椎间盘突出症再次手术的原因分析
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作者Author单位AddressE-Mail
刘兴炎 LIU Xingyan 兰州军医兰州总医院骨科,甘肃兰州730050 Department of Trauma and Orthopaedics,Lanzhou General Hospital of PLA Gansu Lanzhou 730050  
付晨 FU Chen 兰州军医兰州总医院骨科,甘肃兰州730050 Department of Trauma and Orthopaedics,Lanzhou General Hospital of PLA Gansu Lanzhou 730050  
甄平 ZHEN Ping 兰州军医兰州总医院骨科,甘肃兰州730050 Department of Trauma and Orthopaedics,Lanzhou General Hospital of PLA Gansu Lanzhou 730050  
李旭升 LI Xiusheng 兰州军医兰州总医院骨科,甘肃兰州730050 Department of Trauma and Orthopaedics,Lanzhou General Hospital of PLA Gansu Lanzhou 730050  
刘占宏 LIU Zhanhong 兰州军医兰州总医院骨科,甘肃兰州730050 Department of Trauma and Orthopaedics,Lanzhou General Hospital of PLA Gansu Lanzhou 730050  
王宏东 WANG Hongdong 兰州军医兰州总医院骨科,甘肃兰州730050 Department of Trauma and Orthopaedics,Lanzhou General Hospital of PLA Gansu Lanzhou 730050  
高秋明 GAO Qiuming 兰州军医兰州总医院骨科,甘肃兰州730050 Department of Trauma and Orthopaedics,Lanzhou General Hospital of PLA Gansu Lanzhou 730050  
期刊信息:《中国骨伤》2003年,第16卷,第1期,第3-5页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:探索椎间盘突出再次手术的原因。

方法:对102例椎间盘突出再次手术病例之临床表现、影像特点、手术所见进行分析。

结果:微创椎间盘摘除所致28例,定位不准致突出椎间盘未能摘除5例,多椎间隙突出仅摘除1个间隙者11例,术中显露不充分致突出椎间盘组织未能完整摘除或残留对侧椎间盘22例,游离椎管内或突入硬膜下8例,极外侧椎间盘突出12例,神经根粘连或神经根通道继发性狭窄16例。经术后1~10年随访,优良92例、可7例,差3例。

结论:详细分析影像学改变,方能给椎间盘突出切除提供较佳的手术模式,而娴熟的手术技巧、扎实的局部解剖知识是椎间盘完整切除及降低术后并发症的关键。
【关键词】椎间盘移位  椎间盘切除术  手术后并发症
 
Analysis of the factors of revision operation on lumbar disc herniation
ABSTRACT  

Objective:To analyse the factors of revision surgery of lumbar disc herniation(LDH)

Methods:Clinical symptoms,image characteristics and intra-operative observations in 102 cases with revision operation on LDH were analyzed.

Results:Because of incorrect localization,among 28 cases of minimal incision discectomy,5 cases had the LDH not resected,in 11 cases of multiple LDH,only one intervertebral space was explored,22 cases had incomplete extraction or residual disc tissue over the contra-lateral side because of inadequate exposure during operation,8 cases with disc tissue protruded into the vertebral canal or projected into the subdural space,12 cases with extreme-lateral LDH and 16 cases with nerve root adhesion or secondary nerve root pathway stenosis were all re-explorated and had the revision procedures done in the vertebral canal.Through 1~10 years of follow-up,92 cases had excellent results,7 cases good and 3 cases poor.

Conclusion:Perfect operative procedures for LDH resection must be based on detailed analysis of imaging examination results.Dexterity in operation technique and thorough topographic knowledge are the key points for successful LDH surgery.
KEY WORDS  Intervertebral disk displacement  Intervertebral discectomy  Postoperative complications
 
引用本文,请按以下格式著录参考文献:
中文格式:刘兴炎,付晨,甄平,李旭升,刘占宏,王宏东,高秋明.椎间盘突出症再次手术的原因分析[J].中国骨伤,2003,16(1):3~5
英文格式:LIU Xingyan,FU Chen,ZHEN Ping,LI Xiusheng,LIU Zhanhong,WANG Hongdong,GAO Qiuming.Analysis of the factors of revision operation on lumbar disc herniation[J].zhongguo gu shang / China J Orthop Trauma ,2003,16(1):3~5
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