Резорбция грыж поясничных межпозвонковых дисков: несистематический обзор литературы

Цель исследования. Анализ информации, посвященной спонтанной резорбции грыж поясничных межпозвонковых дисков.

Материал и методы. Проведен несистематический обзор 37 публикаций, посвященных резорбции грыж межпозвонковых дисков; обобщены данные о сроках, механизмах и предикторах регресса грыжи поясничных межпозвонковых дисков. Представлен клинический случай, иллюстрирующий резорбцию грыжи межпозвонкового диска L₄–L₅ в течение 8 мес.

Результаты. Частота и сроки резорбции грыж поясничных межпозвонковых дисков разнятся в зависимости от количества пациентов, сроков наблюдения, типа и характера грыжевого выпячивания, других характеристик пациентов. Результаты метаанализов свидетельствуют о том, что средний срок спонтанной резорбции грыж поясничных межпозвонковых дисков составляет более 6 мес. Основными теориями спонтанной резорбции грыж поясничных межпозвонковых дисков являются теория дегидратации, механическая теория и механизмы, связанные с воспалительными процессами и неоваскуляризацией. В настоящее время предикторами резорбции грыжи диска считают тип и размер грыжи, срок наблюдения, изменения по классификации Modic и т.п. Существующие данные о сроках, механизмах и предикторах резорбции грыж поясничных межпозвонковых дисков недостаточны для улучшения тактики лечения пациентов.

Заключение. Грыжа поясничных межпозвонковых дисков имеет склонность к спонтанному регрессу, который, однако, наблюдается не у всех пациентов. Механизмы резорбции могут быть различными, при этом сам факт резорбции может встречаться при  различных вариантах грыжи с разной частотой. Для более точного определения сроков и предикторов резорбции поясничных межпозвонковых грыж необходим анализ больших массивов данных.

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