Vertebral instability of lumbar spine and its neurological presentations

Abstract

 Background. The research results of data of 57 patients with vertebral instability of lumbar spine with neurological presentations are presented. Patients were on in-patient treatment at the Vertebral surgery department of Institute of Traumatology and Orthopedics (Kyiv) in 2010–2014. Research object. The aim of the research was to determine the features of clinical signs and X-ray measures depending on type and stage of instability in lumbar spine. Materials and methods. The research is based on the analysis of management of 57 patients with lumbar spine instability. The management consisted of anamnesis, examination of patients, X-ray of spine, MRI and CT. The majority of patients were males. There were 35 (61.4 %) males, 22 (38.6 %) females among all of the patients. Due to the data of the research it was inquired that the spine instability was detected frequently in the most employable age, from 20 to 44 years – 30 (52.6 %) cases. Results and discussion. The spine instability is clinical and radiographic manifestation of pathological removability of contiguous vertebras due to each other. This resulted in lesion of vertebras and adjoined vessels and nerves, caused by inadequate supporting system of spinal motion segments. Failure of spinal motion segments develops mainly in degenerative and dystrophic disorders resulted in acute or chronic congestions influenced by microtraumas. Development of secondary lesions of spine and spinal radixes are affected by deformation of spine and spinal channel. Emerging of pathological processes is accompanied by orthopedic and neurological presentations, that requiring surgical correction. Conclusions. Instability of VMS is caused by structure alteration of intervertebral discs, aquatics and processes joints and a part of vertebral arc between joints. Clinical signs depend on the level of localization and the stage of spine instability. Among patients with spine instability the manifestation of radixes lesions were on the 1st place – 29 (50.9 %) cases, on the 2nd place – lesions of lumbago – 19 (33.3 %) cases. X-ray features of instability are: enlargement of linear displacement of vertebral body in sagittal plane more than 4.5 mm, segmental axial rotation of vertebra – more than 40°.