vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2026.1.CLIN.1vmireaviz-1359Research ArticleКлиническая медицинаClinical medicineЭффективность лазерной аутопластики пульпозного ядра межпозвонкового диска при дегенеративно-дистрофических заболеваниях позвоночникаThe effectiveness of laser autoplasty of the pulpous nucleus of the intervertebral disc in degenerative-dystrophic diseases of the spinehttps://orcid.org/0000-0002-4032-8575ЖивотенкоА. П.ZhivotenkoA. P.

Животенко Александр Петрович, Научный сотрудник научно-клинического отдела нейрохирургии

664003, Иркутск, ул. Борцов Революции, д. 1

Aleksandr P. Zhivotenko, Researcher, Scientific and Clinical Department of Neurosurgery

1, Bortsov Revolyutsii str., Irkutsk, 664003, Russia

sivotenko1976@mail.ruhttps://orcid.org/0000-0001-9189-3323ЛарионовС. Н.LarionovS. N.

Ларионов Сергей Николаевич, Д-р мед. наук, ведущий научный сотрудник, заведующий научно-клинического отдела нейрохирургии

ул. Борцов Революции, д. 1, г. Иркутск, 664003, Россия

 

 

Sergey N. Larionov, Dr. Sci. (Med.), Leading Researcher, Head of the Scientific and Clinical Department of Neurosurgery

1, Bortsov Revolyutsii str., Irkutsk, 664003, Russia

snlar@mail.ruhttps://orcid.org/0000-0002-9008-6383СороковиковВ. А.SorokovikovV. A.

Сороковиков Владимир Алексеевич, Д-р мед. наук, профессор, директор; заведующий кафедрой  травматологии, ортопедии и нейрохирургии Иркутской государственной медицинской академии  последипломного образования – филиал ФГБОУ ДПО «Российская медицинская академия непрерывногопрофессионального образования» Минздрава России 

 ул. Борцов Революции, д. 1, г. Иркутск, 664003, Россия 

Vladimir A. Sorokovikov, Dr. Sci. (Med.), Professor, Director; Head of the Department of Traumatology, Orthopedics, and Neurosurgery, Irkutsk State Medical Academy of Postgraduate Education – branch of the Russian Medical Academy of  Continuous Professional Education of the Ministry of Health  of the Russian Federation

1, Bortsov Revolyutsii str., Irkutsk, 664003, Russia

vasorokovikov@mail.ruhttps://orcid.org/0009-0001-9419-105XВельмА. И.Vel'mA. I.

Вельм Андрей Иванович, Канд. мед. наук, врач рентгенолог

ул. Борцов Революции, д. 1, г. Иркутск, 664003, Россия

Andrey I. Vel'm, Cand. Sci. (Med.), radiologist

 1, Bortsov Revolyutsii str., Irkutsk, 664003, Russia 

wellem11@yandex.ruИркутский научный центр хирургии и травматологииРоссияIrkutsk Scientific Center of Surgery and TraumatologyRussian Federation2026200520261611422Copyright © Животенко А.П., Ларионов С.Н., Сороковиков В.А., Вельм А.И., 20262026Животенко А.П., Ларионов С.Н., Сороковиков В.А., Вельм А.И.Zhivotenko A.P., Larionov S.N., Sorokovikov V.A., Vel'm A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/1359

