腰椎管狭窄症经关节突减压术后新发腰腿痛的原因

New-onset pain secondary to transforaminal lumbar decompression: the occurrence and reason

[目的]总结分析腰椎管狭窄症经关节突减压手术后新发腰腿痛的情况,探讨其发生原因及处理对策。[方法]回顾性分析2011年1月—2019年12月腰椎管狭窄经关节突减压术后新发腰腿痛患者的临床资料。[结果] 795例患者中,术后新发疼痛53例,占6.67%。其中,因停用激素致神经根水肿21例、早期感染3例、压迫股外侧皮神经4例、下肢静脉血栓6例、椎弓根螺钉侵入椎管3例、椎间融合器移位2例、关节突周围脊神经后支刺激5例、椎管内血肿3例、骶髂关节炎6例。本组53例患者均得到随访,随访时间12~36个月。随时间推移,VSA评分显著降低(P<0.05)。[结论]早期确定术后引起腰腿疼痛的原因,及时处理,对于促进快速康复,提高临床疗效具有重要意义。

[Objective] To explore the occurrence and reason of new-onset pain after transforaminal lumbar decompression surgery.[Results] A retrospective study of new-onset pain occurrence was conducted on the patients who underwent transforaminal decompression for lumbar spine stenosis from January 2011 to December 2019. [Results] Of 795 patients who received transforaminal lumbar decompression, 53 patents proved new-onset pain secondary to the operation, accounted for 6.67%. In term of reason of the newly pain, it was supposed never root edema after withdrawing dehydrate in 21 cases, early infection in 3 cases, compression of lateral femoral cutaneous never in 4 cases, venous thrombosis of the lower extremity in 6 cases, spinal canal invasion by pedicle screw in 3, cage displacement in 2 cases, irritation of nerves around the facet in 5 cases, intracanal hematoma in 3 and iliosacral arthritis in 6 cases. All the patients were followed up for 12~36 months, the VAS score significantly decreased over time(P<0.05). [Conclusion] Early identification of the reason of new-onset pain secondary to transforaminal lumbar spinal decompression is criterial to deal with it, and achieve functional improvement on time.