30例胶原酶治疗腰椎间盘突出症无效原因分析

目的进一步探讨胶原酶治疗腰椎间盘突出症的适应证.方法在2年中对30例用胶原酶治疗腰椎间盘突出症的患者因治疗无效,症状未改善,予以手术摘除术.术中进行探察.结果 30例患者手术后症状均改善.但术中发现,髓核及后纵韧带钙化者18例,突出物较大者10例,髓核粘连4例,椎管狭窄者8例,神经根管狭窄者8例,脊柱退变不稳者3例.结论对于一些椎间盘突出后明显钙化,椎管狭窄,或神经根管明显狭窄者,或椎板及黄韧带增厚者而又同时伴有椎间盘突出者,或巨大型突出者,或个别腰椎不稳定者,均不宜行胶原酶治疗.

Aetiological analysis on the ineffectiveness of treatment on lumbar intervertebral disc herniation with colla- genase in 30 cases

Objective To explore the indication of treatment of lumbar disc herniation with collagenase Methods The surgical operations were made in 30 cases of the lumbar disc herniation treated with collagenase, all of them were uneffective. Then the surgical operations were made on them. Results After operation, all of them were improvement clinically. During the operations, it was discovered that there was 18 cases of calcification at lumbar disc and posterior longitudinal ligament, 10 cases of larger herniation,4 cases of nucleus pulposus adhesion,8 cases of spinal vertebral canal stenosis,8 cases of nervous root canal stenosis,and 3 cases of spinal retrogressive instability. Conclusion The above mentioned pathological changes of patients should not to be treated with collagenase and the application of surgical operation could shorten the period of treatment.