前路腰间盘摘除术远期疗效及再手术原因分析

The Analysis of Long term Outcome of Anterior Lumbar Discectomy

目的 :应用定量指标判定前路腰间盘摘除术远期疗效 ,分析再手术原因 ,为临床工作提供一定的理论根据。方法 :应用 Roland及 Greenough定量评级标准 ,随访 1987～ 1991年于我院行首次前路腰间盘摘除术的患者。结果 :有效随访 6 7例 ,随访时间 3～ 7年。应用以上两标准 ,术后优良率分别为 82 .0 9%、89.0 9% ,再手术 4例(5 .97% )。根据年龄及病程进行分层分析 ,各层间无显著差异。结论 :前路手术可获得较高的手术成功率 ,提高手术技巧及指导病人康复可有效避免再手术。病程及年龄并不是判定是否应用前路手术的绝对指标。术前影像学诊断判定无椎管和神经根管狭窄及准确定位是手术成功的关键。

Objective: Our aims were to determine the long term outcome of anterior lumbar discectomy by quantitative questionnaire, to analyze the reasons of re operation, and to provide a theoretical foundation for the clinic. Methods: The Roland and Greenough quantitative questionnaires were used to follow up the cases who underwent first anterior lumbar discectomy in our hospital from 1987 to the end of 1991. Results: Sixty seven patients were available during the follow up and the time of follow up was 3 to 7 years. The post operative good results of the 2 methods were 82.09% and 89.09%. Four patients underwent re operation (5.95%). Stratum analysis by duration of disease and age revealed that there was no significant difference among different stratums. Conclusion: High percentage of good results was got after anterior lumbar discectomy. Improving surgical technique and the rehabilitation guiding could prevent re operation. Duration of disease and age were not the absolute criteria for anterior lumbar discectomy. Determining of no lumbar stenosis and root canal stenosis before the operation and accurate localization were the key points of success of the operation.