Аңдатпа
BACKGROUND: To date, the effectiveness of neurosurgical treatment in patients with lumbar spine degenerative diseases associated with anomalies of the lumbosacral junction has been insufficiently studied. AIM: To prospectively evaluate the outcomes of the developed treatment and diagnostic approach in the neurosurgical management of patients with degenerative lumbar spine diseases associated with anomalies of the lumbosacral junction, stratified according to the proposed clinical and morphological classification. METHODS: Treatment outcomes were compared between a prospective group (n = 139) treated using the developed treatment and diagnostic approach and a retrospective cohort (n = 352) in which the choice of surgical procedure was based on the surgeon's preference. Intergroup analysis was performed based on patient stratification according to the proposed clinical and morphological classification, assessing long-term clinical outcomes and the rate of postoperative complications. RESULTS: In the long-term postoperative period, the prospective group showed significant improvement in long-term clinical outcomes, as reflected in the dynamics of compression symptoms, compared with the retrospective group. In particular, pain levels in the lumbar spine and lower extremities decreased, functional status improved according to the Oswestry Disability Index and quality of life according to the SF-36 questionnaire, and the incidence of postoperative complications (Clavien–Dindo classification) was also reduced. CONCLUSION: The developed differentiated treatment and diagnostic approach for patients with degenerative lumbar spine diseases associated with anomalies of the lumbosacral junction, stratified according to the proposed clinical and morphological classification, resulted in significant improvement in long-term clinical outcomes and a lower incidence of postoperative complications, with a minimum 2-year postoperative follow-up period.