Issue: 2022, Vol. 27, No. 2

А. B. Тalanov, А. Yu. Gogolev, N. А. Balandin

CLINICO-SURGICAL PECULIARITIES OF DEGENERATIVE LESIONS OF LUMBAR SPINE IN YOUNG PATIENTS

Keywords

spine degenerative lesions, intervertebral disk degeneration, intervertebral disc hernias, spinal pain, microdiscectomy, osteochondrosis

Abstarct

Objective – to optimize the approaches to the treatment of patients with spine degenerative lesions (SDL). Мaterial and methods. Patients with lumbar spine pain syndrome (PS) aged 25 years and younger were enrolled in the study; they were treated at spinal neurosurgical unit of Ivanovo regional clinical hospital in the period from January 2017 to August 2019. 19 patients (14 men and 5 women, average age – 22,2 ± 2,3 years) composed the basic group. The comparison group was formed by random selection of 25 patients who were treated at the same period of time (15 men and 10 women, average age – 45,1 ± 11,1 years). Demographic features, type of labor activity, PS duration and its connection with physical load, presence of sensitive and motor disorders, size and peculiarities of intervertebral hernias location, results of the treatment after one week and one year after the operation were estimated. Parametric and nonparametric statistical methods were used, and distinctions were considered to be significant at p< 0,05. Results and discussion. The basic group contained less patients engaged in physical labor in comparison with control group (21 and 56 % respectively, p < 0,05), and those patients who had increased physical load (21 and 64 %, p < 0,01). Central hernias were determined in patients of basic group (n = 5), there were no such hernias in the comparison group (p < 0,01), reflex disorders were registered less often (in 26 and 80 % respectively, p < 0,001). Central hernias were located at L5-S1 level and were accompanied by sensitivity disorders, decrease of force and reflexes. None of patients with central hernias was engaged in physical labor and referred to physical load as the cause of disease. Other features of the groups including the results of the treatment did not differ statistically. Conclusion. Mechanisms which were not connected with physical load played the dominative role in SDL pathogenesis in young age. The differentiated approach in the selection of surgical method of treatment in young patients was proved to be the most justified with due regard to complexity of pathogenesis, differences in hernias localization and clinic of lesions.

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