Results of treatment of herniated lumbar intervertebral discs, clinical and neurological aspects

Recently, there has been a significant trend in the views of researchers and practitioners on the pathogenesis, course, and biochemical changes in the elements of the spinal cord and ligamentous apparatus that occur in osteochondrosis. This is due to the new opportunities that have opened up thanks to the advent of computed tomography (CT) and magnetic resonance imaging (MRI) in the arsenal of diagnostic tools. With the introduction of CT and MRI, the reliability of information increased to 82-93%. The aim of the study: to improve the diagnosis and increase the effectiveness of surgical treatment of patients with disc hernias in the lumbar spine by studying the relationship of clinical manifestations and the results of the applied research and treatment methods. Materials and methods. The work includes the results of data analysis of a complex of clinical, diagnostic examinations and surgical treatment of 120 patients with neurological complications of herniated lumbar intervertebral discs and received inpatient (operative - 97 (80,8%) and conservative – 23 (19,2) patients) in neurosurgery departments. Results. By using a highly informative MRI method, the dependence of the severity of pain syndrome and sensitive disorders on the number of levels of disc damage, their localization in the diameter of the spinal canal and their size was determined. The severity of pain and sensory disorders depended on the number of prolapsed discs. Moreover, the greater the number of intervertebral discs affected by the degenerative-dystrophic process, the greater the likelihood of a pronounced and pronounced pain syndrome. Conclusion. The most informative method of radiation diagnosis of degenerative-dystrophic processes in the intervertebral discs of the lumbar spine is magnetic resonance imaging, which allows you to identify the number, location and size of herniated protrusions. The optimal algorithm for examining patients before deciding on neurosurgical intervention for herniated lumbar intervertebral discs includes radiography of the lumbar spine, MRI of the spinal cord and spinal column, and, if indicated, magnetic resonance myelography