Introduction

Surgical interventions on spine concerning hernias of intervertebral disks are one of the most spread interventions in neurosurgery. NLS may become one of the leading methods in diagnostics of intervertebral hernias and evaluation of their treatment effectiveness by surgical methods. Failure rate after herniated disks surgeries with progression of «failed» intervention syndrome is registered not less than in 10-40% cases. Some researchers believe that absence of effect in case of spinal surgery is registered not less than in 25% of cases. NLS-method allows obtaining reliable and visual images of vertebral bodies, spinal canal, intervertebral discs, ligamentous apparatus and soft tissues; it also reveals all changes in surgery area and shows reasons that caused unsuccessful treatment of disc herniation.

The purpose of given study was clarifying lumbar spine condition after operative treatment of intervertebral hernias according to NLS data.

Material and methods

NLS-study results of 42 patients operated for lumbar hernias were analyzed. NLS was performed in the period from 14 days to 16 years after surgery. Research was conducted due to recurring pain syndrome and occurrence of neurological symptoms in patients. Patients age ranged from 30 to 70 years; 27 women and 15 men. Patients underwent various operations: interlaminectomy (15) hemilaminectomy (12), laminectomy (6) interlaminar hernia excision (6), anterior interbody fusion by titanium implant with diskal hernia removal (3) at single (36), two or more (6) levels.

NLS was performed using Metatron 4025 hunter system. «Metapathia Hospital» special-purpose software with three-dimensional visualization of surgical contact area was used. Maximum possible reduction of total research time for low tolerance adaptation of spinal patients with acute pain syndrome for long-term lying on their backs was practiced; by doing so we have received maximum complete and accurate information on nature and prevalence of pathological process with minimal loss of image quality.

Multi-positional research conducted in 3D-mode with ultramicroscanning thus provides full information on nature of changes in all anatomical and histological structures of discovertebral unit in patients with compression nerve-root pain syndromes.

Results and discussion

Postoperative period was divided into early (6-8 weeks), intermediate (from 3 months to 2 years), late (two years or more). Analysis of lumbar spine NLS-grams demonstrated that all patients had hyperchromogenic zones (5-6 according to Fleindler’s scale) typical for epidural scarring after spinal surgery. Epidural scarring occur in all types of intervertebral hernia surgeries. It is considered that scarring develop due to post-operative hematoma. In most cases they are asymptomatic, but according to some researches in 10% of patients they envelop root, breaking its trophism and causing radicular ischemia. After surgery scar tissue may penetrate central part of the disk. According to our research, some patients must undergo NLS with ultramicroscanning once again to exclude unremoved