腰椎间盘突出症再手术原因分析

Analysis of reoperation for lumbar disc protrusion

自1989年6月～1996年6月,我院手术治疗腰椎间盘突出症906例,再手术26例,再手术率为2.87％。分析原因有:原椎间盘切除不彻底11例,再突出5例,合并椎管或根管狭窄共3例,定位错误和双间隙突出遗漏共5例,三间隙再突出和医源性损伤各1例。作者提出术前应明确诊断,术中定位准确,充分显露突出的椎间盘,反对片面强调小切口开窗术式,仔细操作,彻底减压以提高手术疗效。

906 cases suffering from lumbar disc protrusion were operated from 1989 to 1996,among them26 cases were reoperated accounting for 2-87%. The causes of reoperation were: 1. reside of the her-niated disc during the first operation in 11 cases ; 2. reprotrusion in 5 cases; 3-stenosis of the spinal canal or nerve root canal in 3 cases; 4. failure in location or two spases of the disc protrusion leading to miss the herniated disc in 4 cases; 5-reprotrusion in three spasses in 1 case; 6. iatrogenic damage 1 case. Authors put forward that a definite diagnosis must be made preoperatively and the location must be accurate intra-operatively. The undue emhasis on small fenestration was wrong. The herniated disc should be fully exposed and completely resected. The treated results were satifactiory if managment carefully and decomres-sion cmpletely.