术后腰椎间盘炎治疗的临床分析

Clinical analysis of the treatment for postoperative lumbar discitis

目的:探讨术后腰椎间盘炎保守、介入、手术治疗的临床疗效与特点。方法:回顾性分析本院1991～2002年5月收治的8例术后腰椎间盘炎的诊疗过程,比较保守、介入、手术3种治疗方法疗效、治疗时间的差异。结果:保守治疗患者好转2例(2?8)。介入和手术治疗患者2例次好转(2?7),5例次治愈(5?7)。保守治疗时间与介入和外科术后恢复时间存在显著性差异(P<0.05);介入治疗后恢复时间均值(19.7天)明显短于手术后恢复时间均值(31.5天)。结论:腰椎间盘炎保守治疗时间长,疗效不确切;外科手术治疗可迅速缓解疼痛,疗效显著,但术后仍需较长恢复时间;介入治疗能以更小的创伤达到与外科手术相同的治疗效果,术后恢复时间短;可作为腰椎间盘炎治疗时优先考虑的方法。

Objective:To evaluate the therapeutic effect of conservative method,interventional procedure and surgical method in the treatment of postoperative lumbar discitis.Methods:A retrospective analysis of the treatment in8cases of postoperative lumbar discitis was made.The cases were treated in our hospital from1991to May2002through conservative method,interventional procedure or surgical method.Their therapeutic effect and the duration of therapy were studied.Re -sults:Only two cases got clinical improvement through conservative method.Two cases got clinical improvement and five cases were cured through interventional or surgical therapy.There was significant difference between duration of the conserva-tive therapy and that of postoperative recovery(P<0.05).The mean of recovery duration after interventional therapy was less than that after surgery.Conclusions:The conservative therapy for postoperative lumbar discitis often needs longer recovery time and its effect is equivocal.The surgery of anterior or posterior remnant disc debridement can obviously relieve the symp-toms in a short time and its therapeutic effect is explicit.Interventional therapy can acquire the same efficacy as surgery;how-ever,it is less invasive and needs shorter time of rehabilitation.Interventional therapy should be the first choice for the treat-ment of the postopera tive lumbar discitis.