Suvremeni pristup liječenju lumboischialgije minimalno invanzivnim metodama

master's thesis

• Title (english): Modern approach to treatment of sciatic pain using minimally invasive spine procedures
• Author: Kristina Detković
• Mentor: Miroslav Vukić (mentor)
• Committee member: Goran Mrak (predsjednik povjerenstva)
• Committee member: Darko Chudy (član povjerenstva)
• Committee member: Miroslav Vukić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2018-09-06, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Bolesti slabinske kralježnice, a među njima i lumboishialgija značajni su javnozdravstveni problem s obzirom da od njih u svom životnom razdoblju oboli velika većina ljudi. Najvažniji uzrok lumboishialgije kod mlađih ljudi je hernija intervertebralnog diska, dok je kod starijih ljudi najčešći uzrok lumboishialgije stenoza lateralnog recesusa ili neuralnog foramena kroz koji spinalni živac izlazi iz spinalnog kanala. U patogenezi lumboishialgije sudjeluju različiti pro upalni faktori među kojima su najvažniji interleukin 1 i čimbenik tumorske nekroze. S obzirom da su troškovi operacijskog liječenja bolesnika s lumboishialgijom iznimno visoki, u posljednjih dva desetljeća počela se razvijati svijest o liječenju lumboishialgije minimalno invazivnim procedurama. Među njima najučinkovitijima su se pokazale epiduralne steroidne injekcije iako su se kroz godine razvijali i razni pristupi intradiskalnih metoda liječenja bolesnika s lumboishialgijom. Sljedeći trendove brzog oporavka i smanjenja troškova i kirurške tehnike u zadnjem su desetljeću usmjerene prema manjoj traumi živčanih i mekih tkiva pa su se tako pojavila različita rješenja tijekom kojih se u spinalni kanal pristupa kroz tubularne retraktore. Posljednji iskorak u kirurgiji slabinske kralježnice s ciljem liječenja hernije diska i posljedične lumboishialgije svakako je pojava endoskopije. Ove se operacije izvode u lokalnoj anesteziji uz minimalan rez kože, minimalnu traumu tkiva i stvaranje ožiljka te uz najbrži postoperativni oporavak i smanjenje troškova liječenja.

Abstract (english)

Lumbar spinal diseases causing low back and radicular pain present a major public health problem. The majority of the population suffer from sciatic pain at some time during their life. The most frequent cause of sciatic pain in younger people is intervertebral disc herniation, while in older people the most common cause of sciatic pain is the lateral recessus stenosis or stenosis of the neural foramen through which the spinal nerve emerges from the spinal canal. Various pro-inflammatory factors are involved in the pathogenesis of sciatic pain, among which the most important are interleukin 1 and the tumor necrosis factor. Since the cost of surgical treatment of patients suffering from sciatic pain is significantly high, in recent decades, there has been an increase in awareness to treat intervertebral disc herniations using minimally invasive procedures. Among these minimally invasive procedures epidural steroid injections have been shown to be the most effective, although various intradiscal procedures have been developed over the years to treat intervertebral disc herniations. Following the trends of rapid recovery and reduction of medical costs the surgical techniques in the last decade have also become less invasive causing less trauma to soft and nervous tissue. This is achieved using tubular retractors. The last cutting edge technique in spinal surgery is endoscopy. These operations are performed in local anesthesia with a minimal skin incision, minimal tissue trauma and scarring, and with the fastest postoperative recovery and reduced treatment costs.

• Keywords: minimalno invazivni postupci; minimalno invazivne operacije; lumboishialgija; slabinska kralježnica
• Keywords (english): minimally invasive procedures; minimally invasive surgery; sciatic pain; lumbal spine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:747205
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-03-07 10:47:03