人工髓核置换术治疗腰椎间盘突出症术后疼痛

目的:探讨人工髓核假体(PDN)治疗腰椎间盘突出症术后疼痛的原因和治疗。方法:自2002年12月～2004年7月对17例单节段腰椎间盘突出症施行PDNSolo置换术,其中7例术后出现腰部疼痛,并获得8～22个月(平均13.4个月)的随访,。结果:其中5例为术后短期剧烈疼痛,经消炎止痛类药物对症治疗后症状消失,无运动功能丢失,2例术后出现长期腰部疼痛,取出PDN假体,予以重新置入,术后1周腰部疼痛消失。结论:PDN置换术后患者出现腰部疼痛,其原因可能为术后腰背肌受刺激,引起肌肉痉挛所引起腰部疼痛,而长期腰部疼痛可能为椎间不稳所致,所有术后疼痛患者经对症早期积极治疗后均能获得满意效果。

Investigation of PND in Postoperative LDH Pain

Objective:To investigate the reason and the treatment of PDN in postoperative LDH pain.Methods:From December 2002 to July 2004,17 consecutive cases with single-level LDH undergoing PDN Solo replacement.7 of the 17 patients suffered from lumbar pain after operation and were followed up for 8 to 22 months(average 13.4 months).Results:Among the 7 cases,5 cases suffered from short-term postoperative lumbar pain,and were successfully treated by anti-inflammatory and antalgesic drug without loss of motor function.Long-term lumbar pain after operation was observed in other 2 cases,who were taken out of the PDN and re-inserted it,then lumbar pain disappeared one week after reoperation.Conclusions:The reason why the patients underwent PDN replacement suffered postoperative lumbar pain might be that the lumbodorsal muscle got stimulation and spasm,while long-term lumbar pain might be caused by the unsteadiness of the lumbar spine.Satisfactory outcome can be obtained by earlier active treatment in all the patients with postoperative lumar pain.