腰椎间盘突出症首次手术失败76例相关因素分析

目的对腰椎间盘突出症手术失败的原因进行分析，旨在提高首次手术的成功率。方法对1997—2007年76例腰椎间盘突出症手术失败患者进行回顾性分析，对患者的初次术前诊断、手术方法、再术前临床表现、影像学检查进行评估。探讨首次手术失败原因。结果76例首次手术患者术后获得随访，随访时间12—120个月，平均60个月。首次手术出现术后症状复发、腰椎不稳等问题，需再次手术治疗，初次手术失败中行开窗、扩大开窗法腰椎间盘摘除术占52．8％。结论手术失败的原因主要有：未严格掌握手术适应证多间隙突出遗漏定位错误及髓核摘除不彻底、并发后腰椎不稳等。

Lumbar Disc Herniation Surgery for the First Time 76 Cases of Failure Analysis of Relevant Factors

Objective To discuss the lumbar intervertebral disc surgery to analyze the reasons for the failure to improve the success rate of surgery for the first time. Methods 1997 - 2007 in 76 cases of lumbar disc herniation in patients with failure of the operation were reviewed for the first time in patients with preoperative diagnosis, surgical techniques, pre - operative clinical manifestations, imaging for evaluation. For the first time to explore the reasons for the failure of the operation. Resuits 76 cases of patients after surgery for the first time was followed up for 12 to 120 months, an average of 60 months. For the first time after surgery appear recurrence of symptoms, lumbar instability, and so on, need surgery again, the failure of the Bank of China initial surgery window, expand the law windows lumbar discectomy accounted for 52. 8 percent. Conclusion The failure of the operation of the main reasons are ： not strictly indication gap more prominent positioning errors and omissions discectomy is not complete, complicated by post - lumbar instability, and so on.