复发性腰椎间盘突出症再手术临床分析

Study of reoperation for recurrent lumbar disc herniation after discectomy

目的探讨复发性腰椎间盘突出症的原因和治疗方法。方法该院自2002年1月～2008年1月共手术治疗复发性腰椎间盘突出症39例,均获得随访,平均随访时间(14.4±1.2)个月。按Nakano标准进行术后疗效评定。结果优24例,良12例,尚可2例,差1例,优良率92.3%。结论初次手术处理不当以及术后腰椎局部生物力学的改变是腰椎间盘突出复发的主要原因。再次手术治疗复发性腰椎间盘突出症,在同时解决减压和稳定两个问题后,可获得良好的效果。

【Objective】 To investigate the etiology and treatment of recurrent lumbar disc hemiation.【Methods】 Thirty -nine patients with recurrent lumbar disc herniation were treated surgically from January 2002 to January 2008.Thirty nine patients were followed up from 6 months to 36 months [mean （14.4±1.2） months].【Results】According to Nakano’s criteria,outcomes were excellent in 24 cases,good in 12 cases,fair in 2 cases,and poor in 1 case.The excellent and good rate is 92.3%.【Conclusion】 The improper treatment of the first time and biomechanics changes of lumbar spine after surgery is the main cause of lumbar discrecurrent protrusion.Reoperative treatment for recurrent protrusion of lumbar disc can deal with decompression and segmental fusion simultaneously,which guarrentee better outcome.