МЕТОД ПРОФИЛАКТИКИ ЭПИДУРАЛЬНОГО ФИБРОЗА ПРИ ПОЯСНИЧНОЙ МИКРОДИСКЭКТОМИИ БИОДЕГРАДИРУЕМОЙ МЕМБРАНОЙ

Abstract

Objective. Assessment of method for preventing scar adhesions after lumbar microdiscectomy using biodegradable membrane. Material and Methods. Results of surgical microdiscectomy in 90 patients aged 23 to 60 years with lumbar disc herniation were analyzed. Group I included 30 patients who underwent standard microdiscectomy with biodegradable material, Group II - 30 patients with adipose tissue autograft placed after microdiscectomy, and Group III (control) - 30 patients without any adhesion prevention. Preoperative, immediate postoperative and long-term results were evaluated based on clinical status and MRI, VAS, and Oswestry questionnaire data. Results . Average VAS score for radicular pain syndrome in the leg decreased from 7.07 ± 1.62 to 1.53 ± 0.68 at discharge, to 1.40 ± 0.50 in 6 months, and to 1.30 ± 0.50 in 1 year after surgery. Average Oswestry index was 55.80 ± 19.90 before surgery and 15.80 ± 6.40 in 6 months after surgery. Dynamics of the VAS scores demonstrates the grater reduction of pain syndrome in Group I (1.23-0.90-0.80) as compared with those in Group II and in the control group (1.23-1.20-1.10 and 1.53-1.40-1.30, respectively). Conclusion. Data of clinical status, MRI, VAS, and repeated surgical interventions allow to make assumption about safety and probable efficacy of biodegradable material in the prevention of periradicular fibrosis.