METHOD OF PREOPERATIVE PREDICTION OF DEVELOPMENT OF RECURRENT DISC HERNIA AT THE LEVEL OF THE LUMBAR SPINE Russian patent published in 2023 - IPC A61B5/00 A61B5/55 A61B5/107 G01N33/68 G01N33/573 

FIELD: medicine; neurosurgery.

SUBSTANCE: invention can be used for preoperative prediction of the development of recurrent disc herniation at the level of the lumbar spine. The presence or absence of modifiable or non-modifiable risk factors is determined, followed by an assessment of the probability of a high or low risk of developing a recurrent disc herniation. Modifiable prognostically significant risk factors include the following indicators: the presence of obesity from grade I to II, difficult working conditions from categories 2 to 3 according to the WHO classification, smoking 1 pack a day for more than 5 years, the presence of diabetes mellitus, low adherence to treatment according to the COP-25 questionnaire less than 50%. Non-modifiable prognostically significant risk factors include the following: intervertebral disc height more than 24.6 mm, or Modic from II to III degrees, age from 40 to 61 years, Grogan from II to III degrees, vascular endothelial factor VEGF value from 3,206.89 pg/ml to 6,146.75 pg/ml, the value of matrix metalloproteinase-8 MMP8 from 11.19 pg/ml to 20.15 pg/ml and the value of beta transforming growth-factor TGFβ1 from 3,674.42 to 5,594.12 pg/ml. The number of modifiable and non-modifiable risk factors is summed up separately. If not more than one non-modifiable factor and 1–3 modifiable factors are identified, as well as if 2–3 non-modifiable factors and 1 modifiable factor are identified, a low risk of relapse after planned microdiscectomy is predicted — less than 30%. When identifying 4–5 non-modifiable factors and 1 modifiable factor, as well as 2–5 non-modifiable factors and 2–3 modifiable factors, as well as 1–5 non-modifiable factors and 4–5 modifiable factors, a high risk of relapse after planned microdiscectomy is predicted — more than 30%.

EFFECT: method provides the possibility of a simple, reliable preoperative prediction of the likelihood of developing a recurrence of a herniated disc at the level of the lumbar spine through an integrated approach — assessment of general clinical, radiation, as well as biochemical and immunological factors reflecting the state of the tissues of the spinal motion segment in real time, available for research in the hospitals with tests examined in the patient’s serum before surgical treatment.

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