腰椎间盘突出症再手术原因及疗效分析  

Analysis of Causes and Therapeutic effect of Reoperation for Lumbar Disc Prolapse

作　　者：刘振宁[1] 贾长青[1] 韩长旭[1] 王俊丰[1] 梁峰[1] 

机构地区：[1]中国医科大学盛京医院脊柱与关节外科,辽宁沈阳110004

出　　处：《医学临床研究》2007年第11期1858-1860,共3页Journal of Clinical Research

摘　　要：【目的】探讨腰椎间盘突出症术后复发的原因,以及再手术治疗的方法和疗效。【方法】2000年1月至2006年12月腰椎间盘突出症复发病例共计45例,再手术方式为中央开窗椎间盘切除术28例,全椎板切除减压椎间盘切除术13例,全椎板切除减压椎间盘切除联合椎间植骨融合内固定术4例。【结果】45例患者经6-80个月随访,平均35个月,按Macnab疗效评定标准,优22例（48.89%）,良17例（37.78%）、可5例（11.11%）、差1例（2.22%）。【结论】腰椎间盘突出症术后复发主要原因为髓核摘除不彻底,术前及术中突出节段定位错误,腰椎节段性不稳,术式选择不当等,正确选择手术时机和方法,复发腰椎间盘突出症的再手术治疗仍可以获得满意效果。[Objective]To explore the causes, methods and outcomes of reoperative treatment of lumbar disc after surgery. [Methods] Forty five patients with recurrent lumbar disc herniation were treated surgically from January 2000 to December 2006. The surgical approaches taken in the second time included enlarged central laminectomy for 28 cases, total laminectomy for 13 cases and total laminectomy with vertebral interbody fusion for 4 cases. [Results]All the 45 patients were followed up for an average of 35 months （6 months to 80 months）. According to the Macnab＇s criterion, the outcomes were excellent in 22 cases （48.89%）, good in 17 cases （37.78%）, fair in 5 cases （11.11%） and poor in 1 cases （2, 22%）. [Conclusion] The major causes of reoperation after lumbar disc surgery include incomplete removal of herniated nucleus pulposus, wrong preoperative or intraoperative dislocation, lumbar segmental unstability, inappropriate surgical method, etc. With the optimal time and appropriate surgical approaches, reoperation for patients who undergo the lumbar disc surgery can achieve satisfactory outcomes.

关 键 词：腰椎/外科学 椎间盘移位/外科学 再手术 

分 类 号：R681.53[医药卫生—骨科学]