| 再次腰椎间盘手术病人的临床特征分析 |
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Received:December 01, 1997 Revised:February 01, 1998
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| 期刊信息：《中国骨伤》2000年13卷，第5期，第264-266页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:对84例腰椎间盘再次手术病人临床特征进行了资料分析,评价临床症状体征指标与术后诊断的相关性。
方法:所有病人再次手术后至少随访2年以上。其中复发性椎间盘突出症34例,继发性侧椎管狭窄20例,神经根周围纤维化症20例。
结果:经统计学分析,神经根周围纤维化症最常见临床诊断指标是神经根压迫症,休息痛,行走能力>0.5公里和前次手术后无痛期<1年,其中3项以上阳性者诊断符合率达75%.再次手术随访效果,神经根再压迫病变效果优于神经根周围纤维化症(P<0.01).
结论:休息痛,行走能力>0.5公里,神经根压迫症,无痛期<1年4项指标对鉴别诊断神经根周围纤维化症有较高临床实用价值。当排除实质性神经根受压后,神经根周围纤维化症的手术选择应尽量避免。 |
| [关键词]:椎间盘突出,腰 诊断,术后 再手术 |
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| The Clinical Manifestations of Patients Undergone Revision Surgery of Intervertebral Disc Herniation |
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Abstract:
Objective:To analyze the clinical characteristics of patients undergone secondary lumbar disc surgery and to evaluate the correlation between post operative diagnosis and clinical symptoms and signs
Methods:All the patients were followed up for more than 2 years Of the 84 cases,34 had recurrent protrusion of intervertebral discs,20 had subsequent lateral spinal canal stenosis and 20 had periradicular fibrosis
Results:Clinical diagnostic criteria of periradicular fibrosis includes nerve root compression,rest pain,walking distance of more than 0.5 km and pain free period less than 1 year after last operation 3 or all of the 4 criteria were positive in 75% of patients with periradicular fibrosis The effect of secondary operation showed that patients with nerve root compression had better results than those with periradicular fibrosis.
Conclusion:The above four criteria are of high clinical significance for differential diag nosis of periradicular fibrosis Surgical treatment of periradicular fibrosis should beavoided if parenchymatous compr ession of the nerve can be ruled out. |
| KEYWORDS:Intervertebral disk displacement lumbar Diagnosis postoperative Reoperation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 高苏宁,陈长玉,沈晓秋,邹晓波.再次腰椎间盘手术病人的临床特征分析[J].中国骨伤,2000,13(5):264~266 |
| 英文格式: | GAO Su ning,CHEN Chang yu,SHEN Xiao qiu.The Clinical Manifestations of Patients Undergone Revision Surgery of Intervertebral Disc Herniation[J].zhongguo gu shang / China J Orthop Trauma ,2000,13(5):264~266 |
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