Furman A. Differentiated surgical treatment of discogenic neurocompression syndromes at multiple cervical hernia spine

The dissertation is devoted to the study of the effectiveness and justification of differentiated surgical tactics for multiple hernias of the cervical spine. The results of a comprehensive examination and treatment of 208 patients treated in Department of Minimally Invasive Laser Spinal Neurosurgery of SI "Institute of Neurosurgery named after A.P. Romodanov NAMS of Ukraine" from 1997 to 2016 were analyzed. Among patients involved in the study, men were 112 (53.8%), and women - 96 (46.2%). 118 (56.7%) of young patients, 76.6 (36.6%) - middle-aged patients, 14 (6.7%) of elderly patients. Depending on the choice of surgical procedure, all patients were divided into 3 main groups: 1 group - 79 (37,9%) - patients who had surgical treatment of intervertebral disc herniation using puncture techniques, 2 groups - 84 (40,4 %) - patients with open surgical treatment of the intervertebral disc herniation with subsequent installation of a cage, 3 groups - 45 (21,7%) - patients who had been treated with combined surgical treatment, namely: 8 patients undergoing puncture laser microdiskectomy in combination with open A microdiskectomy with the establishment of an intercellular cage at the adjacent level, 15 patients who performed a puncture laser microdiskectomy in combination with an endoscopic portal microdiskectomy, 22 patients, who performed an open microdiskectomy with the establishment of an intercostal cage in combination with a fenestration of the intervertebral disc at adjacent levels. Clinico-neurological manifestations of the disease are compared with the data of neuroimaging study methods, which allowed to optimize the indications for the differentiated use of various surgical techniques. The methodology of differentiated application of various surgical interventions in patients with multiple hernias of the cervical spine is substantiated.