implantation after microdiscectomy, and 107 of them were followed up for 8 years after surgery (Oswestry, VAS). Lumbar CT scans helped characterize the bone resorption area around the ACD.
Results: The median of follow-up was 85 [74; 93] months (from 73 to 105 months). The prevalence of bone resorption around the ACD was up to 63.6%, and it was mainly around the polymer mesh of the ACD (70.6%). The resorbed bone volume increased with time and reached its maximum of 5.2 cm 3 (12% of the vertebral body volume) once a sclerotic rim developed around the bone resorption area. No differences in VAS pain intensity or in Oswestry Disability Index were found between patients with resorption and patients without it (p > 0.05). The volume of the intervertebral disc before surgery is a predictor of bone resorption (OR = 0.79, p = 0.009): if it is less than 13.2 cm 3 , the risk of bone resorption increases significantly (p < 0.05).
Conclusion: The majority of patients (up to 63.6%) with implanted ACDs have vertebral bone resorption around them. The bone resorption area around the ACD mesh increases with time to up to 12% of the vertebral body volume, with no clinical evidence, though. The formation of a sclerotic rim prevents the bone resorption area from further growth. If the volume of the intervertebral disc before surgery is less than 13.2 cm 3 , the risk of bone resorption increases significantly.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)
Databáze: MEDLINE
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