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YKpaiHCbKuu neupoxipypziunuu mypnaa, №3, 2007
Pe3y^bTaTM ..iKyBaHHJi Ta oцiнкa HKOCTi WHTTa y xbopmx nic.H Bi^KpMTo'i nonepeKOBo'i Miipo^MCKeKTOMii
rydaK n. C., Turn I.I.
TepnoniMCbKuu depxaenuu Meduunuu ynieepcumem iM. I. H. rop6aueecbKozo, TepnoniMCbKa o6aacna KoMynaabna KMniuna MKapna., 46001, m. Tepnoniab, eya. Kainiuna, 1, mea. po6. 8 (0352) 52-72-89, mea. mo6. 8(095) 330-30-60, e-mail: [email protected]
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OUR EXPERIENCE IN THE SURGICAL TREATMENT OF THE LUMBAR DISC HERNIA
Guranda Viorel, Deliu Constantin
Clinical Municipal Hospital of Balti, Neurosurgical Department, Republic of Moldova, 3100 Balti, Decebal street 101, Tel.: 0 373 690 55329, fax: 0 373 231 72703, , viorel_guranda@mail. ru
THE AIM OF THE STUDY. The present work has the analysis of the personal experience in the surgical treatment of the lumbar disc hernia for an object, which is accomplished in order to improve the quality and the results of the ulterior treatment.
THE MATERIAL AND THE METHODS OF THE INVESTIGATION. There have been analyzed 83 fully examined cases of the lumbar disc hernia that have undergone the surgical treatment within the neuro-surgical service CMH Balti in the period of the years 2005—2006.
THE RESULTS AND THE DISCUSSIONS. In the study there have been included 83 patients with lumbar disc hernia, 39 of which (46 %) are men and 44 (53 %) are women.
The incidence of the patience according to the age is: 10—20 years old 1 (1 %); 21—30 years old 4 (4 %); 31—40 years old 31 (37 %); 41—50 years old 24 (28 %); 51—60 years old 17 (20 %); 61—70 years old 6 (7 %).
At admission a series of patients displayed motor deficiency: 3 (3 %) patients had minor paresis, 1 (1 %) patient had moderate paresis and 2 (2%) patients had a severe paresis of the foot. In the case of 3 (3 %) patients there has been detected an inferior paraparesis of different degrees of intensity.
The lumbar imaging CT/MRI showed the following levels: L3 in 2 (2 %) cases; L4 in 28 (33 %) cases; L5 in 42 (50 %) cases; 2 levels L4 and L5 in 11 (13 %) cases.
The indications for the surgical treatment were: the persistent radicular algetic syndrome and clear signs of extrusion of pulp nucleus according to the data of the lumbar CT/MRI.
Three (3 %) patients have been promptly operated and 80 (96 %) patients have been operated according to schedule. We have given the priority to the ventral position, 50 patients been operated in the ventral position (60 %) and in lateral decubitus — 33 (39 %) patients. In order to treat the lumbar intervertebral disc we have used the following methods: interlaminar — 15 (18 %) cases; interlaminar-interapophysary — 68 (81 %) cases; discectomy with posterior stabilization has been effectuated in 2 (2 %) cases.
Reintervention in time has occurred in 1 (1 %) case, the patients was anteriorly operated in 1992, 1998.
CONCLUSION. This work is the result of the personal experience and constitutes an argument in favour of the surgical intervention from which only the perfectly examined patients must benefit. The examin ation must be completed with a thorough paraclinical exploration in accordance with the possibilities of the service.
