腰椎间盘突出症术后并发椎间盘炎原因分析及治疗

目的探讨椎间盘突出手术后椎间盘炎发生的原因及治疗。方法对自1999年至今行腰椎间盘突出症髓核摘除术后发生椎间盘炎23例患者进行回顾性研究,分析该并发症发生相关原因,对椎间盘炎患者采取抗炎、制动、病灶清除、置管冲洗等综合措施治疗。结果本组椎间盘炎的密切相关因素有糖尿病4例(17.4%),身体其他部位存在感染4例(17.4%),术中髓核摘除不彻底3例(13.0%),椎管内血肿形成6例(26.1%),脑脊液漏2例(8.7%),其他原因4例(17.4%)。治愈20例,治愈率87.0%。结论术前准备充分,术中规范、细致操作,术后加强护理可有效减少椎间盘炎的发生。制动、椎间盘病灶清除、置管冲洗、使用抗生素是治疗椎间盘炎的有效措施。

Analysis and Treatment of Complicated Discitis Following Removal of Nucleus Nulposus in Lumbar Disc Herniation

Objective To investigate the cause and treatment of postoperative discitis in lumbar disc herniation.Methods The clinical data of 23 cases with discitis following removal of nucleus pulposus in lumbar disc herniation were analyzed retrospectively to explore the cause of the complication.All causes were treated by using antibiotic,immobilization,nidi debridement and nidi irrigation.Results The close relation factors to discitis in this group were diabetes(4 cases,account for 17.4%),other region infection,(4 cases,account for 17.4%),incomplete removal of nucleus pulposus(3 cases,accounted for 13.0%),intravertebral hematoma compression(6 cases,accounted for 26.1%),leakage of cerebrospinal fluid(2 cases,account for 8.7%) and other(4 cases,accounted for 17.4%).20 cases were cured and the curative ratio was 87.0%.Conclusions Ample preoperative preparation,canonical manipulation during operation and postoperative adequate nursing were necessary to reduce incidences of discitis.Using antibiotic,immobilization,nidi debridement and nidi irrigation were effective curative measures to discitis.