Neurosurgery

doi: 10.25005/2074-0581-2018-20-4-362-367
SURGICAL TREATMENT OF INTERVERTEBRAL HERNIA OF THE LUMBOSACRAL SPINE

Kh.D. Rakhmonov, R.N. Berdiev

Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: Comparative analysis of the results of microsurgical and endoscopic discectomy in patients with intervertebral hernias of the lumbosacral spine.

Methods: The obtained results allows asserting that during performing operations on intervertebral hernias of the lumbosacral spine, endoscopic discectomy is more preferable. It has a positive effect on the result of the operation and the condition of the patient at the rehabilitation stage, and its effectiveness is not inferior to microsurgical discectomy.

Results: In both groups, the deterioration of the general indicators of disease symptoms not marked. Patients operated by the microsurgical method had lower quality of life criteria than patients of the first group. Patients with endoscopic discectomy were quicker to recover activity, than in patients operated by the microsurgical method.

Conclusion: The obtained results allows asserting that during performing operations on intervertebral hernias of the lumbosacral spine, endoscopic discectomy is more preferable. It has a positive effect on the result of the operation and the condition of the patient at the rehabilitation stage, and its effectiveness is not inferior to microsurgical discectomy.

Keywords: Herniated disc, endoscopic micro-discectomy, endoscopic discectomy, lumbosacral spine.

