老年腰椎间盘突出症再手术疗效分析  

Surgical effects of recurrent lumbar disc herniation in old people

作　　者：李玉茂[1] 王剑火[1] 林奇益[1] 

机构地区：[1]南京军区福州总医院第一附属医院骨科中心,福建莆田351100

出　　处：《颈腰痛杂志》2012年第6期437-439,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨老年患者腰椎间盘突出症再手术的原因及手术治疗的效果。方法回顾分析我院2001-07-2010-07收治随访资料完整的老年腰椎间盘突出症再次手术者21例,均行椎间盘切除术。合并腰椎管狭窄或腰椎失稳者,行后路椎间植骨融合及椎弓根螺钉内固定术。采用视觉模拟疼痛评分法(Visual analogue scale,VAS)和Oswestry功能障碍指数(Oswestry disability index,ODI)分别在术前、术后3个月,末次随访时,对患者的疼痛程度和功能进行评价。结果随访时间10～27个月,平均17个月。VAS评分术前为7.23±1.52,术后3个月为3.72±1.13,末次随访时为2.54±0.86;ODI指数术前为69.45±12.53,术后3个月为28.97±8.72,末次随访时为18.64±7.46。术后VAS评分及ODI指数与术前相比均明显改善,差异有统计学意义(P<0.05)。结论老年腰椎间盘突出症再次手术患者做好围手术期处理,行彻底减压,维护或重建腰椎稳定性的再次手术,可以取得满意的临床效果。Objective To discuss the reoperation causes and effects for lumbar disc herniation in old people. Methods From July 2001 to July 2010,23 reoperation old patients were all performed by diseeetomy and the ones with lumbar spinal stenosis or lumbar vertebrae instability, they would had vertebral pedicle screw fixation. According to the Visual Analogue Scale （VAS） and the Oswestry Disability Index （ODI）,the functional status and the pain degree were evaluated before and after operation 3 months and at the latest follow up,respectively. Results All patients were followed up for an average of 17 months,range 10 to 27 months. VAS score was decreased from 7.23±1.12 before operation to 3.72±1.13 .after operation 3 months,then to 2.54±0.86 at the latest follow up.ODI was decreased from 69.45±12.53 before operation to 28.97±8.72 after operation 3 months,then to 18.64±7.46 at the latest follow up.The VAS score and ODI were both significantly improved after operation （P〈0.05）. Conclusion If the elder patients underwent well in peri operation period,maintained the stability of lumbar spine and decompressed completely,they will obtain satisfactory effectiveness of reoperation.

关 键 词：腰椎间盘突出症 再手术 疗效 

分 类 号：R681.53[医药卫生—骨科学]