A herniated disc is the most frequent manifestation of the degenerative-dystrophic process in the spine, which manifests itself in the most working age. Often, when a herniated disc is detected, such patients are referred for surgical treatment. Published meta-analyzes have shown that there are no significant differences in the effectiveness of surgical treatment of disc herniation and conservative tactics in a long-term comparison. The ineffectiveness of epidural blockade with glucocorticosteroid hormones and long-term use of non-steroidal anti-inflammatory drugs has been shown. All this dictates the need to study other methods of effective treatment of patients with discogenic pain syndrome. This article provides an overview of the study of the mechanisms of spontaneous resorption of intervertebral hernias, which is essentially a sanogenetic response of the body. The focus on patterns, connected to development of neurological manifestations, is vital. This direction in the study of degenerative disc disease, in our opinion, is the most promising at the present stage of development of medical science.

1. Gushcha, A. O. Sovremennye koncepcii degeneracii mezhpozvonkovyh diskov / A. O. Gushcha, A. R. YUsupova // ZHurnal «Voprosy nejrohirurgii» imeni N. N. Burdenko. – 2020; 84 (6). – S. 112–117.

2. Deduh, N. V., Mekhanizmy spontannoj rezorbcii gryzhi mezhpozvonochnogo diska (analiticheskij obzor literatury) / N. V. Deduh, L. M. Bengus // Bol‘. Sustavy. Pozvo-nochnik. – 2013. – № 1 (9). – S. 58–66.

3. Drivotinov, B. V. Vertebro-visceral‘nyj i viscero-vertebral‘nyj bolevoj sin-drom pri osteohondroze pozvonochnika / Medicinskij zhurnal. – 2010. – № 3. – S. 4–8.

4. Drivotinov, B. V. Nevrologicheskie narusheniya pri poyasnichnom osteohondroze. – Minsk : Belarus‘, 1979. – 144 c.

5. Drivotinov, B. V. Rol‘ autoimmunnyh reakcij v patogeneze recidivov i remissij koreshkovogo bolevogo sindroma pri poyasnichnom osteohondroze / B. V. Drivotinov, V. M. Hodosovskaya // Perifericheskaya nervnaya sistema. – Minsk, 1978. – Vyp. 1. – S. 62–67.

6. Evzikov, G. Yu. Regress gryzhi diska poyasnichnogo otdela pozvonochnika / Evzikov G. Yu., A. I. Isajkin, A. V. Kavelina i dr. //. Nevrologiya, nejropsihiatriya, psihoso-matika. – 2015. – № 1. – S. 61–65.

7. Kurilina, L. R. Spontannaya rezorbciya gryzh mezhpozvonkovyh diskov poyasnichnogo otdela pozvonochnika / L. R. Kurilina, M. N. Velichko, E. V. Sokolova, S. S. Vorob‘e-va, F. L. Len‘shina // Medicinskij al‘manah. – 2013. – № 6 (30). – S. 198–201.

8. Kiseleva, E. P. Faktor rosta sosudistogo endoteliya i immunnayasistema / E. P. Kiseleva, A. V. Krylov, E. A. Starikova, S. A. Kuznecova // Uspekhi sovremennoj biolo-gii. – 2009. – T. 129, № 4. – S. 1–12.

9. Latysheva, V. Ya. Patogenez i terapiya nevrologicheskih proyavlenij poyasnichnogo osteohondroza (kliniko-immunologicheskie issledovaniya): avtoref. dis. … d-ra med. nauk : 14.00.13 / V. Ya. Latysheva. – Minsk, 1985 – 46 s.

10. Petrov, K. B. Eshchyo raz o tak nazyvaemom «osteohondroze pozvonochnika» [Elek-tronnyj resurs]. URL: https://www.profmedobr.ru/articles/eshhjo-raz-o-tak-nazyvaemom-osteohondroze-pozvonochnika/ (data obrashcheniya: 10.05.2021).