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References
  1. Konovalov NA, Nazarenko AG, Asyutin DS, Zelenkov PV, Onoprienko RA, Korolishin VA, i dr. Sovremennye metody lecheniya degenerativnykh zabolevaniy mezhpozvonkovogo diska. Obzor literatury [Modern treatments for degenerative disc diseases of the lumbosacral spine. A literature review]. Voprosy neyrokhirurgii im. N.N. Burdenko. 2016;4:102-8. Available from: http://dx.doi.org/10.17116/neiro2016804102-108.
  2. Antipko AL. Prognozirovanie gryzh mezhpozvonkovykh diskov poyasnichnogo otdela na osnove dannykh magnitorezonansnoy tomografii. Sistemnyy analiz i upravlenie v biomeditsinskikh sistemakh [Prediction of herniated lumbar intervertebral discs based on magnetic resonance imaging data. System analysis and management in biomedical systems]. Zhurnal prakticheskoy i teoreticheskoy biologii i meditsiny. 2009;8(3):664-7.
  3. Klishin DN, Dreval ON, Kuznetsov AV. Topografo-anatomicheskie osobennosti obosnovaniya khirurgicheskogo lecheniya gryzh mezhpozvonkovykh diskov verkhnepoyasnichnogo urovnya [Topographic and anatomical features of substantiation of surgical treatment of hernias of intervertebral discs of the upper lumbar level]. Rossiyskiy neyrokhirurgicheskiy zhurnal im. prof. A.L. Polenova. 2012;1:17-22.
  4. Arestov SO, Gushcha O, Kashcheev A, Vershinin AV, Dreval MD, Poltorako EN. Sovremennye podkhody k lecheniyu gryzh mezhpozvonkovykh diskov poyasnichno-kresttsovogo otdela pozvonochnika [Modern approaches to the treatment of hernias of intervertebral discs of the lumbosacral spine]. Nervnye bolezni. 2017;3:19-23.
  5. Volkov IV, Karabaev ISh, Ptashnikov DA, Konovalov NA, Poyarkov KA. Rezul’taty transforaminal’noy endoskopicheskoy diskektomii pri gryzhakh mezhpozvonkovykh diskov poyasnichno-kresttsovogo otdela pozvonochnika [Results of transforaminal endoscopic discectomy for hernias of intervertebral discs of the lumbosacral spine]. Travmatologiya i ortopediya Rossii. 2017;23(3):32-42. Available from: http://dx.doi.org/10.21823/2311- 2905-2017-23-3-32-42.
  6. Arestov SO, Gushcha AO, Kashcheev AA. Algoritm lecheniya patsientov s bolyami v oblasti poyasnitsy [Algorithm for treating patients with lower back pain]. Russkiy meditsinskiy zhurnal. 2012;20(31):1540-2.
  7. Arestov SO, Vershinin AV, Gushcha AO. Sravnenie effektivnosti i vozmozhnostey endoskopicheskogo i mikrokhirurgicheskogo metodov udaleniya gryzh mezhpozvonkovykh diskov poyasnichno-kresttsovogo otdela pozvonochnika [Comparison of the effectiveness and possibilities of endoscopic and microsurgical methods for removing hernias of intervertebral discs of the lumbosacral spine]. Voprosy neyrokhirurgii im. N.N. Burdenko. 2014;6:9-14.
  8. Borshchenko IA, Migachev SL, Dreval ON, Baskov AV. Opyt chreskozhnoy endoskopicheskoy poyasnichnoy diskektomii. Rezul’taty i perspektivy [Experience percutaneous endoscopic lumbar discectomy. Results and prospects]. Neyrokhirurgiya. 2009;4:25-34.
  9. Borshchenko IA, Baskov AV. Minimal’no invazivnaya khirurgiya degenerativnogo porazheniya poyasnichnykh mezhpozvonkovykh diskov [Minimally invasive surgery of degenerative lesions of the lumbar intervertebral discs]. Neyrokhirurgiya. 2010;1:65-71.
  10. Merzhoev AM, Gulyaev DA, Davydov YEA, Singaevskiy SB, Prishvin AP. Perkutannaya endoskopicheskaya poyasnichnaya diskektomiya – interlaminarnyy dostup [Percutaneous endoscopic lumbar discectomy – interlaminar access]. Rossiyskiy neyrokhirurgicheskiy zhurnal im. professora A.L. Polenova. 2017;1:48-56.
  11. Aliev ML, Mirzabaev MZh, Aglakov BM, Mustafinov DB, Satbaev SZ. K probleme stabilizatsii segmenta pri lechenii bol’nykh s gryzhami diska poyasnichno-kresttsovogo otdela pozvonochnika [To the problem of segment stabilization in the treatment of patients with disc herniation of the lumbosacral spine]. Neyrokhirurgiya i nevrologiya Kazakhstana. 2017;2:54-8.
  12. Shevelyov IN, Gushcha AO, Konovalov NA, Arestov SO. Ispol’zovanie endoskopicheskoy diskektomii po Destando pri lechenii gryzh mezhpozvonkovykh diskov poyasnichnogo otdela pozvonochnika [The use of endoscopic diskectomy for Destado in the treatment of hernias of intervertebral discs of the lumbar spine]. Khirurgiya pozvonochnika. 2008;1:51-7.
  13. Arts MP, Brand R, van den Akker ME, Koes BW, Bartels RH, Peul WC. Leiden The Hague Spine Intervention Prognostic Study Group (SIPS). Tubular diskectomy versus conventional microdiskectomy for sciatica: a randomized controlled trial. JAMA. 2009;302(2):149-58. Available from: http://dx.doi. org/10.1001/jama.2009.972.
  14. Balestroni G, Bertolotti G. EuroQol-5D (EQ-5D): an instrument for measuring quality of life. Monaldi Arch Chest Dis. 2012;78(3):155-9.
  15. Sairyo K, Higashino K, Yamashita K, Hayashi F, Wada K, Sakai T, et al. A new concept of transforaminal ventral facetectomy including simultaneous decompression of foraminal and lateral recess stenosis: Technical considerations in a fresh cadaver model and a literature review. J Med Invest. 2017;64(1.2):1-6. Available from: http://dx.doi.org/10.2152/ jmi.64.1.
  16. Malik K, Cohen S, Walega D, Benzon H. Diagnostic criteria and treatment of discogenic pain: a systematic review of recent clinical literature. The Spine Journal. 2013;13(11):1675-89. Available from: http://dx.doi.org/10.1016/j. spinee.2013.06.063.
  17. Rosner MK, Campbell VA. Treatment of disc disease of the lumbar spine. Winn HR Youmans Neurological Surgery. 6th ed WB Saunders Philadelphia. 2011: 2919-2922.
  18. Mysliwiec L, Cholewicki J, Winkelpleck M, Eis G. MSU Classification for herniated lumbar discs on MRI: toward developing objective criteria for surgical selection. European Spine Journal. 2010;19(7):1087-93. Available from: http://dx.doi.org/10.1007/ s00586-009-1274-4.
  19. Lee S, Lee JW, Yeom JS, Kim KJ, Kim HJ, Chung SK, Kang HS. A practical MRI grading system for lumbar foraminal stenosis. AJR. 2010;194(4): 1095-1098. Available from: http://dx.doi.org/10.2214/AJR.09.2772.

Authors' information:


Rakhmonov Khurshed Dzhamshedovich,
Candidate of Medical Sciences, Associate Professor of the Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University

Berdiev Rustam Namozovich,
Doctor of Medical Sciences, Head of the Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University

Conflicts of interest: No conflict

Address for correspondence:


Berdiev Rustam Namozovich

Doctor of Medical Sciences, Head of the Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave, 139

Tel.: +992 (918) 813282

E-mail: rnamozzoda@mail.ru

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