Современные стратегии лечения дегенеративно-дистрофических заболеваний позвоночника: Обзор литературы
DOI:
https://doi.org/10.52889/1684-9280-2024-1-71-41-49Ключевые слова:
дегенеративно-дистрофические заболевания позвоночника, межтеловой спондилодез, кейдж, поясничный отдел позвоночника, лечениеАннотация
В настоящее время существует большой выбор методов лечения грыжи межпозвонкового диска, такие как:
консервативное лечение, применение эпидуральных инъекций, лечебных блокад позвоночника, методов молекулярной терапии и генной инженерии, различные методы оперативного лечения.
Цель данного обзора заключается в изучении существующих на сегодняшний день методов лечения дегенеративно дистрофических заболеваний позвоночника, в том числе их преимуществ и недостатков.
Исследования I уровня доказательности показали преимущества хирургических методов лечения. В применении
хирургического подхода на сегодняшний день существует большой выбор методик (малоинвазивные операции с использованием эндоскопии, межтеловой спондилодез с использованием различных трансплантатов и кейджей, в том числе с применением клеточных технологий), что также осложняет задачу выбора определенной тактики лечения. Варианты хирургического лечения заболеваний межпозвоночных дисков противоречивы, при этом доказательная база среднего и низкого качества поддерживает каждый из методов: декомпрессию, дискэктомию, формирование спондилодеза и замену межпозвоночных дисков. Хирургические вмешательства сопряжены с определенными рисками и осложнениями, поэтому их следует предлагать после того, как консервативные меры не смогли улучшить качество жизни пациента.
Последние достижения в области восстановительных и реконструктивных стратегий лечения дегенеративно дистрофических заболеваний позвоночника в молекулярной науке в области клеточной, генной терапии и терапии факторами роста межпозвоночных дисков развиваются в надежде на восстановление и регенерацию диска, имеют определенные трудности, но также показывают многообещающие результаты. Хирургическое вмешательство является последним вариантом, при этом выбор тактики хирургического лечения является предметом дебатов среди врачей.
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