A clinical case of the intervertebral disc rehydration after dynamic transpedicular fixation using nitinol rods

Introduction. The clinical case of a patient with a generalized degenerative lesion of the lumbar spine in combination with clinical and radiological signs of the adjacent disk syndrome is presented in the article.

Materials and methods. The patient turned to the neurosurgical department of the Research Center of Neurology with complaints of low back pain with irradiation on the external surface of the left leg, and numbness in this area. In the anamnesis: microsurgical removal of the HIVD at the levels L4–L5 and L5–S1. According to magnetic resonance imaging (MRI), a disc herniation and according to functional radiography – signs of instability were revealed at the level of L3–L4. In order to prevent further progression of the degenerative cascade, the patient underwent surgical intervention – dynamic transpedicular fixation with nitinol rods, a metal with shape memory effect. At pre- and postoperative periods we performed clinical evaluation (VAS pain scale, Oswestry quality of life assessment, modified Macnub scale), MRI of the lumbar spine (an analysis of the fixed and adjacent segments degeneration extent according to Pfirman classification), and functional radiography (estimation of the range of motion in the fixed and adjacent segments).

Results. We observed a significant reduction in back pain, a complete regression of leg pain and an improvement in the quality of life compared to the preoperative level. Twelve months after the surgery, on the MRI scan we observed signs of rehydration and regeneration on a fixed segment and the absence of acceleration of degeneration on adjacent segments