Введение. Дегенеративно-дистрофические заболевания позвоночника (ДДЗП) являются ведущей причиной хронической боли в спине и потери трудоспособности. Существующие консервативные и хирургические методы часто не устраняют первопричину боли и связаны с рисками. Целью исследования была оценка клинической эффективности и безопасности минимально инвазивного метода лазерной аутопластики пульпозного ядра у пациентов с хроническим болевым синдромом. Материалы и методы. Проведено проспективное одноцентровое исследование с участием 20 пациентов. Критерии включения: хроническая нерадикулярная боль или радикулопатия в фазе ирритации на фоне дегенерации диска I–III стадии классификации (Pfirrmann). Под рентген-контролем выполнялось лазерное воздействие (диодный лазер, 1061 нм) на три зоны пульпозного ядра. Оценка результатов проводилась до операции, после, а также через 3 и 12 месяцев с использованием шкал ВАШ, ODI, DN4, PainDetect, SF-36, HADS и МРТ позвоночника. Результаты. Наблюдалось достоверное снижение интенсивности боли в пояснице (ВАШ: с 4,8±1,2 до 1,25±1,11 через 12 мес., p<0,001) и улучшение функционального статуса (ODI: с 15,15±4,87 до 5,88±4,28, p=0,0056). Доля пациентов с нейропатической болью сократилась с 30% до 10%. Значительно улучшились показатели качества жизни (SF-36) и снизился уровень тревоги и депрессии (HADS). Осложнений не зафиксировано. Заключение. Лазерная аутопластика пульпозного ядра является высокоэффективным и безопасным методом лечения хронического болевого синдрома у пациентов с ДДЗП I–III стадий, обеспечивая значительное и стойкое клиническое улучшение. Метод может рассматриваться как перспективная альтернатива более инвазивным вмешательствам.

Degenerative spine diseases (DSD) are a leading cause of chronic low back pain and disability. Existing conservative and surgical methods often fail to address the root cause of pain and are associated with risks. This study aimed to evaluate the clinical efficacy and safety of a minimally invasive method of laser autoplasty of the nucleus pulposus in patients with chronic pain syndrome.Materials and methods. A prospective single-center study was conducted with 20 patients. Inclusion criteria: chronic non-radicular pain or radiculopathy in the irritation phase due to disc degeneration of stages I-III according to a classification (Pfirrmann). Under X-ray control, laser exposure (diode laser, 1061 nm) wasapplied to three zones of the nucleus pulposus. Outcomes were assessed before surgery, after, and at 3- and 12-months using VAS, ODI, DN4, PainDetect, SF-36, HADS scales, and MRI of spine. Results. A significant reduction in low back pain intensity (VAS: from 4.8±1.2 to 1.25±1.11 at 12 months, p<0.001) and improvement in functional status (ODI: from 15.15±4.87 to 5.88±4.28, p=0.0056) were observed. The proportion of patients with neuropathic pain decreased from 30% to 10%. Quality of life (SF-36) scores significantly improved, and levels of anxiety and depression (HADS) decreased. No complications were recorded. Conclusion. Laser autoplasty of the nucleus pulposus is a highly effective and safe method for treating chronic pain syndrome in patients with stages I-III DSD, providing significant and sustained clinical improvement despite the lack of confirmed long-term structural disc restoration. The method can be considered a promising alternative to more invasive interventions.

дегенеративно-дистрофические заболевания позвоночника [D055959]межпозвонковый диск [D007403]nucleus pulposus [D009687]лазерная хирургия [D007902]минимально инвазивные вмешательства [D019060]хроническая боль в спине [D017116]нейропатическая боль [D009437]радикулопатия [D011843]качество жизни [D011788]degenerative disc disease [D055959]intervertebral disc [D007403]nucleus pulposus [D009687]laser surgery [D007902]minimally invasive surgical procedures [D019060]chronic low back pain [D017116]neuralgia [D009437]radiculopathy [D011843]quality of life [D011788]ReferencesFrancisco V., et al. A new immunometabolic perspective of intervertebral disc degeneration. Nature reviews. Rheumatology. 2022;18(1):47-60. https://doi.org/10.1038/s41584-021-00713-zFrancisco V., et al. A new immunometabolic perspective of intervertebral disc degeneration. Nature reviews. Rheumatology. 2022;18(1):47-60. https://doi.org/10.1038/s41584-021-00713-zXu, Hao et al. 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The authors declare that there are no conflicts of interest present.