靶位注射胶原酶治疗腰椎间盘突出术后复发

目的：探讨靶位注射胶原酶治疗腰椎间盘突出术后复发的临床意义。方法：27例术后复发患者接受注射胶原酶治疗，早期行侧隐窝注射法5例，后期行CT介入靶位注射法16例，CT介入联合靶位注射法6例。结果：所有患者经6个月～2年随访，优9例，良8例，可5例，差5例，优良率63．0％，有效率81．5％；靶位穿刺37次，首次穿刺失败4次(1／9)；4例于注射胶原酶后6～13个月复查CT，发现突出物缩小80％～90％。结论：靶位注射胶原酶溶盘术可与手术互补，适用于腰椎间盘突出术后复发的治疗。

Target-injection of collagenase for the treatment of recurrent postoperative lumbar disc herniation

Objective:To investigate the clinical significance of the target-injection of collagenase for the treatment of recurrent postoperative lumbar disc herniation.Methods:27 patients with recurrent lumbar disc herniation at L 4,5 to L 5S 1 were included in this study.The lateral recess injection was applied in 5 cases at early stage,the target-injection method by CT intervention in 16 cases and the combined target-injection method with CT intervention in 6 cases at later period.Results:All patients were followed up 6 months to 2 years after treatment.9 cases got excellent result,8 cases good,5 cases fair and 5 poor.The excellent and good rate was 63.0% and the effective rate was 81.5%.There were 4 times with the miss of puncture (1/9) on the first time.The CT image showed in 6 to 13 months:The prominence was minified 80% to 90% in 4 cases.Conclusion:The target-injection of collagenase for intervertebral disk chemolysis may be complementary therapy for recurrent postoperative lumbar disc herniation.