Our experience in surgical treatment of spinal disc herniation
Background. The purpose of the study was to evaluate the effectiveness of the transforaminal endoscopic microdiscectomy, to highlight the disadvantages and advantages of this method in comparison with traditional methods, based on the data obtained to determine the main indications and contraindications to this procedure. Materials and methods. One-hundred and ninety clinical records of the patients with lumbar spinal cord injuries were analyzed, which were treated at the Regional Centre of Orthopedics, Traumatology and Vertebrology “Rivne Regional Clinical Hospital” from April 2016 to April 2018. We performed a quantitative and qualitative assessment of pain syndrome by the Visual Analogue Scale of Pain (VAS); assessment of the quality of life by Oswestry Disability Index. Results. The use of transforaminal endoscopic microdiscectomy for the treatment of patients with spinal disk herniation confirmed the high efficiency of this technique. So, the international Oswestry Disability Index demonstrated in average 21.1 % for the group in operated patients, which corresponds to a good result. The dynamics of the pain syndrome was estimated by VAS and its preoperative level was 8.5 scores, and in 6 months after the operation — 1.5 with the predominance of lumbalgia, and with the almost complete absence of root pain. This technique makes it possible to enter the endoscope into the vertebral canal under the local anaesthesia minimally invasive and under visual control to decompress the nerve root by removing the hernial bulging. However, the technique is not universal and cannot be applied to all patients. Conclusions. Considerable practical experience has shown that the surgeon can meet certain technical difficulties in cases of cranial or caudal migration of sequestration, in some cases access to the level of L5-S1 is difficult due to the high position of the iliac crest. However, with the correct indications, this technique allows solving the problem of the radicular syndrome in a short time.
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