腰椎间盘突出症术后对侧复发再手术分析

Analysis of Reoperation on Contralateral Recurrent Lumbar Disc Herniation

目的：分析腰椎间盘突出症术后对侧复发的原因、手术指征．评价翻修手术的效果和预防。方法：分析1993-2004年对8例对侧腰椎间盘突出症复发的患者进行再手术治疗的临床资料及手术效果。结果：经平均16个月的随访．按改良Macnab疗效评定标准．优5例．良2例，可1例，优良率87．5％。结论：再手术的主要原因是初次手术摘除髓核不彻底等因素造成。预防措施为采用对脊柱稳定性破坏小的术式。手术时尽量将髓核取尽。

Objective： To investigate the causes for contralateral recurrent lumbar disc herniation, indications for surgery and efficacy of reoperation as well as preventive measure. Methods： Eight patients with contralateral recurrent lumbar disc herniation underwent revision operation. Results： The effective rate was 100%（8/8） and 7 （87.5%）patients achieved superior results. Conclusion：The main cause for reoperation is that the nucleus puplosus is not completely enucleated during the prior operations. The prophylactic measures are used,which is less destructive to spine stability, to enucleate nucleus puplosus as much as possible during the operation.