腰椎间盘突出症术后复发的原因及预防

Prolapse of lumbar intervertebral disc the causes of recurrent discussion and prevention

目的:探讨腰椎间盘突出症术后复发的原因及预防措施。方法:针对我院自2000年1月～2006年12月收治的46例腰椎间盘突出症再复发的患者,根据情况分别采用不同的方法治疗,术后35例获得随访,随访1个月～2年,对患者的术前体检、影像学检查以及手术情况进行回顾分析。结果:初次手术效果不佳原因有腰椎间隙定位错误、手术方式选择不当、椎间盘病变组织摘除不彻底、椎管减压不彻底、神经根粘连、椎间隙感染、术后功能训练不当。结论:术前全面查体,尤其是必要的辅助检查,选择正确的手术方式,术中准确定位、仔细探查,彻底减压,术后充分引流、正确的恢复期指导,是避免腰椎间盘突出症再手术的关键。

Objective： To evaluate the postoperative recurrence of lumbar disc herniation causes and preventive measures. Methods： In our hospital from January 2000 - December 2006 admitted 46 patients with lumbar disc herniation in patients with recurrence, according to different methods of treatment respectively, after 35 patients have been followed up from 1 month - 2 years, an average of 10 months, the patient＇s preoperative physical examination, imaging studies and surgical cases were analyzed retrospectively .Results： The initial surgery was found ineffective for two reasons： lumbar positioning errors, inappropriate selection of surgical method, incomplete removal of intervertebral disc lesions, spinal decompression is not complete, nerve root adhesion, intervertebral space infection, postoperative functional exercise properly. Conclusion： Preoperative comprehensive investigation body, in particular, it is necessary laboratory examinations, select the correct surgical approach, intraoperative accurate positioning, careful explo- ration, a thorough decompression, after full drainage, the correct recovery guidance is to avoid lumbar disc herniation reoperation the key.