腰椎间盘突出复发的相关因素初步探讨与预防策略

Relevant factors and preventive strategy for recurrent lumbar disc herniation

[目的]对腰椎间盘突出复发(recurrent lumbar disc herniation)的相关因素进行探讨和评价,为预防提供策略。[方法]16例因腰椎间盘突出复发住院接受再手术患者,对本次手术术前和前一次手术术前的病史、体格检查、影像学资料进行归纳分析,并进行手术探查。[结果]腰椎间盘突出复发的相关因素包括:椎间盘退变程度;椎间稳定性;前次手术术后下地时间;患者体重等。[结论]除医源性因素,腰椎间盘突出复发与椎间盘和腰椎本身性质以及患者医从性有关。正确评估患者病情,以及加强患者医从性能够有效降低腰椎间盘突出复发率。

[ Objective] To analyze and evaluate the relevant factors of recurrent lumbar disc herniation for providing strategy of prevention of this syndrome. [ Method ] Sixteen cases of recurrent lumbar disc herniation were analyzed according to medical history, physical examination and image examination before re - operation and the primary operation, and all the patients received exploration during operation. [ Result] The relevant factors of recurrent lumbar disc herniation were as follows： the extent of disc degeneration, the stability of lumbar spine, the time of getting out of bed after primary operation and the weight of the patients. [ Conclusion] Besides iatrogenic factors, there are several factors related to recurrent lumbar disc herniation, including the characteristics of disc and lumbar spine, as well as the compliance of patients. To remove these factors is the main preventive strategy of recurrent lumbar disc herniation.