摘要
目的:对腰椎间盘突出症术后综合征的发生原因进行分析和评价,为预防提供策略,提高椎间盘突出手术治疗的满意率。方法:结合42例腰椎间盘突出症术后综合征患者的病史、症状体征、影像学检查和手术探查资料,进行分析和评价。结果:腰椎间盘突出症术后综合征的主要原因有:(1)椎间盘突出复发和邻近椎间盘突出;(2)椎管内瘢痕形成神经受压,椎管狭窄;(3)神经根减压不充分,侧隐窝狭窄;(4)腰椎不稳;(5)神经损伤;(6)手术节段错误;(7)术前失诊漏诊。治疗效果参照日本矫形外科协会(JOA)下腰痛评分标准,34例行手术治疗:优21例,良8例,可3例,差2例;8例行保守治疗:优3例,良3例,可2例。结论:腰椎间盘突出症术后综合征原因比较多。手术前全面正确的诊断、手术中谨慎仔细和正规准确的操作、维持脊柱稳定性,术后合理的功能锻炼,是减少腰椎间盘突出症术后综合征发生率的有效手段。
Objective： To analyze and evaluate the common causes of postoperative syndrome of lumbar intervertebral disc herniation intending to offer prevention strategies for postoperative complications and improve the efficiency of the operation. Methods： Forty-two patients with operative syndrome of lumbar intervertebral disc herniation who had performed discectomy were given a retrospective study by analyzing their medical history, symptoms and signs, radiology and operational records. Results： The main causes of postoperative syndrome of lumbar intervertebral disc herniation were as follows： （1） disc herniation recurrence and adjacent disc herniation; （2） vertebral canal stenosis and nerve compression caused by scars in vertebral canal; （3） insufficient decompression of nerve root and stenosis of lateral recessus; （4） lumbar instability; （5） nerve injuries; （6） wrong choices operative segments; （7） preoperative misdiagnosis or missed diagnosis. The curative effect was referred to the lumbago scale of Japanese Orthopaedic Association （JOA）. Among 34 cases performed by operation, 21 cases were excellent, 8 cases were effective, 3 cases were average and 2 cases were poor. Among 8 cases treated by non--operation treatment, 3 cases were excellent, 3 cases were effective and 2 cases were average. Conclusion： Multiple factors were responsible for postoperative syndrome of lumbar intervertebral disc herniation, and the following strategies could effectively reduce its incidence, including overall and accurate diagnosis before operation, careful and normative performance in operation and appropriate functional exercise after operation.
出处
《中国中医骨伤科杂志》
CAS
2008年第3期14-16,共3页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
腰椎间盘突出症
术后综合征
原因
预防
Lumbar intervertebral disc herniation
Post-operative syndrome
Etiology
Prevention