11. Popelyanskij, Ya. Yu. Ortopedicheskaya nevrologiya (vertebronevrologiya) : ruk. dlya vrachej. - 3-e izd., pererab. i dop. – M. : Medpress-inform, 2003. – 672 s.

12. Sel‘e, G. Na urovne celogo organizma / G. Sel‘e ; per. s angl. I. A. Dobrohvoto-voj. – M. : Nauka, 1972. – 123 s.

13. Tkachev, A. M. Patofiziologicheskie aspekty rezorbcii gryzh mezhpozvonkovogo diska / A. M. Tkachev, A. V. Epifanov, E. S. Akarachkova i dr. // Consilium Medicum. – 2019. – № 21 (2). – S. 59–63.

14. Tkachev, A. M. Patofiziologicheskie mekhanizmy degeneracii mezhpozvonkovyh dis-kov. / A. M. Tkachev, A. V. Epifanov, E. S. Akarachkova i dr. // Russkij medicinskij zhur-nal. Medicinskoe obozrenie. – 2019. № 4 (II). – S. 72–77.

15. Tkachev, A. M. Rol‘ vospaleniya v spontannom regresse gryzh mezhpozvonkovyh dis-kov / A. M. Tkachev, A. V. Epifanov, E. S. Akarachkova i dr. // Russkij medicinskij zhur-nal. Medicinskoe obozrenie. – 2019. № 7. – S. 30–33.

16. Chowdhury, I. Current concepts in apoptosis: the physiological suicide program revisit-ed / I. Chowdhury, B. Tharakan, G. K. Bhat // Cell Mol. Biol. Lett. – 2006. – Vol. 11. – P. 506–525.

17. Enthoven, W. T. Non-steroidal anti-inflammatory drugs for chronic low back pain. / W. T. Enthoven, P. D. Roelofs, R. A. Deyo, et al. // Cochrane Database of Systematic Reviews 2016; 2 (2):CD012087. Published 2016 Feb 10. doi: 10.1002/14651858.CD012087. Accessed 03 April 2021.

18. Feng, C. Disc cell senescence in intervertebral disc degeneration: Causes and molecular pathways / C. Feng, H. Liu, M. Yang et al. // Cell Cycle. 2016. – Vol. 15 (13). – R. 1674–1684.

19. Habtemariam, A. A comparative immunohistochemical study of inflammatory cells in acute-stage and chronic-stage disc herniations / A. Habtemariam, M. Gronblad, J. Virri et al. // Spine. – 1998. – Vol. 23. – P. 2159–2166.

20. Haro, H. Matrix metalloproteinase-7-dependent release of tumor necrosis factor-alpha in a model of herniated disc resorption / H. Haro, H. C. Crawford, B. Fingleton, K. Shinomiya, D. M. Spengler, L. M. Matrisian // J Clin Invest. 2000; – Vol. 105 (2). – R. 143–150.

21. Hasegawa, T. The effect of age on inflammatory responses and nerve root injuries after lumbar disc herniation: an experimental study in a canine model / T. Hasegawa, H. S. An, A. Inufusa et al. // Spine. – 2000. – Vol. 25. – P. 937–940.

22. Ikeda, T. Pathomechanism of spontaneous regression of herniated lumbar disc: histologic and immunohistochemical study / T. Ikeda, T. Nakamura, T. Kikuchi et al. // J. Spinal. Disord. – 1996. – Vol. 9. – P. 136–140.

23. Jakoi, A. M. The Clinical Correlations between Diabetes, Cigarette Smoking and Obesity on Intervertebral Degenerative Disc Disease of the Lumbar Spine./ A. M. Jakoi, G. Pannu, A. D’Oro et al. // Asian Spine J. 2017. – Vol. 11(3). – R. 337–347.

24. Kawaguchi, S. Chemokine profile of herniated intervertebral discs infiltrated with mono-cytes and macrophages / Kawaguchi S., Yamashita T., Katahira G. et al. // Spine (Phila Pa 1976). – 2002. – Vol. 27. (14). – P. 1511–1516.

