EVOLUTION OF TREATMENT METHODS FOR DEGENERATIVE DISEASES OF THE SPINE: A LITERATURE REVIEW
Keywords:
degenerative spine disease, lumbar disc herniation, decompression, microdiscectomy, endoscopic discectomy, minimally invasive spine surgery, spinal fusion, sagittal alignment, surgical navigation, intraoperative neuromonitoringAbstract
Degenerative diseases of the spine remain among the leading causes of chronic pain, temporary work disability, and long-term functional impairment in working-age populations. This literature review summarizes the key milestones in the evolution of treatment strategies, ranging from predominantly conservative management—emphasizing immobilization, traction, bracing, physiotherapy, and symptomatic pharmacotherapy—to the establishment of surgical paradigms focused on neural decompression and biomechanical stabilization. Historical drivers behind the adoption of laminectomy and open discectomy are discussed, along with their limitations related to invasiveness and postoperative instability. The introduction of microdiscectomy is highlighted as a major step toward reducing surgical morbidity while maintaining high clinical effectiveness. The review further addresses the expansion of minimally invasive and endoscopic spine surgery, including tubular retractors, percutaneous approaches, and transforaminal/interlaminar endoscopic techniques, which are commonly associated with lower blood loss, reduced postoperative pain, and faster rehabilitation. Contemporary trends toward personalized care are considered, including sagittal alignment assessment, intraoperative navigation, neuromonitoring, and 3D planning, as well as motion-preservation concepts and disc arthroplasty in appropriately selected patients. Overall, the evidence indicates a sustained shift toward less traumatic, technology-assisted, and patient-tailored interventions aimed at optimizing functional recovery with comparable clinical outcomes.
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