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Интеллектуальная Система Тематического Исследования НАукометрических данных |
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Study participants According to the eligibility criteria, the study included 96 medical records of respondents (50 (52%) male patients, 46 (48%) female patients, age ranged from 18 to 84 years) who underwent MMD surgery on the lumbosacral spine for monosegmental stenosis. Average period of postoperative observation was 20.1±6.7 months. It is important to emphasize that the most common localization of spinal canal stenosis was the level of L4-L5 intervertebral disc (49.8%). Main outcomes of the study When assessing the severity of pain in the lower back and lower extremities according to VAS, the following results were obtained. Pain intensity in the lumbar spine and lower extremities according to VAS was 9.0 and 9.0 respectively. In the early postoperative period, the vast majority of patients (81%) showed complete or partial regression of radicular pain on the 1st day after the operation. None of the patients had an increase in pain. However, moderate pain persisted in the surgical area. An analysis of pain severity in the lower back and lower extremities at 3, 6, 9, 12, and 24 months after the MMD showed a significant decrease in this indicator both in the lower back and lower extremities (p<0.001) (Fig. 2 a, b). When assessing ODI before surgery, the following data were obtained. The indicator for ODI 45% or more points was noted in 31.2%. In the early postoperative period (the first 7 days after the operation), there was a statistically significant improvement in ODI up to 5-12% in 72.9% (p=0.055). In the late period of postoperative follow-up, we also noted a significant improvement in ODI (p<0.001) (Fig. 3). In the studied group, the level of achievement of treatment goal was assessed 12 and 14 months after the operation. However, 2 (2%) respondents failed to achieve the final clinical goal of treatment. Additional study outcomes When assessing the duration of the surgical intervention, it was found that the duration of MMD on average is 90 minutes. First of all, this is due to the absence of the need to stabilize the operated spinal segment. The analysis of intraoperative blood loss also showed that when performing MMD, the volume of blood loss was less than 100 ml in 87.5%, 100-200 ml in 12.48% and no indicator of blood loss of more than 200 ml (the average blood loss was 56 ml ). Adverse clinical events were detected in 6 (6.2%) respondents. So, after 14 days from the moment of performing the surgical intervention, 2 (2%) patients underwent repeated surgical interventions for the removal of hematomas. Damage to the dura mater was noted in 4 (4%) patients.