腰椎间盘突出症术后复发的机理与手法治疗

The mechanism and manipulative treatment of postoperative recurrence of lumbar intervertebral disk hernia

报告腰椎间盘突出症术后复发病例５６例，其中椎间盘再突出者３８例，其它病理改变引起神经根受压者１８例。结合临床和有关文献分析认为，腰椎间盘突出症术后复发的主要原因是在原间隙或上下椎间隙椎间盘再突出，其次是术后继发的硬脊膜粘连或非手术椎间隙黄韧带增厚，再次是椎体和小关节的退行性改变等。保守治疗应遵循辨证施法的原则。

Fifty six cases of postoperative recurrence of lumbar intervertebral disk hernia are reported in the paper.They included 38 cases of intervertevral disk re protrusion and 18 cases of nervous root compression due to other pathological changes. Through clinical analysis and related literature review,if was believed that the main causes for the postoperative recurrence of the disease included re protrusion of the same intervertebral disk,or the upper of lower one next to it;postoperative secondary adhesion of the spinal dural matter or hypertrophy of ligament flavum;degenerative changes of the vertebral body and the small joint,etc.The conservative treatment should follow the principle“manipulating according to the differentiation of the syndromes”.