Puncture laser microdiscectomy in treatment of large lumbar spinal hernias

Degree of hernia size influence on final result of PL M E in 34 patients with discogenic ne u rocompressive lumbar spin al syndrome was detected. I n medical center "Endoscopic Neurosurgery" from 2006 to 2010 w e examined and treated 34 patients with hernia size from 6 to 8 mm by CT data . Patients were from 19 to 49 years of age. Average age was 35.9 ± 1.5 years. Males – 16 (47.1%), females – 18 (52.9%). Disease duration – 5.53 ± 0.44 months with duration of last exacerbation – 1.87 ± 0.21 months. Duration of conservative therapy is 4.6 ± 2.1 weeks. During survey and objec ­ tive examination we determined pain syndrome intensity, pain location, degree of spin al static – dynamic function disorder. Neurological examination determined severity of sensory and motor disorders. Pain syndrome intensity, quality of life in patients before and after surgery, surgery effectiveness were determined by common scales: VAS, OSWESTRY, Roland - Morris, McNab. Before PLM E we evaluated preoperative spondylograms performed with functional load. Height of intervertebral fissure was determined by these images. B y SCT and MRI data w e measured hernia size, its shape and location as well as intervertebral disk dehydration degree. For PLM E performance we used neodymium laser with aluminum garnet (Dorinyer Fibertom Medilas 4060) with wave - length of 1.06 micrometers. In the next period of observation after PLM E its effectiveness was 79%, and in 3 - 5 years - 76%. At the same time it must be emphasized that 75% of patients with discogenic ne u rocompressive lumbar spin al syndrome significantly and for a long time improved their life quality avoiding more traumatic surgery. Satisfactory results with PLM use in the nearest future could be obtained in 79% of patients , in the remote term - in 76% of patients with large hernia size .