INVESTIGATION OF THE EFFECT OF SPINAL STABILIZATION AND FUSION ON INTERVERTEBRAL DISC STRUCTURES USING DENSITY

SPINAL STABILIZATION AND DISC DENSITY

Abstract

Introduction: The effects of stabilization and fusion on the intervertebral discs in the fusion region of the spine and adjacent segments have been rarely studied in the literature. In the literature, few animal experiments and biomechanical studies have shown that the disc structure undergoes some metabolic changes and degeneration develops after posterior fusion. The response of cells in the intervertebral discs to inmobilization or overmobilization was thought to occur mostly due to the effect of mechanical forces on disc nutrition. The aim of our study; To determine the density (IVDD) changes in the intervertebral discs in the early and late postoperative period in patients who underwent posterior spinal fusion and to contribute to the few studies in the literature.

Material and Method: The records of patients who were diagnosed with lumbar spondylosis and narrow canal in our clinic between 2015-2021 were reviewed retrospectively. Postoperative early (day 1) and postoperative late (4-6 months) lumbar computed tomography (CT) scans of patients who underwent L2-3-4-5 transpedicular screw and L2-3-4 lumbar laminectomy were examined. Density measurements were made in the fusion region and adjacent segment. The results were evaluated statistically.

Results: The difference between early and late IVDD values performed at the same disc level in all disc levels was statistically significant (p<0.001). In repeated measurements, postoperative early postoperative IVDD values of disc levels were statistically insignificant (p>0.05), while late-term IVDD values were significant (p<0.001).

Conclusion: In patients who underwent rigid fusion of the lumbar with the posterior instrumentation technique, significant density differences develop in the disc segments in the fusion region and less frequently in the adjacent disc segments in the fusion region within a period of 4-6 months. This may support that the rigid fusion technique causes a degenerative process in disc structures.