967例腰椎间盘突出症术后远期疗效分析

Long term Outcome Analysis in 967 Cases of Lumbar Discoidectomy

目的：观察腰椎间盘突出症手术的远期疗效。方法：对术后３年以上的９６７例进行随访分析，随访率７２２％。结果：术后优良率９３２％。存在的主要问题：腰无力占１２８％，腿麻木１１３％，腿痛５０％，性功能低下４４％，排便排尿费力各为２１％，１９％。结果提示：①选择合适的手术方式，以减少硬膜外及神经根周围纤维化；②严格手术适应证，对神经严重受压者应及时手术，以防止发生不可恢复的神经损伤；③尽早康复训练，提高腰背肌功能。

Aim:To observe the long term results of lumbar discoidectomy.Methods:967 patients who underwent disc surgery for three years and over were investigated.The follow up rate was 72.2%.Results:The excellent and good rate was 93.2%.The major sequelae of discoidectomy include:low back weakness cases 12.8%,numbness in the lower extremity 11.3%,pain in the lower extremity 5.0%,sexual disorder 4.4% ,dyschezia 2.1% and dysuria 1.9%.The results suggest that ①selection of appropriate operative techniques is of importance in that it can reduce the adverse effects of fibrosis and scar adhesion around the nerve roots;②it is advisable to be strict with indications for disdectomy,and the pronounced entrapment of the nerve roots should be removed in time to prevent irreversible neurologic injury;and ③the earliest possible rehabilitation makes for reinforcement of lumbar musculature.