复发性腰椎间盘突出症的影像学分析及临床意义

目的:探讨复发性腰椎间盘突出症的影像学特点及其临床意义。方法:回顾52例复发性腰椎间盘突出症患者的临床资料,分析其站立位腰椎正、侧位及过伸、过屈动力位X线片和腰椎MRI等影像学资料及其临床特点。结果:同节段突出36例,相邻节段突出6例,同节段突出合并相邻节段突出10例。20例存在腰椎失稳,2例合并腰椎滑脱,腰椎失稳主要发生在L4/5节段,与手术方式及椎间隙狭窄程度相关。结论:复发性腰椎间盘突出多伴有椎间隙狭窄和节段性失稳,对复发性腰椎间盘突出症的治疗要兼顾减压和稳定两个方面。

Clinical features and radiographic analysis of recurrent lumbar disc herniation

Objective:To explore the characteristics of radiography and clinical features of recurrent lumbar disc herniation(LDH).Method:52 cases of recurrent LDH were reviewed retrospectively.The clinical manifestation and image data of X-rays including standing lumbar AP?lateral view and flexion-extension dynamic view,and lumbar MRI were analyzed.Result:There were 36 cases of recurrent LDH at the same level,6 cases at the adjacent level,10 cases at the same level combined with adjacent level.20 cases had lumbar instability and 2 cases showed spondylolisthesis.Segmental instability mainly occurred at L4/5 level,it correlated with surgical methods and extent of disc space narrowed.Conclusion:Recurrent LDH has particular characters like disc space narrowed and segmental instability.The reoperative treatment should deal with decompression and stability simultaneously.