腰椎间盘突出症术后复发再次手术疗效分析

Efficiency of a second surgery for lumbar disc herniation

目的:探讨复发性腰椎间盘突出症的再次手术治疗效果。方法:对2006年5月～2011年6月收治的复发性腰椎间盘突出症患者30例进行回顾性研究,用后路腰椎减压植骨融合内固定手术方式进行翻修手术,比较患者手术前、后的症状、体征及影像学上的变化,了解手术治疗效果及是否有手术并发症的产生。结果:30例患者均顺利完成手术,患者随访3个月～3年半,平均随访时间为1.5年,26例患者症状体征完全消失,基本恢复正常。2例随访时间不长,仍诉患侧肢体麻木、乏力;另2例因压迫时间长,术后恢复缓慢。结论:临床上需严格掌握复发性腰椎间盘突出症的手术指征,对于手术适应证明确的患者,后路腰椎减压植骨融合内固定手术有效。

Objective： To discuss the efficacy of a second surgery for lumbar disc herniation.Methods：The clinical data of 30 cases with recurrent lumbar disc herniation admitted to our hospital from May 2006 to June 2011 were retrospectively analyzed.Patients all underwent a second surgery by posterior lumbar decompression and bone graft fusion with internal fixation.Patients＇ symptoms change of signs and iconography images were compared before and after the surgery.The treatment effects and complications were also observed.Result： The operation was completed smoothly in all the 30 cases.According to an average follow up of 1.5 years ranging from 3 months to 3.5 years,symptoms and signs were completely disappeared in 26 cases,recovery in 2 cases were slow,and 2 cases still suffered from limb numbness and hypodynamia.Conclusions： The operation signs of lumbar disc herniation should be mastered strictly in clinic.Posterior lumbar decompression and bone graft fusion with internal fixation is effective for patients who have definite operative indication.