APLD术后复发极外侧型椎间盘突出7例的临床观察

Clinical observation of 7 cases of recurrence APLD extreme lateral disc

目的通过对特定人群经皮腰椎间盘突出切吸术(APLD)后,复发极外侧突出的特殊类型:极外侧经对比的临床现象观察及初步处理,分析此临床现象与特定人群重体力劳动者的相关性,并筛选出最佳的处理措施。方法回顾研究2002-09-2013-09采取APLD术治疗腰椎间盘突出患者2139例.其中单纯APLD组1532例,APLD联合胶原酶组410例,APLD联合臭氧组197例。统计学方法卡方检验比较各组发生率值。结果此类临床现象仅出现在单纯APLD组患者术后,APLD联合胶原酶组及联合臭氧治疗组均未发现。结论 APLD术虽为微创手术,但依旧会对纤维环造成损害,术中应尽量多的取出髓核,并联合胶原酶溶解或臭氧注射后可以明显减少复发率,术后患者应按时加强康复锻炼,半年内尽可能不要从事重体力劳动以降低术后复发率。

Objective Through clinical observation and preliminary processing of the specific people who underwent automated percutaneous lumbar discectomy （APLD） and had postoperative recurrence of special type： suction type extreme lateral disc herniation,to analyze the correlation between clinical phenomenon and the spe- cific people of heavy raanual labor,and thus to select the best treatment. Methods From September 2002 to September 2013, the clinical data of 2139 patients with lumbar disc herniation who received APLD treatment were retrospectively studied. Of 2139 patients, 1532 cases received simple APLD,410 cases received APLD combined with collagenase,197 cases received APLD combined with ozone. Statistical method chi-square test was used to compare the incidence rate. Results This clinical phenomenon only appeared in the simple APLD group after surgery,APLD combined with ozone or eollagenase group were not found. Conclusion Al- though APLD technique is a minimally invasive surgery,but it still has damage to the fiber ring, the nucleus pulposus should be removed as much as possible in the operation, and combined with collagenase dissolved or ozone injection can significantly reduce the recurrence rate,patients should strengthen rehabilitation exercise af- ter operation, and should not engage in heavy manual labor postoperative 6 months as far as possible, in order to reduce postoperative recurrence rate.