腰椎间盘突出症术后下腰痛及再突出的临床分析

目的]探讨腰椎间盘摘除术后下腰痛以及腰椎间盘再突出的情况。方法]在采用后路腰椎板开窗突出椎间盘摘除手术的患者中，随机选择200例，对其中获得5a以上随访的84例患者进行回顾性分析，对手术前后下腰痛JOA评分以及影像学结果进行统计处理。结果]（1）79．8％的患者残留下腰痛，其中14．3％患者存在严重的下腰痛（JOA 1），75％的严重下腰痛患者在35岁以下；（2）13例患者行二次手术，其中12例为腰椎间盘再突出，1例为腰椎不稳，13例患者中主要是50岁以下的成年男性。结论]年轻患者更易发生严重的下腰痛以及腰椎间盘再突出，在年轻患者首次手术时可以根据情况适当考虑脊柱融合。

Clinical analysis of residual low back pain and recurrent herniation after standard discectomy for lumbar disc herniation

Objective]To investigate residual low back pain and recurrent herniation after standard discectomy for lumbar disc herniation.Method]The long-term follow-up was analyzed in 84 patients who were selected randomly from 200 patients during a minimum of 5 years after standard discectomy,which was based on the rating of JOA and image methodology on both before and after the operations.Result](1)Residual low back pain was found in 79.8% of the patients,of which 14.3% had severe low back pain(JOA 1).The majority of the patients with severe low back pain were under age of 35 at time of operation.(2)Twelve patients had operations again because of herniation and 1 patient had operation again because of the unstable of lumbar,who were mainly male adults under age of 50.Conclusion]It is easier for young man to have severe low back pain and herniation recurrence.When conducting the operation for those young patients for the first time,we can consider fusion of spine properly according to their condition.