RECURRENT DISC HERNIATION AFTER LUMBAR MICRODISCECTOMY

DOI: https://doi.org/10.29296/25877305-2021-07-04
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Issue: 
7
Year: 
2021

A. Yarikov(1, 2), Candidate of Medical Sciences; Professor O. Perlmutter(2), MD; I. Smirnov(2);
A. Boyarshinov(2); A. Simonov(2), Candidate of Medical Sciences; Professor A. Fraerman(2), MD; A. Sosnin(1),
Candidate of Medical Sciences; A. Kalinkin(3), Candidate of Medical Sciences; S. Pardaev(4), Candidate of
Medical Science (1)Volga District Medical Center, Federal Biomedical Agency of Russia, Nizhny Novgorod
(2)City Clinical Hospital Thirty-Nine, Nizhny Novgorod (3)Federal Research and Clinical Center, Federal
Biomedical Agency of Russia, Moscow (4)Samarkand Branch, Republican Specialized Research and Practical
Medical Center of Traumatology and Orthopedics, Samarkand, Uzbekistan

Degenerative-dystrophic diseases of the spine are the main cause of temporary disability of young people. The number of microdiscectomies performed worldwide is increasing every year. Recurrence of a herniated disc occurs according to different authors with a frequency of 5–26%. The aim of the work is to identify risk factors for the development of recurrent herniated disc. Materials and methods. The analysis of modern sources of literature presented in the databases PubMed, eLibrary, CyberLeninka and Cochrane is carried out. Results. Recurrent herniated disc is the cause of persistent pain, neurological symptoms and disability. Scientific research in this area is currently attracting more and more attention of vertebrologists and neurosurgeons. The paper presents the views of various researchers on the concept of «relapse» and methods of diagnosis of this pathology. Risk factors for the development of recurrent herniated disc: modifiable and unmodified are described in detail and discussed. The article focuses on the methods of intraoperative and postoperative prevention of hernia recurrence. Described mechanical methods of closing defects in the annulus after the microdiscectomy. Conclusion. The causes of recurrent hernias and potential options for their prevention are still being studied in modern vertebrology. Spinal surgeons provide consistent information about the relapse rate depending on gender, body mass index, age, intervertebral disc height, degree of intervertebral disc degeneration, smoking, microdiscectomy technique, and traumatic history. Among the methods of preventing relapse, recommendations for corsetotherapy, lifestyle correction, abandonment of bad habits, normalization of body weight and regular exercise are more often discussed.
Keywords: 
vertebrology
surgery
recurrent disc herniation
microdiscectomy
аnnuloplasty
fibrotic ring defect
lumbar discectomy

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