Abstract
Objective. To analyze the effectiveness of methods for the prevention of cicatricial adhesive epiduritis (CAE) after lumbar microdiscectomy. Material and Methods . The results of treatment of 108 patients with herniated intervertebral discs at the lumbosacral level were analyzed. Cicatricial adhesive epiduritis was prevented using 4 % sodium carboxymethylcellulose gel in Group I (n = 36), by placing autograft from the internal leaf of the lumbar fascia into the space between the vertebral arches in Group II (n = 32), and prevention of CAE was not carried out in Group III (n = 40). Results. Complete examination of patients after microsurgical removal of the herniated lumbar intervertebral disc revealed cicatricial adhesive changes in the epidural space in all studied groups, though the degree of their expression was different: in Groups I and II, cicatricial adhesive epiduritis was insignificant without clinical manifestations, in Group III, clinical manifestations were observed. Conclusion. The proposed methods for prevention of cicatricial adhesive epiduritis after microsurgical treatment of herniated lumbar intervertebral disc protect the epidural space and perform a barrier function.
Highlights
Complete examination of patients after microsurgical removal of the herniated lumbar intervertebral disc revealed cicatricial adhesive changes in the epidural space in all studied groups, though the degree of their expression was different: in Groups I and II, cicatricial adhesive epiduritis was insignificant without clinical manifestations, in Group III, clinical manifestations were observed
Медиана выраженности болевого синдрома по ВАШ составила в I группе – 4 балла (Me = 4, Q1 = 3,25 и Q3 = 4), во II и III группах – 4 балла (Me = 4, Q1 = 3 и Q3 = 4)
На 10-е сут после оперативного вмешательства у пациентов всех групп отмечено достоверное снижение выраженности болевого синдрома: медиана выраженности болевого синдрома в группах, оцененного по ВАШ, на 10-е сут во всех группах составила 0 баллов (Mе = 0, Q1 = 0 и Q3 = 1)
Summary
To analyze the effectiveness of methods for the prevention of cicatricial adhesive epiduritis (CAE) after lumbar microdiscectomy. The results of treatment of 108 patients with herniated intervertebral discs at the lumbosacral level were analyzed. Complete examination of patients after microsurgical removal of the herniated lumbar intervertebral disc revealed cicatricial adhesive changes in the epidural space in all studied groups, though the degree of their expression was different: in Groups I and II, cicatricial adhesive epiduritis was insignificant without clinical manifestations, in Group III, clinical manifestations were observed. The proposed methods for prevention of cicatricial adhesive epiduritis after microsurgical treatment of herniated lumbar intervertebral disc protect the epidural space and perform a barrier function. Comparative analysis of methods to prevent cicatricial adhesive epiduritis after microdiscectomy in the lumbosacral spine.
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