THE HISTORY OF THE SURGICAL TREATMENT OF DEGENERATIVE-DYSTROPHIC DISEASES OF THE LUMBAR SPINE

Throughout the world, back pain affects a large part of the population. Degenerative-dystrophic diseases of the spine are one of the most important problems of modern medicine. The share of this disease affecting people in the most active social group is from 20% to 80% of cases of temporary disability.
The goal is to present the history of the development of surgical methods for the treatment of degenerative diseases of the spine.
Materials and methods. The literature presented in the PubMed, eLibrary and Cochrane databases is analyzed.
Results. This paper describes all types of surgical interventions used for degenerative diseases of the lumbar spine: decompressive, decompressive-stabilizing and reconstructive-stabilizing. The indications for each of the methods of operative aid are described. The results of decompressive interventions were compared: microsurgical, tubular and endoscopic microdiscectomies. Modern approaches to the lumbar spine are described and compared: PLIF, TLIF, XLIF, ALIF. Further, the paper describes the basic principles of reconstructive and stabilizing operations: measurement of vertebral-pelvic ratios, classification of vertebrotomies.
Conclusion. Endoscopic spine surgery is a prerogative in the treatment of degenerative diseases of the lumbar spine due to a shorter stay in the clinic, less tissue trauma, lower use of analgesics and rapid recovery. Decompression-stabilizing operations are currently used in patients without violation of the sagittal and frontal balances. The choice of the method of fixation (back, front or a combination of them) should depend on the experience of the clinic, the skills of the surgeon and the anatomical features of the patient. Vertebrotomies are performed only when there is a violation of the sagittal and frontal balance.

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