开放手术观察腰椎间盘突出症溶核失败45例分析

Surgical observation of 45 cases failure of lumbar disc herniation treated with intervertebral disc chemolysis

目的 通过开放手术观察分析椎间盘髓核化学溶解术治疗腰椎间盘突出症失败原因。方法 收集溶核失败的腰椎间盘突出症 4 5例行开放手术治疗。结果 术中见 4 5例硬膜外脂肪完全消失 ,4 3例髓核未见溶解 ,2例髓核溶解呈糊状但未被吸收 ,2 1例伴有侧隐窝狭窄 ,15例突出物与神经根粘连 ,2 0例黄韧带增厚 ,2例椎管骨性狭窄 ,14例突出物钙化。结论 腰椎间盘突出症病变间隙合并有侧隐窝狭窄、神经根粘连、椎管狭窄、突出物钙化等 ,不是溶核治疗的适应证。

Objective To investigate the causes of failure of intervertebral disc chemolysis for lumbar disc herniation. Methods 45 cases with failure of intervertebral disc chemolysis were undergone operation. Results The epidural fat disappeared completely in 45 cases. The nucleus pulpous were not lysed in 43 cases. The nucleus pulpous were lysed but not absorbed in 2 cases. 21 cases got lateral recess stenosis. 15 got protrusion mass and nerve root adhension. 20 got yellow ligament hypertrophy. 2 got bony spinal stenosis. 14 got protrusion mass calcification. Conclusion It would not be indication for intervertebral disc chemolysis when the lumbar disc herniation is associated with lateral recess stenosis, nerve root adhension, spinal stenosis or protusion mass calcification at the lesion segment.