DEFINITION AND DIAGNOSTIC CRITERIA FOR SEGMENTAL INSTABILITY OF THE LUMBOSACRAL SPINE (LITERATURE REVIEW)

Introduction. According to the world literature, from 60% to 80% of the population experience pain of varying intensity in the lower back against the background of dorsopathy, with manifestations of unstable spinal segments reaching 45%, and pain of a discogenic nature against the background of unstable segments of the lumbosacral spine occurs in every seventh patient older than 30 years. According to literature data, damage to the ligamentous apparatus in the case of lumbar instability accounts for 39.5% of all manifestations of instability, a pathological process based on the mechanical displacement of the vertebrae relative to each other, which is accompanied by pain syndrome in the lumbar spine. An increase in the range of motion in the spinal motor segment without pathological displacement is also considered as a manifestation of instability. Aim. To highlight and analyze modern approaches to the definition of segmental instability of the lumbosacral spine in degenerative-dystrophic diseases of the spine. Materials and methods. Search, selection and analysis of modern publications, systematic reviews using PubMed and Google Scholar databases. Results. An in-depth analysis of modern literature was carried out with the aim of defining the concept of segmental instability, analysis of modern approaches to the classification of segmental instability of the lumbosacral spine in degenerative-dystrophic diseases of the spine. We have identified a list of the main modern neuroimaging methods used in the diagnosis of an unstable spinal motor segment and an analysis of the most common provocative tests used in the diagnosis of instability. The presence of inconsistencies between the data of instrumental examinations, patient complaints, the little-studied pain syndrome with instability of the lumbar spine indicates the need for a more detailed study of segmental instability of the lumbosacral spine as a whole. Conclusions. When conducting an in-depth content analysis, we found that diagnostic tests can effectively detect the pathology of the lumbar spine, and the complex of diagnostic tests with low back pain syndrome is caused by the instability of the lumbosacral spine.