Comparison of Nitinol and Titanium Nails Effectiveness for Lumbosacral Spine Fixation in Surgical Treatment of Degenerative Spine Diseases

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Abstract

Relevance. Surgical decompression and decompression with stabilization are highly effective for treatment of spinal canal stenosis at the level of lumbar spine. However, complications developing after application of rigid fixation systems resulted in active introduction of dynamic implants into clinical practice.

Purpose of the study — to compare effectiveness of nitinol and titanium nails for lumbosacral fixation in surgical treatment of degenerative spine diseases.

Materials and methods. 220 patients who underwent surgeries in 4 hospitals were randomized into two groups, each consisting of 110 patients (1:1 ratio): a group of patients who underwent stabilization of the vertebral motor segments with rods of nitinol with the required volume of decompression at the operation level and a group of patients who underwent stabilization of the vertebral motor segments with standard rods of titanium with the required volume of decompression at the intervention level. Patients suffered clinically significant spinal canal stenosis in one or two adjacent segments: from L3 to S1. Outcomes were evaluated during three years postoperatively by VAS scale for spine and lower limbs, and by ODI and SF-36 scales.

Results. All scales demonstrated better values in both groups of patients, namely, significant decrease of pain syndrome and improvement in mental and physical health. X-ray examination of all patients during the study period demonstrated restoration of lumbar lordosis. Group of patients with dynamic nails featured less complications rate related to metal implants including adjacent segment disease.

Conclusion. Transpedicular fixation of lumbosacral spine by nitinol nails is an effective technique allowing to preserve motion along with stable fixation.

About the authors

S. V. Kolesov

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru

Sergey V. Kolesov — Dr. Sci. (Med.), professor, the head of Spinal Pathology Department

Moscow

Russian Federation

A. I. Kazmin

Priorov National Medical Research Center of Traumatology and Orthopedics

Author for correspondence.
Email: kazmin.cito@mail.ru

Arkady I. Kazmin — cand. Sci. (Med.), orthopedic surgeon, Spinal Pathology Department,

Moscow

Russian Federation

V. V. Shvets

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru

Vladimir V. Shvets — Dr. Sci. (Med.), leading research fellow, Spinal Pathology Department

Moscow

Russian Federation

A. O. Gushcha

Research Center of Neurology

Email: fake@neicon.ru

Artem O. Gushcha — Dr. Sci. (Med.), the head of Department of Neurosurgery

Moscow

Russian Federation

E. N. Poltorako

Research Center of Neurology

Email: fake@neicon.ru

Ekaterina N. Poltorako — neurosurgeon, Department of Neurosurgery

Moscow

Russian Federation

I. V. Basankin

Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1

Email: fake@neicon.ru

Igor V. Basankin — cand. Sci. (Med.), the head of Department of Neurosurgery

Krasnodar

Russian Federation

A. E. Krivoshein

Omsk State Medical University

Email: fake@neicon.ru

Artem E. Krivoshein — cand. Sci. (Med.), assistant, Department of Traumatology and Orthopedics

Omsk

Russian Federation

K. M. Bukhtin

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru

Kirill M. Bukhtin — cand. Sci. (Med.), scientific secretary

Moscow

Russian Federation

A. A. Panteleev

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru

Andrey A. Panteleev — doctor, Department of Spine Pathology

Moscow

Russian Federation

M. L. Sazhnev

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru

Maxim L. Sazhnev — cand. Sci. (Med.), doctor, Department of Spine Pathology

Moscow

Russian Federation

V. S. Pereverzev

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru

Vladimir S. Pereverzev — doctor, Department of Spine Pathology

Moscow

Russian Federation

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