Современные стратегии лечения дегенеративно-дистрофических заболеваний позвоночника: Обзор литературы

Abstract

Currently, there is a wide range of methods for the treatment of herniated intervertebral disc, such as: conservative treatment, the use of epidural injections, therapeutic spinal blockades, methods of molecular therapy and genetic engineering, various methods of surgical treatment.The purpose of this review is to study the currently existing treatment methods for degenerative diseases of the spine, including their advantages and disadvantages.Level I studies have shown the advantages of surgical treatment methods. In the application of the surgical approach, there is currently a wide range of techniques (minimally invasive surgeries using endoscopy, interbody spondylodesis using various grafts and cages, including those using cellular technologies), which also complicates the task of choosing a particular treatment tactic. Surgical treatment options for intervertebral disc disease are controversial, with a medium- to low-quality evidence base supporting each modality: decompression, discectomy, spondylodesis formation, and interbody disc replacement. Surgical interventions carry certain risks and complications and should be offered after conservative measures have failed to improve the patient's quality of life. In general, the goal of all types of spinal surgeries for the pathology under study is to provide definitive treatment to the patient for long-term pain relief, reduce the incidence of complications and reoperations, and ensure good patient satisfaction. Recent advances in regenerative and reconstructive treatment strategies for degenerative-dystrophic spine diseases in molecular science in the areas of cell, gene therapy and intervertebral disc growth factor therapy are evolving in the hope of disc repair and regeneration, have some challenges but also show promising results. Surgery is the last option, with the choice of surgical treatment tactics being a matter of debate among physicians.Keywords: degenerative-dystrophic diseases of the spine, interbody fusion, cage, lumbar spine, treatment.