腰椎间盘突出外科手术后无效或复发的经皮摘除间盘治疗

Percutaneous lumbar discectomy in patients with non-effective surgical discectomy or recurrent disc herniation

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摘要目的：对腰椎间盘突出手术后无效、复发或感染的病例原来作为经皮摘除间盘治疗（简称ＰＬＤ）的禁忌证之一，在本组１６例此类患者中有１３例行ＰＬＤ治疗。材料和方法：本组中，９例ＣＴ表现为外科术后椎间盘突出，１例术后感染，３例术后复发，另３例影像检查间盘突出表现。对其中１３例行ＰＬＤ治疗。结果：本组８５％（１１／１３）行ＰＬＤ治疗效果良好。结论：初步结果表明，ＰＬＤ同样适应于外科手术后无效、复发或感染的患者，病例选择应根据临床表现和影像学改变而定。 Purpose: Patients with a history of lumbar surgery were excluded from percutaneous lumbar discectomy(PLD)according to previous criteria, 16 patients with low back and eg pain after surgical lumbar discectomy were collected for PLD in this series. Materials and Methods:In this series, lumbar disc herniation was revealed by CT in 9 cases. Disc infection after operation was shown in 1 case. Recurrent disc herniation was found in 3. There was no lumbar disc herniation finding in 3 others. PLDs were performed in 13 cases. Results:Excellent to good result were obtained in 85%(11/13). Conclusion:The preliminary results showed that the PLD is also indicated for the patients with non-effective,recurrent disc herniation and infection of postsurgical discectomy. Criteria for patient selection depende on clinical and imaging findings.