Аналіз результатів лікування гриж міжхребцевих дисків поперекового відділу хребта, які супроводжуються нестабільністю опорно-рухового сегмента, різними хірургічними технологіями

Aim. To compare the outcomes of surgical treatment using open and endoscopic techniques for patients with lumbar disc herniation complicated with segmental instability. Materials and methods. The study analyzed the results of surgical treatment in 96 patients who underwent surgery for lumbar intervertebral disc herniation associated with segmental instability. All the patients were treated in the Department of Minimally Invasive and Laser Neurosurgery at the State Institution “Romodanov Neurosurgery Institute, National Academy of Medical Sciences of Ukraine” (Kyiv) and at the Medical Center “Endoclinic” (Rivne) from 2021 to 2024. Results. In patients who underwent intralaminar hernia removal with a subsequent transpedicular system fixation, pain was reduced from 10.80 ± 1.40 to 4.50 ± 1.40 points in the early postoperative period, to 2.20 ± 0.80 points after 6 months, and to 1.80 ± 0.23 points after 1 year. According to the McBurney scale, positive results were achieved in 93.02 % of cases. As defined by the NPS, in patients who underwent endoscopic techniques, the pain syndrome regressed from 10.20 ± 0.19 to 2.56 ± 0.09 points in the early postoperative period, to 1.12 ± 0.10 points after 6 months, and to 0.50 ± 0.03 points after 1 year. In the endoscopic group, a decrease in the mean blood loss and average operation time was attained (130.0 ± 0.5 ml, 2.0 ± 0.7 hours), in contrast to the group with intralaminar removing the herniated disc followed by the transpedicular system fixation (260.0 ± 0.3 ml, 3.0 ± 0.5 hours). Thus, modern UBE-TLIF surgical technologies have certain advantages compared to traditional techniques and can be recommended for greater use. Conclusions. The use of endoscopic surgical interventions for patients with lumbar intervertebral disc herniation complicated by segmental instability allows for minimal surgical trauma, reduced blood loss, a shorter hospital stay, lower risk of postoperative complications, and significantly shortened rehabilitation time.