Degeneration of the intervertebral disc as an interdisciplinary clinical problem in the context of neurosurgery - a summary of the state of knowledge - part II

Abstract

Background: The management of degenerative musculoskeletal disorders, including degeneration of the intervertebral disc (IVD) and its neurological consequences, is complex. This approach requires coordinated collaboration among specialists, especially neurosurgeons, nurses and physiotherapists.Aim of the study: The aim of the study was to perform the review of scientific reports and summary of the current state of knowledge regarding the degeneration of the IVD in the context of various treatment aspects, both in terms of conservative therapy and surgical treatment.Materials and Methods: The literature review was based on searching key medical databases such as PubMed, MEDLINE, Scopus. A search strategy was defined, including keywords, synonyms, and controlled vocabulary terms (MeSH terms). The search covered the last 20 years and focused on aspects of conservative and surgical treatment. Studies meeting the inclusion criteria underwent a full-text analysis. Data and information gathered from the literature analysis were synthesized to provide a comprehensive overview of the state of knowledge on the investigated issue.Results: Classical conservative methods include neurorehabilitation, heat treatment, proper body positioning, and pain management. The common feature of all minimally invasive methods is percutaneous access, where instruments are introduced through small puncture incisions. The effectiveness of conservative treatment for patients with degenerative lumbar spine disease fluctuates around 40%. Meanwhile, the surgical treatment of lumbalgia remains a controversial topic, with many unknowns, lacking clear algorithms and standards. Further research and the development of clinical practice are crucial for improving diagnostic, therapeutic, and preventive methods related to this exceptionally complex clinical problem.Conclusions: The process of treating IVD degeneration is complex and should be considered individually in each case. Collaboration between a neurosurgeon and a physiotherapist forms a dynamic team that addresses both diagnostic and therapeutic aspects. This synergy allows for close monitoring of the patient, combining surgical and rehabilitation aspects, resulting in comprehensive care and maximizing treatment outcomes, thereby improving the quality of life (QOL).