KẾT QUẢ PHẪU THUẬT CỐ ĐỊNH CỘT SỐNG VÀ HÀN XƯƠNG LIÊN THÂN ĐỐT ĐƯỜNG SAU ĐIỀU TRỊ MẤT VỮNG ĐA TẦNG CỘT SỐNG THẮT LƯNG CÙNG TẠI BỆNH VIỆN BẠCH MAI

Abstract

Objective: To assess the outcomes of posterior spinal fixation and interbody fusion surgery for the treatment of multilevel lumbar-sacral instability. Subjects and Methods: This retrospective cross-sectional study was conducted on 60 patients diagnosed with lumbar-sacral spinal instability due to degeneration. These patients underwent posterior multilevel spinal fixation and interbody fusion (involving two or more levels) at the Department of Orthopedic Trauma and Spine Surgery, Bach Mai Hospital, between January 2021 and July 2023. The minimum postoperative follow-up period was six months. Results: The average age of patients was 59.43 years, with a female-to-male ratio of 4:1. The average duration from onset to surgery was 21.58 months. Preoperative mean scores for back pain (VAS), leg pain (VAS), and JOA were 5.57, 4.57, and 10.95 points, respectively. These scores significantly decreased at the follow-up to 1.41, 0.53, and 24.63 points, respectively. Patients under 60 years old, females, and those classified as ASA (American Society of Anesthesiologists) 1 or 2 were found to have better neurological recovery outcomes at follow-up. Conclusion: Posterior spinal fixation and interbody fusion surgery for the treatment of lumbar instability is a safe procedure with a low intraoperative complication rate. Postoperative pain levels decrease over time. Patients under 60, females, and those with ASA classifications 1 or 2 are associated with better recovery outcomes after more than six months of follow-up.