Piontkovskyi V. K., Zlativ V. P., Myronyk B. M., Dushnyi M. M.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

We analyzed data based on the study of 125 case histories of patients with pathology of the intervertebral discs of the lumbar spine, who underwent inpatient treatment at the Regional Center of Orthopedics, Traumatology and Vertebrology of the Public Healthcare Institution «Rivne Regional Clinical Hospital named after Yuriy Semenyuk» since May 2017 to August 2020. Using endoscopic transforaminal microdiscectomy, through a small approach, and with the help of special micro-instruments, extraction of intervertebral disc extrusions were performed under C-arm control. The significant advantages of surgical intervention are the ability to perform the procedure under local anesthesia, short duration of the operation, minimal trauma to soft tissues, the possibility of performing an additional foraminotomy, endoscopic visualization of intracanal structures, and early possibility of walking for patients. According to the results obtained by us, this technique is associated with a significant improvement in the quality of life of patients and a decrease in pain syndrome in the postoperative period. However, this surgical intervention must be used with a careful analysis of the anatomy of the lumbosacral spine and the absence of contraindications, since successful removal of the hernia can be difficult due to the high position of the iliac wings, fractures of the vertebral structures in the past, scoliotic deformation of the spine or significant migration of the extrusion. In addition, during or after endoscopic transforaminal microdiscectomy, the surgeon may encounter some complications such as damage to the dura mater, recurrence of extrusion or paresthesias etc. Therefore, this operative technique cannot be considered as a single standard in the operative treatment of intervertebral disc extrusions and be used routinely. However, with strict adherence to indications and contraindications during patient selection for surgical intervention, this minimally invasive technique may allow decompression of nerve structures without excessive trauma to the human body.

disc extrusion,transforaminal endoscopic microdiscectomy.

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«Bulletin of problems biology and medicine» Issue 4 (167), 2022 year, 193-203 pages, index UDK 616-072.1:616.711-089

10.29254/2077-4214-2022-4-167-193-203