Neurosurgery

doi: 10.25005/2074-0581-2019-21-1-55-59
NEW APPROACH IN THE SPINAL DISC HERNIATION TREATMENT

Kh.D. Rakhmonov1, R.N. Berdiev1, S.G. Ali-Zade2

1Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Department of Surgical Diseases № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: Improve the surgical results of interventions for intervertebral hernias using modern technology

Methods: The results of endoscopic surgeries performed by 82 patients were analyzed. All patients studied the clinical and neurological status before and after surgery, as well as CT and MRI. The results of the treatment were assessed by the MacNab scale, the severity of the pain syndrome – by the pain audit scale, and the parameter “quality of life” – by the questionnaire SF36 and the duration of the patient’s temporary disability

Results: Assessment of remote postoperative MacNab scores was performed 6 months after surgery. At the same time, 69 (84.1%) patients had an excellent result. In 8 (9.8%) cases, a good result was observed (at the time of discharge, there was a significant decrease in pain syndrome); in 3 (3.7%) cases the result was satisfactory, and in 2 (2.4%) observations there was an unsatisfactory result. At the same time, there was no need to perform reoperation interventions on acute spine pains with the redevelopment of intervertebral hernia. Long-term results of surgical endoscopic interventions in 98.8% of observations showed great efficiency and small injuries.

Conclusions: Endoscopic treatment of intervertebral disc hernia in comparison with the traditional open method helps to reduce the time of the operation and the terms of stay of the patient in a hospital and also more acceptable with the cosmetic point of view

Keywords: Intervertebral disc hernia, endoscopy, pain syndrome, surgical treatment.

Download file:


References
  1. Kamilova GI, Ashurova NS, Chudinov AV, Gaibova MG. Osnovnye faktory, obuslovlivayushchie pervichnuyu invalidnost’ naseleniya Respubliki Tadzhikistan [The main factors contributing to the primary disability of the population of the Republic of Tajikistan]. Vestnik Avitsenny [Avicenna Bulletin]. 2015;3:102-5.
  2. Salimov NF, Razzokov AA. Rezul’taty izucheniya mneniya patsientov pri primenenii razlichnykh form organizatsii lechebno-diagnosticheskogo protsessa pri travmakh i ortopedicheskoy patologii [The results of the study of the opinions of patients with the use of various forms of organization of the therapeutic and diagnostic process for injuries and orthopedic pathology]. Vestnik Avitsenny [Avicenna Bulletin]. 2015;3:127-31.
  3. 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.
  4. 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.
  5. 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]. Zh. Nervnye bolezni. 2017;3:19-23.
  6. 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.
  7. 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;20:1540-2.
  8. 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
  9. Borshchenko IA, Migachyov 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.
  10. 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.
  11. Merzhoev AM, Gulyaev DA, Davydov EA, 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
  12. 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
  13. 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 Destando in the treatment of hernias of intervertebral discs of the lumbar spine]. Khirurgiya pozvonochnika. 2008;1:51-7
  14. Arts MP, Brand R, van den Akker ME, Koes BW, Bartels RH, Peul WC. LeidenThe Hague Spine Intervention Prognostic Study Group (SIPS). Tubular diskectomy versus conventional microdiskectomy for sciatica: a randomized controlled trial. JAMA. 2009;302(2):149-58.
  15. Balestroni G, Bertolotti G. EuroQol-5D (EQ-5D): an instrument for measuring quality of life. Monaldi Arch Chest Dis. 2012;78(3):155-9.
  16. 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.
  17. 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
  18. Rosner MK, Campbell VA. Treatment of disc disease of the lumbar spine. Winn HR Youmans Neurological Surgery. 6th ed. Philadelphia, USA: WB Saunders; 2011. p. 2919-22.

Authors informations:

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

Ali-Zade Sukhrob Gaffarovich , Candidate of Medical Sciences, Assistant of the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University

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

Materials on the topic: