Treatment of a herniated disc and stenosed holes - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Neurosurgery

osteochondrosis , degenerative-dystrophic pathology of the spine, herniated disc, spinal stenosis - a very common diagnosis at the moment.The development of diagnostic methods allow to determine the cause of pain in the spine.

Spinal Canal Stenosis - narrowing - often develops as a degenerative-dystrophic process - a deforming spondylosis, spondylarthritis, hypertrophy and hardening of ligaments, herniated discs.Possible congenital stenosis - anatomical feature of the human and acquired - posttraumatic, against the background of ankylosing spondylitis, spinal tuberculosis.Herniated discs are a manifestation of degenerative changes of the spine vertebral-motor segment.The clinical development of the disease is important is not the fact of having a hernia, and its size, location - that is, its role in root compression, spinal cord, and the development of radiculopathy, radikulomielopatii.Spinal Canal Stenosis and foramenalnyh holes may be the cause of pain only in the presence of compression of the co

ntents - the neuro-vascular structures.

for diagnosis is carried out X-ray study, CT and magnetic resonance imaging, electroneurogram, as well as the exclusion of somatic pathology as a possible cause of pain at this level.

Conservative treatment of vertebral pathologies - a drug treatment - nonsteroidal anti-inflammatory drugs, muscle relaxants, cardiovascular drugs, vitamins, pyrimidine nucleotides, gabapentin ... physiotherapy, manual therapy, traction, spa treatment.

The need neurosurgical treatment determined by the doctor.Long lasting pain, radicular syndrome in the presence of disc herniation, compressing the nerve root stenosis foramenalnogo holes in the presence of radiculopathy clinic ..., lack of effect of conservative treatment.


use of minimally invasive treatments for spinal diseases, the presence of ultra-compact Micro, advanced catheters, lasers, endoscopes, and many other high-tech tools to minimize surgical intervention and to make the operation safer, less traumatic, less prolonged.Modern techniques - a percutaneous endoscopic Nucleotomy, Nucleotomy microscopic, microscopic laminectomy, intervertebral disc prosthesis, percutaneous thermocoagulation, cryotherapy intervertebral joints, minimally invasive stabilization of the intervertebral segment microscopic decompression of spinal canal stenosis.

on the method and scope of the operation will depend on the method of anesthesia, and length of hospital stay, and subsequent rehabilitation, and terms of disability.

volume surgical treatment determines the neurosurgeon: decompressive laminectomy, discectomy - removal (resection) of structures by passing the nerve root decompression laminectomy combined with stabilizing operations interspinous dynamic fixation, the use of stabilizing systems, laser microdiskectomy, endoscopic surgery ...

for minimally invasive neurosurgerytreatment of a herniated disc and stenosed holes at all levels of the spine using spinoskop.

Endoscopic surgery allows the tool motion control in all directions, provides a bend angle of 90 degrees, provides access to the disc L5-S1, inside and vnediskovy control, disc hernia removal by laser or mechanical forceps, perform decompression with the opening of the stenotic opening -foramenoplastika.

Microdiscectomy (mostly L4-L5, L5-S1) is performed in the supine position, under intravenous anesthesia.Produce skin incision and fascia over the spinous processes of L4-L5, Department of paravertebral muscles from the arches and spinous processes, opening yellow ligament, the detection of hernia, isolation and displacement root medially, the dissection of the fibrous ring, removal of herniation, hemostasis, layer by layer closure of the soft tissues, imposeaseptic bandage.Duration interference 20 - 60 minutes.A stay in the hospital up to 7 days.Further rehabilitation is carried out by neurologists.

percutaneous laser decompression is performed under local anesthesia, the operation of short duration, and nerve tissue damage is practically impossible, the scar is practically not formed.Energy Laser "evaporates" part of the intervertebral disc nucleus pulposus, leading to their reduction and removal of compression of the surrounding tissue.Staying in the hospital 1-3 days.

Spiral Nucleotomy - performed under local anesthesia and X-ray control, without cutting the skin.The herniated disc inserted thin hollow needle, a needle is inserted into the spiral.Spinning it captures particles "fallen" drive and makes them necessary decompression occurs.Duration of treatment - 15 - 30 minutes.The surrounding tissue is not damaged.Perhaps outpatient procedure.

Of course, the choice of treatment method is set to accurate diagnosis, clinical specialty, its equipment with modern equipment and qualified specialists - neurosurgeons.

Endoscopic discectomy using a laser

neurologist Kobzev SV