腰椎间盘突出症再手术原因分析及经验教训

目的:通过对椎间盘突出症手术患者再次手术原因进行分析,总结经验教训,提高手术质量。方法:对椎间盘突出症二次手术患者进行详细术前检查,针对不同原因实行不同手术方法。结果:所有病例于再手术后得到随访,全部病例症状较术前明显改善。结论:椎间盘突出症诊断应临床查体、影像学与神经电生理检查互参互证,避免漏诊。术中应尽可能完全彻底取尽髓核,并彻底冲洗,避免复发。复杂性腰椎间盘突出症行全椎板减压,椎间植骨融合,椎弓根螺钉内固定术,预防腰椎不稳的发生。

Analysis and Experience Drawn from the Resurgery of Prolapse of Lumbar Intervertebral Disc

Objective:To analyze the cause of re-surgery on patients with prolapse of lumbar intervertebral disc,draw lessons and experience so as to improve the quality of surgery.Method: Give detailed preoperational examination to patients suffering from prolapse of lumbar intervertebral disc twice and apply different surgical methods in accordance with different causes.Result: All patients followed up after the surgery improved evidently compared to pre-surgery conditions.Conclusion: In the diagnosis of prolapse of lumbar intervertebral disc,clinical examination of the patients combined with physiological examination of iconography and neuron-electricity shall be conducted together in case of any missed diagnosis.Vertebral pulp shall be removed in the surgery and flushed as completely as possible in case of recrudescence.As for complicated case of prolapse of lumbar intervertebral disc,laminectomy and decompression and bone grafting for inter-spinal blend shall be applied,pedicle of vertebral arch shall be immobilized with bolts to prevent lumbar imbalance.