腰椎间盘突出症术后失败的远期疗效

目的 探讨腰椎间盘突出症术后失败的远期疗效。方法 1975～1994年经手术治疗208例腰椎间盘突出症，118例获3年以上远期随访，对其中30例“下腰部手术失败综合征”(FBSS)病因进行回顾性分析。结果 椎管狭窄9例，占30％；临床腰椎不稳8例．占26，7％；硬膜外瘢痕4例．占13.3％；不同水平椎间盘突出4例，占13．3％；同一水平椎间盘突出复发2例。占6.7％；神经根损伤、定位错误和假关节形成各1例，分别占3.3％。结论 术后椎管狭窄仍是FBSS的主要原因．而术后出现的临床腰椎不稳也不容忽视。

Investigate of Long-term Results after a Failure in Lumbar Disc Herniation Surgery Operation

Objective To investigate the long-term results after a failure in lumbar disc protrusion surgery.Methods Two hundred and eight cases of lumbar disc herniation were operated from 1975 to 1994.Among them 118 cases were followed up for more than three years with 74.6% of good and excellent results.The rest 30 cases(25.4%)were failed to surgery which were regarded as Failed Back Surgery Syndrome(FBSS).Results Of the thirty patients,nine cases(30%)were spinal canal stenosis and eight(26.7%)were clinical instability of lumbar spine,four had a severe scar on the epidural space,four had a disc herniation in other level,two were recurrent in the same disc,one was nerve root damage,one was pseudarthrosis and one was mistaken location respectively.Conclusion The spinal canal stenosis is the main cause of FBSS,but the clinical instability of lumbar spine is a serious problem after operation.Therefore,we should pay attention to these unsolved problems in the clinical practice.