Abstract: the analysis of the state of the peripheral circulation in 117 patients who underwent surgery for a herniated disc of the lumbar spine was performed. When performing the work, the effectiveness of local permanent blockades of the source of reactive inflammation in the surgical zone of the lumbar spine was evaluated in correcting disorders of the peripheral circulation of the lower limbs due to the implementation of the spinal-vasal reflex. All patients considered in our work signed an informed consent to participate in the program and a bilateral agreement on non-disclosure of personal data and research protocol. Patients considered in our work, depending on the correction of circulatory disorders in the lower extremities, were divided into 2 groups. Group I included 50 patients for whom correction of circulatory disorders in the lower limbs was not performed. In group II in 67 patients in the postoperative period, in order to correct circulatory dysfunction in the lower extremities, local permanent blockades of the surgical zone were performed. To do this, during the operation, a catheter was fed through a separate puncture to the intervention area, according to which, during the postoperative period, 30.0-40.0 ml of a 0.25% novocaine solution was injected 4 times a day. The criteria for the analysis were indicators of oximetry, capillaroscopy and clinical symptoms characteristic of impaired peripheral circulation in the lower limbs. When conducting an oximetric study, the state of oxygen supply to the tissues of the upper and lower extremities was evaluated 3 days after the operation for a herniated disc of the lumbar spine depending on the correction of peripheral circulatory disorders. The indicators of capillaroscopy used for analysis were the total number of vessels, the number of active vessels containing blood units in their lumen, inactive vessels without uniform elements in their lumen, which were determined in 50 fields of view in the Avtandilov grid. In addition, an integrative ratio of active and inactive vessels was calculated. Comparative analysis of the studied parameters depending on the correction of peripheral circulatory disorders showed that local permanent blockade of the surgical area provides regression of clinical symptoms and positive dynamics of peripheral circulatory disorders of the lower extremities in the postoperative period. It is promising to continue research in this direction.
Keywords: disc herniation, lower back pain, spinal-vasal reflex, capillaroscopy, oximetry