腰椎间盘突出症术后症状复发的相关问题分析

Analysis on postoperative recurrence of lumbar disc herniation

目的总结腰椎间盘突出症术后症状复发的原因,探讨预防术后复发的治疗方案。方法对2001-2008年收治的74例腰椎间盘突出症术后症状复发患者的资料进行回顾性分析。结果随访15月～8年,再次手术术后优良率90.1%,术前术后JOA评分差异具有统计学意义(P<0.01)。结论术后复发的原因为:突出椎间盘髓核组织摘除不彻底、术后瘢痕粘连、合并或继发侧隐窝狭窄、术后继发腰椎不稳等。二次手术要注意重建脊柱的稳定性。

Objective To study the postoperative recurrent causes of lumbar disc herniation and its reoperation.Methods Postoperative information on 74 cases of lumbar disc herniation from 2001 to 2008 was retrospectively analyzed.Results Postoperative follow-up lasted 15 month to 8 years (an average of 4.8 years) .The excellent rate of reoperation was 90.1% .The JOA scoring was statistically different when compared between before and after reoperation.Conclusion The major causes of recurrent lumbar disc herniation are incompletion of herniated disc excision,postoperative cicatricle syncretion,coexisting narrow and stenosis of nerve root canal,and postoperative segmental instability.The stability of spinal column should be reconstructed in reoperative procedure.