腰椎手术失败综合征的再手术治疗

目的]探讨腰椎手术失败综合征（FBSS）再手术治疗的方式和注意事项。方法]对20例再手术治疗的腰椎手术失败综合征（FBSS）患者进行回顾性研究，综合分析FBSS患者的病史、体征、影像学表现以及术中探查结果等资料。术中行硬膜囊和神经根减压以及自体骨植骨融合，其中12例腰椎失稳的患者辅以椎弓根钉系统固定，术后进行一定的康复锻炼。结果]术中损伤神经根1例，术后暂时性的脑脊液漏3例。治疗效果参照Ragab的评估标准进行综合评估。本组20例患者，治疗效果优12例，良5例，可2例，差1例；优良率为85％。结论]FBSS是一多病因多表现的综合征，术前应当综合分析患者的临床表现，寻求病因，制订适宜的手术方案。

Re-operation for failed back surgery syndrome

Objective]To investigate the manner and the key of reoperation for failed back surgery syndrome(FBSS).Method]Twenty reoperated FBSS cases were investigated retrospectively.The data about the history,physical sign,image and exploration were analyzed.The treatment protocols were made correspondingly.Twenty cases were all operated with decompression of nerve root and dura assisted with fusion of auto-bone kraft between posterior arches of vertebra.In them,12 cases who were suffered from spinal instability were treated with pedicle screw fixation supplementarily.All patients were rehabilitated after operation.Result]The complications included neural root injury in 1 case and tear of dural cyst in 3 cases.The outcome was evaluated according to the standard of Ragab's,10 cases were excellent,5 cases good,2 cases fair and 1 case poor.The rate of excellent and good was 85%.Conclusion]FBSS is a complication of back surgery manifesting as a syndrome with multi-factor and multi-present.We should analyze the clinical present of patient integratively to find out the cause before operation,and map out appropriate operational protocol.