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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Annals of Clinical and Experimental Neurology</journal-id><journal-title-group><journal-title xml:lang="en">Annals of Clinical and Experimental Neurology</journal-title><trans-title-group xml:lang="ru"><trans-title>Анналы клинической и экспериментальной неврологии</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2075-5473</issn><issn publication-format="electronic">2409-2533</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">538</article-id><article-id pub-id-type="doi">10.25692/ACEN.2018.3.8</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Unknown</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Surgical methods of treatment of back pain syndrome recurrence in the degenerative pathology of the lumbar spine</article-title><trans-title-group xml:lang="ru"><trans-title>Хирургические методы лечения рецидива болевого синдрома при дегенеративной патологии поясничного отдела позвоночника</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Shnyakin</surname><given-names>Pavel G.</given-names></name><name xml:lang="ru"><surname>Шнякин</surname><given-names>Павел Геннадьевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>doktor_anton@rambler.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Botov</surname><given-names>Anton V.</given-names></name><name xml:lang="ru"><surname>Ботов</surname><given-names>Антон Витальевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>doktor_anton@rambler.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Amelchenko</surname><given-names>Andrey A.</given-names></name><name xml:lang="ru"><surname>Амельченко</surname><given-names>Андрей Андреевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>doktor_anton@rambler.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Красноярский государственный медицинский университет имени проф. В.Ф. Войно-Ясенецкого»</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Regional Clinical Hospital</institution></aff><aff><institution xml:lang="ru">КГБУЗ «Краевая клиническая больница»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2018-10-05" publication-format="electronic"><day>05</day><month>10</month><year>2018</year></pub-date><volume>12</volume><issue>3</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>61</fpage><lpage>68</lpage><history><date date-type="received" iso-8601-date="2018-10-08"><day>08</day><month>10</month><year>2018</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2018, Shnyakin P.G., Botov A.V., Amelchenko A.A.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2018, Shnyakin P.G., Botov A.V., Amelchenko A.A.</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="en">Shnyakin P.G., Botov A.V., Amelchenko A.A.</copyright-holder><copyright-holder xml:lang="ru">Shnyakin P.G., Botov A.V., Amelchenko A.A.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://annaly-nevrologii.com/pathID/article/view/538">https://annaly-nevrologii.com/pathID/article/view/538</self-uri><abstract xml:lang="en"><p>The number of surgical interventions on the lumbar spine is constantly growing due to the emergence of new surgical techniques aimed at treatment of degenerative spine pathology and a large number of patients, suffering from the back pain. Quite often, surgical intervention turns to be not effective enough and the pain syndrome persists, leading to the necessity for the repeated revision surgeries with the use of stabilizing systems. The review represents research data on the causes of recurrent-remitting course of degenerative process, problems of epidural adhesion as one of the back pain syndrome predictors, the survey of various stabilization systems and operative approaches for their implantation. The disadvantages and advantages of ventral approach with the use of interbody fusion are summarized in comparison with dorsal approach used for the installation of the transpedicular system and interbody fusion with a bone graft.</p> <p>The positive features of interbody fusion from anterior retroperitoneal approach include the ability to quickly and completely remove the entire disc, decompress the dural sac without entering the vertebral canal, optimally select an implant corresponding to the size of the vertebral end plates, creation of the optimal lordosis angle, and provision of the shortest approach to the operated disk and to the place of neural structures compression.</p> <p>The advantages of the dorsal approach with transpedicular system implantation and interbody fusion with a bone graft are better visualization of neural structures in comparison with discectomy from the ventral approach, the possibility of wide decompression and expansion of the extent of operation, the possibility of ablation of the facet joints by diathermocoagulation after the surgical wound was made, the reliability of posterior fixation, and familial approaches for a neurosurgeon with a lesser duration of training.</p></abstract><trans-abstract xml:lang="ru"><p>Количество операций на поясничном отделе позвоночника постоянно растет в связи с появлением новых методов хирургического лечения дегенеративной патологии позвоночника и большим количеством пациентов с болевым синдромом в пояснице. Часто хирургическое вмешательство оказывается недостаточно эффективным, и болевой синдром сохраняется, что приводит к необходимости повторных ревизионных операций с применением стабилизирующих систем. В обзоре представлены данные научных исследований о причинах рецидивирующего течения дегенеративного процесса, описаны проблемы рубцово-спаечного эпидурита как одного из предикторов болевого синдрома, результаты использования различных систем стабилизации и доступов для их имплантации, обобщены недостатки и преимущества вентрального доступа с использованием межтелового эндопротезирования в сравнении с дорсальным доступом для установки транспедикулярной системы и межтелового корпородеза.</p> <p>К положительным сторонам межтелового протезирования из переднего забрюшинного доступа относятся возможность быстрого и полного удаления всего диска, декомпрессии дурального мешка без вхождения в позвоночный канал, оптимальный подбор импланта, соответствующего размеру замыкательных пластинок позвонков, создание оптимального угла лордоза, обеспечение кратчайшего подхода к оперируемому диску и точке компрессии невральных структур. Преимуществом дорсального доступа с имплантацией транспедикулярной системы и межтелового корпородеза являются лучшая визуализация невральных структур в сравнении с дискэктомией при вентральном доступе, возможность широкой декомпрессии, расширения объема операции и абляции фасеточных суставов диатермокоагуляцией на этапе доступа, надежность задней фиксации. Этот доступ привычен для нейрохирурга и требует меньшей длительности обучения.</p></trans-abstract><kwd-group xml:lang="en"><kwd>Surgical methods of treatment of back pain syndrome recurrence in the degenerative pathology of the lumbar spine</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>протезирование межпозвонкового диска</kwd><kwd>транспедикулярная фиксация</kwd><kwd>рецидив грыжи диска</kwd><kwd>рецидив болевого синдрома</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><citation-alternatives><mixed-citation xml:lang="en">Bykova E.V. 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