MODERN IDEAS ABOUT EPIDURAL FIBROSIS (LITERATURE REVIEW)
Rubrics: NEUROLOGY
Authors:
1.
Irkutsk Scientific Center of Surgery and Traumatology
(Clinical Research Department of Neurosurgery, Junior Research Officer)
employee from 24.12.1943 until now
Irkutsk, Irkutsk region, Russian Federation
employee from 24.12.1943 until now
Irkutsk, Irkutsk region, Russian Federation
2.
Irkutsk Scientific Center of Surgery and Traumatology
(Director)
employee from 20.12.1939 until now
Irkutsk, Irkutsk region, Russian Federation
employee from 20.12.1939 until now
Irkutsk, Irkutsk region, Russian Federation
3.
Irkutsk, Irkutsk region, Russian Federation
4.
Irkutsk, Irkutsk region, Russian Federation
5.
Irkutsk, Irkutsk region, Russian Federation
6.
Irkutsk, Irkutsk region, Russian Federation
Type:
Article
Pages:
from 27
to 33
Status:
Published
Received:
14.11.2017
Accepted:
30.11.2017
Published:
30.11.2017
Subject area:
UDK 61 Медицина. Охрана здоровья
Language:
Russian
Keywords:
pozvonochnik, epidural'nyy fibroz, etiologiya, patogenez
Abstract (English):
Epidural'nyy fibroz – eto dinamicheskiy patologicheskiy process, razvivayuschiysya i progressiruyuschiy vo vremeni i yavlyayuschiysya polietiologichnym i mul'tifaktornym oslozhneniem v posleoperacionnom periode pri operaciyah na pozvonochnike. Epidural'nyy fibroz formiruetsya vokrug dural'nogo meshka i sosudisto- nervnyh obrazovaniy pozvonochnogo kanala v posleoperacionnom periode i yavlyaetsya odnoy iz chastyh prichin sindroma neudachno operirovannogo pozvonochnika. Pri povtornyh hirurgicheskih vmeshatel'stvah epidural'nyy fibroz vstrechaetsya v 100 % sluchaev, chto uslozhnyaet operacionnuyu tehniku raboty s dural'nym meshkom i na sosudisto-nervnyh obrazovaniyah, raspolozhennyh v pozvonochnom kanale, privodya k ih povrezhdeniyam. V dannom obzore rassmotreny istoriya voprosa, nekotorye aspekty anatomii, etiologii, patogeneza i patofiziologii rubcovo-spaechnogo epidurita. Analiz literaturnyh dannyh pokazyvaet vysokiy interes issledovateley k vyyavleniyu kriteriev diagnostiki, prognozirovaniya i metodov profilaktiki epidural'nogo fibroza. Odnako v nastoyaschee vremya otsutstvuyut chetkie klinicheskie rekomendacii dlya obsledovaniya pacientov i kriterii prognozirovaniya epidural'nogo fibroza posle provedennyh operaciy na pozvonochnike. Suschestvuyuschie metody vizualizacii i diagnostiki ne obladayut vysokoy specifichnost'yu i chuvstvitel'nost'yu otnositel'no dannogo processa, chto trebuet kompleksnogo podhoda v ustanovke diagnoza. Epidural'nyy fibroz ostaetsya slozhnoy i nereshennoy problemoy kak v profilaktike i diagnostike, tak i v lechenii, privodit k stoykomu bolevomu sindromu, ne poddayuschemusya konservativnomu lecheniyu i, kak sledstvie, k invalidnosti v kategorii bol'nyh trudosposobnogo vozrasta, chto predstavlyaet soboy ser'eznuyu mediko-social'nuyu problemu.
Epidural'nyy fibroz – eto dinamicheskiy patologicheskiy process, razvivayuschiysya i progressiruyuschiy vo vremeni i yavlyayuschiysya polietiologichnym i mul'tifaktornym oslozhneniem v posleoperacionnom periode pri operaciyah na pozvonochnike. Epidural'nyy fibroz formiruetsya vokrug dural'nogo meshka i sosudisto- nervnyh obrazovaniy pozvonochnogo kanala v posleoperacionnom periode i yavlyaetsya odnoy iz chastyh prichin sindroma neudachno operirovannogo pozvonochnika. Pri povtornyh hirurgicheskih vmeshatel'stvah epidural'nyy fibroz vstrechaetsya v 100 % sluchaev, chto uslozhnyaet operacionnuyu tehniku raboty s dural'nym meshkom i na sosudisto-nervnyh obrazovaniyah, raspolozhennyh v pozvonochnom kanale, privodya k ih povrezhdeniyam. V dannom obzore rassmotreny istoriya voprosa, nekotorye aspekty anatomii, etiologii, patogeneza i patofiziologii rubcovo-spaechnogo epidurita. Analiz literaturnyh dannyh pokazyvaet vysokiy interes issledovateley k vyyavleniyu kriteriev diagnostiki, prognozirovaniya i metodov profilaktiki epidural'nogo fibroza. Odnako v nastoyaschee vremya otsutstvuyut chetkie klinicheskie rekomendacii dlya obsledovaniya pacientov i kriterii prognozirovaniya epidural'nogo fibroza posle provedennyh operaciy na pozvonochnike. Suschestvuyuschie metody vizualizacii i diagnostiki ne obladayut vysokoy specifichnost'yu i chuvstvitel'nost'yu otnositel'no dannogo processa, chto trebuet kompleksnogo podhoda v ustanovke diagnoza. Epidural'nyy fibroz ostaetsya slozhnoy i nereshennoy problemoy kak v profilaktike i diagnostike, tak i v lechenii, privodit k stoykomu bolevomu sindromu, ne poddayuschemusya konservativnomu lecheniyu i, kak sledstvie, k invalidnosti v kategorii bol'nyh trudosposobnogo vozrasta, chto predstavlyaet soboy ser'eznuyu mediko-social'nuyu problemu.
Keywords:
pozvonochnik, epidural'nyy fibroz, etiologiya, patogenez
pozvonochnik, epidural'nyy fibroz, etiologiya, patogenez
1. Sovremennye predstavleniya ob epidural'nom fibroze
