OBJECTIVE: To optimise the radiologic diagnostics of the degenerative-dystrophic changes in lumbar vertebral-motor segment (VMS) on the base of the evaluated results after stabilizing surgical intervention, using dual-energy computerized tomography (DECT). ASSIGNMENTS: Methods of spectral analysis of VMS by means of DECT Criteria to measure VMS degeneration based on DECT Roentgenomorphometric and spectral indexes of VMS with different types of fixation during post-operation time

The research was carried out in Clinical Diagnostic Centre and included 25 patients from 25 to 35 years old with degenerative-dystrophic lumbar vertebral changes (stages III, IV, V, according to Pfirrmann classification). The patients had long-lasting, over four months, intractable or relapsing pain syndrome. In 10 cases it was caused by foraminal and paramedian hernias, in 15 cases - by protrusions of 4-5mm. All the patients had their lumbar spines MRT-scanned in standard regime and MSCT-scanned in DE regime before surgical intervention and 6 months...

Correlation of degenerative-dystrophic changes in VMS based on classic roentgen indexes of pre- and post-operation periods did not show any distinctions among the observed patients. While applying DECT showed quite different picture. Two patient groups had differences in post-operation period, which we can see in table 1 and table 2. The patients with dynamic stabilizing systems had minimal trabecular substance changes in vertebral bodies and articular processes or did not have any: Ca reduction per volume unit within [0- 10] ME 6mg, increase of adipose...

DECT method provided extra possibilities to estimate VMS by measuring Ca, adipose degeneration in vertebral body and H2O in intervertebral disk. The given indexes make it possible to see early minimal DDC, which was not available in traditional X-ray CT. The patients with dynamic stabilizing systems had much less evident DDC in VMS during post-operation time. Thus, back dynamic fixation of VMS is more physiological and able to allocate load on adjacent VMS evenly as opposed to rigid fixation.

Contact person: Nikitenko Sergey Omsk, Clinical diagnostic center, tel. +79139684444, E-mail:[email protected]

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