摘要
目的 探索椎间盘突出再次手术的原因。方法 对 10 2例椎间盘突出再次手术病例之临床表现、影像特点、手术所见进行分析。结果 微创椎间盘摘除所致 2 8例 ,定位不准致突出椎间盘未能摘除 5例 ,多椎间隙突出仅摘除 1个间隙者 11例 ,术中显露不充分致突出椎间盘组织未能完整摘除或残留对侧椎间盘 2 2例 ,游离椎管内或突入硬膜下 8例 ,极外侧椎间盘突出 12例 ,神经根粘连或神经根通道继发性狭窄 16例。经术后 1～ 10年随访 ,优良 92例、可 7例 ,差 3例。结论 详细分析影像学改变 ,方能给椎间盘突出切除提供较佳的手术模式 ,而娴熟的手术技巧、扎实的局部解剖知识是椎间盘完整切除及降低术后并发症的关键。
Objective To analyse the factors of revision surgery of lumbar disc herniation(LDH) Methods Clinical symptoms,image characteristics and intra-operative observations in 102 cases with revision operation on LDH were analyzed.Results Because of incorrect localization,among 28 cases of minimal incision discectomy,5 cases had the LDH not resected,in 11 cases of multiple LDH,only one intervertebral space was explored,22 cases had incomplete extraction or residual disc tissue over the contra-lateral side because of inadequate exposure during operation,8 cases with disc tissue protruded into the vertebral canal or projected into the subdural space,12 cases with extreme-lateral LDH and 16 cases with nerve root adhesion or secondary nerve root pathway stenosis were all re-explorated and had the revision procedures done in the vertebral canal.Through 1～10 years of follow-up,92 cases had excellent results,7 cases good and 3 cases poor.Conclusion Perfect operative procedures for LDH resection must be based on detailed analysis of imaging examination results.Dexterity in operation technique and thorough topographic knowledge are the key points for successful LDH surgery.
出处
《中国骨伤》
CAS
2003年第1期3-5,共3页
China Journal of Orthopaedics and Traumatology
关键词
椎间盘突出症
再次手术
原因
临床分析
临床表现
手术治疗
Intervertebral disk displacement
Intervertebral discectomy
Postoperative complications
