Abstract
Degenerative-dystrophic diseases of the spine are chronic diseases, often leading to limited activity in people of working age. In the modern world, this pathology is the most common disease affecting up to 90–97% of the adult population [4, 10]. According to a number of researchers, up to 90% of radiculopathies are caused by herniated intervertebral discs (HMPD) [5,17]. Therefore, one of the most significant manifestations of the degeneration process is the formation of a herniated disc, and in more than 80% of cases the pathology is detected in the lumbar region [3,9]. In our country, degenerative diseases of the spine account for up to 76% of all cases and 72% of days of temporary disability in the outpatient network, and in neurological hospitals 56% and 48%, respectively [8,11]. As a rule, patients suffering from back pain are actively working people [2, 14]. A significant duration of the disease, clinical manifestations in the form of the inability to work, move independently, serve oneself, the low efficiency of existing methods of treatment - all this leads to enormous costs for the treatment of this pathology [12, 16]. The chronic, recurrent nature of the course of HMPD, often leading to disability of patients, as well as the increase in the frequency and “rejuvenation” of this pathology observed throughout the world, puts the solution of the problems of choosing a treatment method and increasing its effectiveness to the forefront of medical science and practice [1, 15 ]. Conservative methods of treating this disease are mainly reduced to symptomatic treatment, physiotherapy and/or manual therapy, and a significant proportion of patients (19%) require surgical treatment after 1-3 months due to the ineffectiveness of conservative treatment [6, 18]. The frequency of hospitalization of patients with HMPD for surgical treatment over the past 10 years has tripled and continues to grow steadily [13]. Every year, 50% of operations in neurosurgical hospitals are performed on patients with discogenic pathology [20]. With the increase in the number of surgical interventions, the number of patients for whom the operation did not bring relief from pain and even increased the existing clinical symptoms is also growing. Severe clinical manifestations of these diseases in 70% of cases lead to temporary disability, and a significant proportion of patients become disabled [7, 19 ].