22例腰椎间盘突出症术后复发的原因分析及治疗  

Reason Analysis and Treatment of Postoperative Recurrence of 22 cases of Lumbar Disc Herniation

作　　者：刘海龙[1] 

机构地区：[1]铁岭市中心医院骨一科,辽宁铁岭112000

出　　处：《中国伤残医学》2017年第15期5-7,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：研究腰椎间盘突出症患者术后复发的原因以及治疗.方法：选择2013年8月~2015年8月我院收治的22例经手术治疗后复发的腰椎间盘突出的患者作为研究对象,分别对患者进行2次手术治疗,根据患者病史、腰椎部位MRI检查结果、CT检查结果以及2次手术具体情况,分析患者复发的原因以及治疗效果.结果：患者进行2次手术后显效的有13例,有效的8例,治疗有效率为95.45%;患者术后复发的原因按照比例多少依次为髓核突出、继发神经根通道狭窄、瘢痕组织粘连、腰椎继发性不稳4类,偶有患者复发原因在2类以上.此外,大多数术后复发患者多为肥胖、年龄在45岁以上、长期负荷过重、具有吸烟史.结论：腰椎间盘突出症术后复发的原因包括髓核突出、继发神经根通道狭窄、瘢痕组织粘连、腰椎继发性不稳等4类,其中尤以髓核突出和瘢痕组织粘连最为常见,根据患者的不同情况选择适当的2次手术术式,治疗效果将会更好.Objective： To study lumbar disc herniation in patients with postoperative recurrence and treatment. Methods; From Au- gust 2013 to August 2015, in our hospital of 22 cases after surgical treatment of recurrent lumbar disc prominent patients as the research object, the patients were treated for two times, according to the patient＇s medical history, lumbar site MRI examination results, CT exami- nation results and 2 times the specific circumstances of the operation analysis of the causes of recurrence and treatment effect. Results： Two cases were markedly effective in 13 cases, effective in 8 cases, the effective rate was 95.45% ;Postoperative recurrence in accordance with the proportion of how much followed by herniation of the nucleus pulposus, secondary nerve root canal stenosis, scar tissue adhesion, secondary lumbar instability four, occasionally in patients with relapsed in 2 class above. In addition, most of the patients with postopera- tive recurrence of obesity, older than 45 years of age, long - term overload, with a history of smoking. Conclusion： Lumbar fat herniation recurrence after including nucleus pulposus, secondary nerve root canal stenosis, scar tissue adhesion, secondary to lumbar spine of insta- bility four categories, especially with herniation of the nucleus pulposus and scar tissue adhesion is most common, choose the appropriate 2 times operation according to the different situation of the patient, treatment, the effect will be better.

关 键 词：腰椎间盘突出症 术后复发 原因 治疗 

分 类 号：R681.5[医药卫生—骨科学]