髓核摘除术治疗复发性腰椎间盘突出症

Revision discectomy for recurrent lumbar disc herniation

目的比较再次腰椎间盘摘除术与初次髓核摘除术的临床效果。方法2000年1月～2007年1月，因腰椎间盘术后复发再次行髓核摘除术的患者共31例，其中21例首次手术在本院施行者作为对照组。统计再手术患者症状缓解期，椎间盘突出侧别，手术时间，术中出血量，住院时间，术后并发症以及症状改善优良率，采用t检验及，检验进行统计学处理。结果随访6～48个月，首次术后症状缓解期平均为85个月，同侧复发22例，对侧复发9例。首次手术时间、出血量、并发症等指标均小于再次手术组（P〈0．05）；平均住院日及症状优良率差异无统计学意义（P〉0．05）。结论对于单纯椎间盘突出不合并椎管狭窄以及椎节不稳者，单纯行髓核摘除术临床效果令人满意。

Objective To compare the result differences between primary discectomies and revision discectomies. Methods From January 2000 to January 2007, 31 patients with recurrent lumbar disc herniation underwent revision discectomy. Twenty-one cases underwent primary surgeries in the same hospital were set up as control group. Data of symptomatic relief duration, the side of recurrent disc herniation, operation time, blood loss, hospital day, complications and symptomatic improvement which was assessed by Macnab standard were recorded and compared with Student＇ s-t test andx^2 test. Results All patients were followed up for 6-48 month. Average symptomatic relief duration was 85 months after primary surgery. Recurrent disc herniation occurred in 22 patients on same sides and 9 on opposite side. Operation time, average blood loss and complications of primary surgery were less than revision surgery （P〈0.05）. The differences in the average hospital day and symptomatic improvement rate was insignificant （P〉0.05）. Conclusion Revision discectomy alone was effective for patients suffered from recurrent lumbar disc herniation without spinal, stenosis or instability.