25. Kawakami, M. MRNA expression of interleukins, phospholipase A2, and nitric oxide synthase in the nerve root and dorsal root ganglion induced by autologous nucleus pulposus in the rat / M. Kawakami, T. Matsumoto, K. Kuribayashi et al. // J. Orthop. Res. – 1999. – Vol. 17. – P. 941–946.

26. Martirosyan, N. L. Genetic Alterations in Intervertebral Disc Disease / N. L. Martirosyan, A. A. Patel, A. Carotenuto et al. // Front Surg. 2016; 3 : 59.

27. Minamide, A. Effects of Basic Fibroblast Growth Factor on Spontaneous Resorption of Herniated Intervertebral Discs: An Experimental Study in the Rabbit / A. Minamide, H. Hashizume, M. Yoshida et al. // Spine. – 1999. – Vol. 24 (10). – P. 940–945.

28. Mochida, K. Regression of cervical disc herniation observed on magnetic resonance im-ages / K. Mochida, H. Komori, A. Okawa, T. Muneta, H. Haro, K. Shinomiya // Spine (Phila Pa 1976). 1998. – Vol. 23 (9). – R. 990–997.

29. Oliveira, C. B. Epidural corticosteroid injections for lumbosacral radicular pain / C. B. Oliveira, C. G. Maher, M. L. Ferreira, et al. // Cochrane Database of Systematic Reviews 2020, Issue 4. Art. No.: CD013577. Accessed 03 April 2021.

30. Park, J. B. Expression of fas ligand and apoptosis of disc cells in herniated lumbar disc tissue / J. B. Park, H. K. Chang, Ki-Won // Spine. – 2001. – Vol. 26 (6). – P. 618–621.

31. Park, J. B. Expression of Fas-receptor on disc cells in herniated lumbar disc tissue / J. B. Park, K. W. Kim, C. W. Han et al. // Spine. – 2001. – Vol. 26. – P. 142–146.

32. Podichetty, V. K. The aging spine: the role of inflammatory mediators in intervertebral disc degeneration / V. K. Podichetty // Cell Mol. Biol. – 2007. – Vol. 53(5). – P. 4–18.

33. Sadowska A, Touli E, Hitzl W, Greutert H, Ferguson SJ, Wuertz-Kozak K, Hausmann ON. Inflammaging in cervical and lumbar degenerated intervertebral discs: analysis of proin-flammatory cytokine and TRP channel expression. European Spine Journal. 2018; Vol. 27(3). – R. 564–577.

34. Schistad, E. I. Association between baseline IL-6 and 1-year recovery in lumbar radicular pain / E. I. Schistad, A. Espeland, L. M. Pedersen,et al. // Eur J Pain. 2014. Vol. 18 (10). – R. 1394–401.

35. Van der Gaag, W. H. Non-steroidal anti-inflammatory drugs for acute low back pain / W. H. Van der Gaag, DDM Roelofs, WTM Enthoven, et al. // Cochrane Database of Sys-tematic Reviews 2020, Issue 4. Art. No.: CD013581. Accessed 03 April 2021.

36. Wang, A. M. Detection of extracellular matrix degradation in intervertebral disc degenera-tion by diffusion magnetic resonance spectroscopy / A. M. Wang, P. Cao, A. Yee et al. // Magn Reson Med. 2015; Vol. 73 (5). – R. 1703–1712.

37. Woertgen, C. Influence of macrophage infiltration of herniated lumbar disc tissue on out-come after lumbar disc surgery / C. Woertgen, R. D. Rothoerl, A. Brawanski // Spine. – 2000. – Vol. 25. – P. 871–875.

38. Yoshida, M. Intervertebral disc cells produce tumor necrosis factor alpha, interleukin-1beta, and monocyte chemoattractant protein-1 immediately after herniation: an experi-mental study using a new hernia model / M. Yoshida, T. Nakamura, A. Sei et al. // Spine. – 2005. – Vol. 30 (1). – P. 55–61.

39. Zhong, M. Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis / M. Zhong, J. T. Liu, H. Jiang, et al. // Pain Physician. 2017. Vol. 20 (1). – R. 45–52.