[EXPERIENCE WITH ENDOSCOPIC TRANSFORAMINAL MICRODISKECTOMY IN THE TREATMENT OF HERNIAS OF INTERVERTEBRAL DISCS OF THE LUMBAR SPINE].

The aim of the study is to evaluate the effectiveness of transforaminal endoscopic microdiscectomy in patients with herniated intervertebral discs at the L3 - S1 level of the lumbar spine. A retrospective analysis of the treatment of 468 patients with hernias of intervertebral discs of the lumbar spine was conducted, of them: 262 patients were treated in the Rivne Regional Clinical Hospital; 206 patients in the spinal surgery department of the State Institution "Institute of Traumatology and Orthopedics of the National Academy Medical Sciences of Ukraine". The study was conducted in the period from April 2016 to January 2019. In the preoperative period, all patients underwent an MRI or CT scan - examination of the lumbar spine, functional radiographs, and general clinical examinations were performed. According to the results of studies in the postoperative period, a significant improvement in the quality of life of the operated patients was revealed in accordance with the Oswestry Disability Index (the average for the group was 35,9%, which corresponds to a good result). There was a positive dynamics of pain in VAS (in the preoperative period - 8,8 ± 0,7 points; 6 months after the operation - 1,2 ± 0,5 points, with a predominance of lumbodynia and with an almost complete absence of radicular syndrome). In 28 (6,0%) patients, a hernia recurred within 6 months, however, in the remaining 440 (94,1%) patients, positive results of neurological symptoms were observed in dynamics. The obtained results confirm the high efficiency of ETD and the low risk of postoperative complications.

[COMPARATIVE CHARACTERISTICS OF OPEN AND TRANSFORAMINAL ENDOSCOPIC DISCECTOMY IN THE TREATMENT OF HERNIATED DISCS].

Open lumbar discectomy was considered the gold standard among surgical methods for the treatment of hernias, however, due to technological progress in endoscopy and improved surgical approaches, a transforaminal discectomy technique has been developed that can reduce tissue trauma and reduce the risk of postoperative complications. The aim of the study was to evaluate the results of surgical treatment of hernias of the intervertebral discs with transforaminal endoscopic discectomy, and compare them with the results of a conventional open microdisectomy. From 2014 to 2019, out of 298 examined, 146 patients underwent transforaminal endoscopic discectomy and 152 patients underwent open microdiscectomy. Clinical results were evaluated using the Visual Analogue Pain Scale and the Oswestry Disability Index. Long-term results were evaluated based on the modified Macnab criteria. Patients who underwent transforaminal endoscopic discectomy showed shorter periods of return to working capacity and a hospital stay, which is associated with a shorter operation time and less tissue trauma compared to the group in which open microdiscectomy was performed. Our data showed that transforaminal endoscopic discectomy can provide the typical benefits of minimally invasive surgery, including: reducing the time of surgery, the time spent in the hospital, restoring disability, as well as reducing the use of painkillers.