СВЯЗЬ БИОМЕХАНИЧЕСКИХ И БИОХИМИЧЕСКИХ ПАРАМЕТРОВ ПОЗВОНОЧНО-ДВИГАТЕЛЬНЫХ СЕГМЕНТОВ С РЕЦИДИВОМ ГРЫЖ ПОЯСНИЧНЫХ МЕЖПОЗВОНКОВЫХ ДИСКОВ

Abstract

Objective. To identify natural radiological parameters of degenerative spinal motion segments and biochemical changes in intervertebral disc tissues, which have a significant connection with the hernia recurrence after microdiscectomy. Material and Methods . The MRI, radiography and biochemical parameters of the nucleus pulpous and annulus fibrosus tissues from patients operated for L4–L5 and L5–S1 herniation were assessed and statistically analyzed. Two groups of patients were examined: Group I (n = 50) – with recurrent hernias, Group II (n = 50) – without recurrence during three years. Results . Significant correlation was observed between recurrent lumbar disc herniation after microdiscectomy and the following biomechanical parameters: height of the intervertebral disc (p = 0.001; r = 0.69), segmental sagittal range of motion (p = 0.001; r = 0.61), lumbar lordosis (p = 0.001, r = 0.78), stage of the intervertebral disc degeneration (p = 0.001; r = 0.46), and type of hernia (p = 0.001, r = 0.45). The quantitative and qualitative characteristics of proteoglycans/glycosaminoglycans of the nucleus pulposus and annulus fibrosus differed significantly in patients of the studied groups, but significant correlation with recurrent hernias was not found (r < 0.3). Conclusion . The preserved intervertebral disc height, hypermobility of the spinal motion segment, the smoothness of the lumbar lordosis, moderate intervertebral disc degeneration, and the disc protrusion have significant connection with the recurrence of lumbar intervertebral disc herniation after microdiscectomy.