Вісник проблем біології і медицини, Випуск 1 (168)
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Перегляд Вісник проблем біології і медицини, Випуск 1 (168) за Автор "Dushnyi, M. M."
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Документ Lumbar foraminal stenosis (review article)(Полтавський державний медичний університет, 2023) Piontkovskyi, V. K.; Zlativ, V. P.; Myronyk, B. M.; Dushnyi, M. M.; Піонтковський, В. К.; Златів, В. П.; Мироник, Б. М.; Душний, М. М.Foraminal lumbar spinal stenosis has been a social problem relevant for many decades. This pathology usually arises due to degenerative-dystrophic diseases of the spine. It is characterized by a pathological reduction of the intervertebral foramen through which the nerve root of the corresponding segment exits. We conducted a review of the literature on the problems of foraminal stenosis and the methods of its treatment. Knowledge of the anatomy and pathogenesis of this nosology is significant for determining treatment tactics and the scope of surgical intervention. Causes of foraminal stenosis can be both congenital and acquired conditions. The most common are degenerative phenomena of the arcuate joint and intervertebral disc, spondylolisthesis, scoliosis, and intervertebral disc extrusion. The main link of the pathogenesis is the instability of the vertebral-movable segment, which leads to subluxation of the upper articular process and the development of hypertrophy of the arcuate joint. The primary treatment method is conservative therapy, which includes non-steroidal anti-inflammatory drugs, gabapentin and vitamin preparations. However, in the absence of a clinical effect, blockade of steroid drugs or placement of an epidural catheter is indicated. Endoscopic foramenotomy and laminectomy through translaminar access are promising directions of operative surgical techniques. Due to their minimal trauma, small intraoperative blood loss, and early rehabilitation, these techniques are gaining wide popularity among spinal surgeons. It is worth noting that with these techniques, setting up a cage and stabilizing the vertebral-movable segment minimally invasively is possible. Open-type operations lose their relevance due to high trauma; however, in the presence of concomitant central stenosis, spondylolisthesis, and degenerative scoliosis, there is a need for their use.