溶盘术并发神经根损伤临床观察

A Clinical Report on Nerves Root Injury Due to Chemonucleolysis with Collagenase

目的 :探索胶原酶溶盘术并发神经根损伤的原因。方法 :对 6个临床病例的症状、体征及影像资料和治疗反应进行总结分析。结果 :全部病例均于施术后发生剧烈腰腿痛 ,吗啡类镇痛效果不明显 ,疼痛持续半个月 ,同时逐渐出现神经根性损害 ;神经营养药物及松解术治疗效果不好。结论 :胶原酶溶盘术所致神经损伤是一种严重的根性化学伤 ,恢复困难。为减少神经并发症的发生 ,溶盘术指征要严格为非破的间盘突出症。

Objective:To study the causes of nerves root injury due to chemonucleolysis.Methods:6 cases of lumbar disc herniation treated with collagenase chemonucleolysis had been analyzed.Results:All the cases had a severe pain after operation.The pain continued for half a month and a local paralysis came on at the same time.2 cases had been teated with operative explore.All the cases had been teated with vitamin B etc for 2～3 months.The nerves injury could not recover intactly.Conclusion:The nerve injury due to chemonucleolysis is chemical injury of the nerve root.The indication of chemonucleolysis must be limited to the disc herniation in which the anulus fibrosus is not ruptured.