摘要
目的分析复发性腰椎间盘突出症的病理机制并探讨合理的手术方法。方法42例复发性腰椎间盘突出症的患者采取手术治疗,其中19例腰4～5椎间隙行经椎间孔椎间融合术(TLIF),另外23例腰5骶1椎间隙采取后路双开窗椎间融合术(PLIF),对以上病例临床资料进行总结。结果全部病例均获得6个月以上的随访,无机械性不稳引起的并发症如椎体滑脱,无椎间融合器后退及下沉,无椎弓根螺钉断裂及松动,根据JOA疗效评定优良率95%。结论复发性腰椎间盘突出症再手术采取合理的术式是取得良好效果的关键。经椎弓根螺钉内固定椎间融合术符合生物力学要求,疗效确切。
[Objective] To analyze the pathomechanism of recurrent lumbar disc herniation and to evaluate appropriate surgical management. [Methods] 42 cases recurrent lumbar disc herniation underwent operation, 19 cases occurred in L4-5 were treated with transforminal lumbar interbody fusion, 23 cases occurred in L5S1 were treated by double expanded open-window with posterior lumbar interbody fusion, the clinical data were summarized. [Results] All cases were followed-up more than 6 months. No complication of mechanical unsteadiness such as spondylohsthesis occurred, no cage moved, no screw broken. The satisfactory rate was 95% based on JOA criteria. [Conclusions] It is important to take reasonable operative methods for good results. Posterior and transforaminal interbody fusion with internal fixation for recurrent lumbar disc herniation accord with mechanical requirement, curative effect is definite.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2009年第15期2356-2358,共3页
China Journal of Modern Medicine
关键词
椎间盘
腰椎间盘突出症
复发
内固定
融合
intervertebral disc
lumbar disc herniation
recurrence
interbody fusion
