Микрохирургическая дискэктомия в поясничном отделе позвоночника: эффективность, болевой синдром, фактор ожирения

Objective. To analyze the effectiveness and features of microsurgical discectomy of herniated intervertebral discs in patients with excessive body weight. Material and Methods . A total of 104 patients (37 men and 67 women) aged 24–58 years with intervertebral disc hernias in the lumbar spine accompanied by compression of neural structures and radicular pain syndrome were operated on. The study group consisted of 48 obese patients who underwent microdiscectomy at the lumbar level. The control group included 56 non-obese patients operated in the same way. The level of the pain syndrome was assessed using the VAS and Oswestry’s functional activity questionnaire. Results. Preoperative pain intensity was slightly higher in patients with obesity than in those with normal body weight. Six weeks after the microdiscectomy, the radicular pain syndrome was arrested. The clinical effect of microdiscectomy persisted after 6 and 12 months. By the end of the follow-up period, some patients with excessive body weight had a tendency to have pain in the back and lower extremities. Also, patients with obesity had slightly greater intraoperative blood loss, the incidence of superficial infectious complications, the duration of the operation, and the length of hospital stay. Conclusion. The overweight factor should be considered when planning anesthesia and microsurgical discectomy in the lumbar spine.