Staude V. Artificial ligaments fibrotization in the treatment of degenerative lumbar instability

3. Objective: To assess the effectiveness of AFL for de-generative instability of the lumbar spinal motion segments. Purpouse. Evaluation of artificial posterior spinal ligaments artificial fibrotisation (AFL) for increase of segments stabil-ity. Methods. Study of stabilizing effect of AFL in finit-element model, biomechanical and histological study of AFL in experimental rats model; clinical and radiological investi-gation of preliminary results of AFL in 30 patients, ultra-sonographical meosurement. New knowledge. It was con-firmed by means of finite-element model study that block of fibrotized interspinous and suprospinous ligaments with an appropriate geometry can resist to shearing loads and de-crease of intervertebral disc strain. In the biomechanical and histological study of experimental rat model it was proved that electrotermal treatment (electrocoagulation) is optimal for artificial LF. Vertebral motion segments stiffness in-creases is firmly correlated with time after LF modeling. 30 patients with proved lumbar degenerative instability were treated by miniinvasive artificial LF. In a 12 month follow-up ultrasonographical meosurement of newly formed fibrous tissue volume was made. It was more than 2 sm2 in all pa-tients. Index of disability Oswestry at 12 month after invasion decreased from 47,5%, to 4,2%, the mean index recovery is 91%. It was proved, that the mean range of sagithal motion and the mean vertebral translation was decreased. It was de-signed 4 methods ALF, 2 methods preinvasive and postinva-sive treatment degenerative instability (6 patents of Ukraine). Practical importance. Use developed miniinvasive meth-ods ALF, preoperative preparation and postoperative treat-ment allow to short therms of degenerative instability treat-ment and to make impossible complications and progress degenerative spine diseases. All above allow to improve the results of degenerative instability treatment. Developed methods are used in practice of Sytenko Institute of Spine and Joints pathology clinic, surgery department of 17-th Kharkov out patients clinic. Developed methods preoperative preparation and postoperative treatment degenerative insta-bility are applied in practice of traumatologic clinic of Kharkov regional clinical hospital, children orthopaedic clinic and spine pathology clinic of Kharkov region trauma-tologic hospital.