Pichkar I. Grounding the Application of Diode Laser at Treatment of Protrusion and Non-sequestered Hernias of Intervertebral Discs (experimentally-clinical research)

Object: degenerative changes in intervertebral disc tissues and their regeneration under the influence of high intensity laser radiation with a wavelength of 940 nm. Aim: to develop in the experiment and implement into the clinical practice the method of treating patients with protrusions and non-sequestered slipped discs using high intensity laser radiation with a wavelength of 940 nm. Methods: clinical, radiological, experimental modelling, histological, statistical. For the first time, based on morphological analysis, features of the structure of intervertebral discs of experimental rats have been revealed after using the diode laser of high intensity radiation with a wavelength of 940 nm under conditions of use of different modes of work and examination periods. It has been proved, that vaporization of intervertebral disc results in replacement of damaged structures with connecting and cartilageous tissues, which is accompanied with the formation of fibro-cartilage symphysis. For the first time it has been found, that increasing the power of laser radiation causes the formation of cell destruction without manifestations of reparations in fibro-cartilaginous areas, which in turn negatively affects particular results of treatment. For the first time the advantages of use of laser radiation with a wavelength of 940 nm and capacity of 6 W for the treatment of hernias and protrusions of intervertebral discs have been grounded and experimentally proved. In clinical settings for the first time the effectiveness of percutaneous laser vaporization has been proved with diode laser radiation with a length of 940 nm and wave capacity of 6 W and a one-time exposure 5s and the total energy of radiation of 180-600 joules for the treatment of patients with hernias and protrusions of intervertebral discs. Based on experimental research the new technology of treatment the patients with protrusion and hernias of intervertebral discs using high intensive diode laser radiation with wavelength 940 nm and power of 6 Wt have been grounded and developed and its effectiveness have been proved. The research results have been implemented into the learning process at the Department of General Surgery, Traumatology and Orthopedics, Operative Surgery and Forensic Medicine of the Higher Educational Establishment "Uzhgorod National University", at the Department of Traumatology, Orthopaedics and Neurosurgery of the Higher Educational Establishment "Bukovyna State Medical University", at the Department of Traumatology, Orthopaedics and of Ivano Frankivsk National Medical University, at the Department of Orthopedics and Traumatology of Dnipropetrovsk State Medical Academy. The research results have been implemented into the clinical practice at the institute of "Injuries" of the Higher Educational Establishment "Uzhgorod National University," at the Department of Traumatology and Orthopedics of "Chernivtsi Oblast Clinical Hospital", at the Department of Orthopedics and Microsurgery of Transcarpathian Oblast Clinical Hospital named after A.Nowak, at the Department of Orthopedics of Kharkiv Oblast Clinical Trauma Hospital. Traumatology and orthopaedy.