Еroshkin O. Recurrent intervertebral lumbar disc hernias: surgical treatment and prophylactics.

Dissertation is devoted to peculiarities of clinical manifestations, diagnostiсs, surgical treatment and prophylactics of true recurrent discs' hernias of lumbar spine. The research is based on results of diagnostics and surgical treatment of 171 patients, been operated in the clinic of lazer-endoscopic spine neurosurgery of SI "Institute of neurosurgery named after acad. A.P. Romodanov of Academy of Medical Sciences of Ukraine" from 1996 to 2008 because of true (ipsilateral) recurrent intervertebral discs' hernias of lumbar spine. There were 98 (57.3%) men and 73 (42.7%) women. Patients were from 18 to 80 years old.Features of disease clinical manifestation, instrumental diagnostics, depending on the methods of primary surgical treatment and type of access used (intra- or extracanal) were analyzed. Rational scheme of additional patients' examination with further data comparison enabled correct choice of treatment tactics and selection of reasonable indications for reoperation. Surgical treatment features of intervertebral discs' recurrent hernias were described. Indications for repeated surgery were clearly defined. The surgical intervention technique was described and effectiveness of different methods for intervertebral discs hernias recurrence surgical prevention was determined.The retrospective analysis of surgical treatment results at recurrent hernias of lumbar spine intervertebral discs revealed their characteristics and helped to develop practical recommendations for reoperation planning and performing