腰椎间盘突出症术后复发的原因分析及预防

Analysis and Prevention of Recurrence of Lumbar Disc Herniation

目的探讨腰椎间盘突出症术后复发的原因及预防措施,为减少术后再复发提供科学的依据。方法针对我院收治的35例腰椎间盘突出症患者再手术原因进行分析。结果腰椎间盘突出症术后复发的原因有:术前检查不完善、诊断不准确;手术者缺乏经验,手术操作不规范、不熟练造成手术定位错误、髓核切除不彻底、术后神经根粘连、马尾神经损伤、椎间隙感染;患者术后功能训练不当。本组35例患者经对症治疗后随访6～12个月,优良率77.1%,有效率91.4%。结论术前完善必要的辅助检查、明确诊断;手术规范、熟练、严格掌握手术指征、合理选择手术方式、术中定位准确、操作仔细,预防神经根粘连、马尾损伤、椎间隙感染以及正确的恢复期指导是避免腰椎间盘突出症术后复发的关键。

Objective Investigate the causes of recurrence of lumbar disc herniation and preventive measures, provide a scientific basis for the reduction of postoperative recurrence. Methods Our hospital, 35 cases of lumbar disc herniation surgery to analyze the causes. Results Causes of recurrence of lumbar disc herniation： preoperative examination is imperfect, inaccurate diagnosis; surgery who lack experience, the operation is not standardized, unskilled caused by surgical positioning error, not completely removed nucleus pulposus, nerve root adhesions aftercauda equina injury, disc space infection; improper postoperative functional training.This group of 35 patients were symptomatic after treatment were followed up for 6 to 12 months, excellent rate of 77.1%, efficiency 91.4%.Conclusion Improve the necessary auxiliary examination before surgery, to confirm the diagnosis; surgery practices, skilled, strict control of the indications for surgery, a reasonable choice of surgical approach, intraoperative positioning accuracy, careful operation, to prevent nerve root adhesion, the cauda equina injury, disc space infection, and the correct recoveryof guidance is to avoid the recurrence of lumbar disc herniation.