手术治腰椎间盘突出症的远期疗效观察

Long Term Follow-up of Operated Lumbar Intervertebnal Disc Protrusion

腰椎间盘突出症的手术成功率为７０～８７％．我们一组１３２６例随访１３年的优良率为８５．６％．而本组６３７例随访时间７～３２年．平均１８年２个月．优３３６例（５２．７％），良２６０例（４０．８％），进步２２例（３．５％）．差１９例（３．０％），总优良率为９３．５％。我们同意腰椎间盘突出症术后随时间的推移可提高优良率的观点．我们认为应严格掌握手术适应证，绝对适应证为马尾神经损害综合征，或有进行性加重者，相对适应证为顽固的疼痛，严重的姿势受限．影响工作和日常生活者．手术方法首选开窗法，对椎管或侧隐窝狭窄者宜扩大减压，以提高疗效。再手术的指征更应严格控制．尤对粘连性蛛网膜炎因再手术的疗效不佳，更持保留态度。

SurgicaI treatment usually yields a satisfactory result in patients with lumbar intervertebral discorotrusion.In this study 93.5%of637 patients showed good or excellent results、The follow-up ra-nged from 7 to 32.years. The results showed excellent in 336 cases,good in 260 cases,fair in 22 cas-es and bad in 19 cases.The operative indications should be strictly followed:caudal equina injury isabsolute indication.Other indications are persistent pain affccting daily activities and the first cho-ice of iperative methods is fenestration operation.