Clinical efficacy of laser denervation of lumbar spine facet joints in non-compressed forms of the syndrome of disease of adjacent levels after dorsal decompressive-stabilizing interventions

The dominant complication of rigid stabilization of the lumbar spine is the syndrome of the disease of adjacent level (SDAL), one of the common causes of which is the facet syndrome (FS). Treatment of an isolated FS in SDAL is currently a poorly understood problem. The aim of the study was to analyze clinical efficacy of laser denervation of facet joints (FJ) of the lumbar spine with SDAL non-compressive forms after dorsal decompressive-stabilizing interventions. 354 patients were taken into the study after rigid stabilization who developed SDAL at different terms in the form of isolated FS and who had minimally invasive treatment – FJ laser denervation. Patients were divided into two groups: in Group I patients (n = 139) previously had one-segment decompressive-stabilizing surgery; in Group II patients (n = 215) had two-segment surgery. Anthropometric indexes (sex, age, body mass), clinical parameters (visual-analogue pain syndrome (VAS), Oswestry (ODI) functional status, Macnab subjective outcome scale), neuroimaging data (magnetic resonance imaging) were analyzed in both groups. Clinical outcomes after treatment were assessed in the minimal follow-up period – 36 months. As a result, it has been established that FJ laser denervation in patients with SDAL non-compressed forms after dorsal decompression-stabilizing interventions promotes good clinical outcomes as to pain syndrome and functional status. It also leads to minimal risks of perioperative adverse effects.

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