Analysis and strategy on the less approved results of lumbar discectomy
- VernacularTitle:腰椎间盘突出症术后疗效不佳的原因分析及对策
- Author:
Nan-Min JI
;
Wei-Tao YAO
;
Hui ZHANG
;
- Publication Type:Journal Article
- Keywords:
Lumbar vertebrae;
Intervertabral disk displacement;
Postoperative complications;
Re -operation;
Retro spective studies
- From:
Chinese Journal of Orthopaedics
2000;0(11):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the relationship of surgical procedures with clinical effect in herniat-ed lumbar disc in order to improve operative methods and obtain a better outcome.Methods Retrospec-tive analysis was carried out in7235patients with herniated lumbar disc,who had been operated by removal of nucleus pulposus using small incision and fenestration in our hospital since1983,313cases of whom re-ceived second operation because of postoperative complications.There were187males and126females aging from27to62years(mean,45.8years),the incidence of morbidity was4.32%.During the same period,552patients,who had less approved operative result primarily treated in other hospitals,were admitted to our hospital.There were317males and235females aging from31to64years(mean,46.0years).Results The postoperative complications could be divided into short term(within1month after operation)and mid-dle to long term(more than1month after operation)groups.The total446cases with short term compli-cation were133cases primarily treated in our hospital and313cases in other hospital,including of re-herni a-tion or incomplete nuclear extirpation in77treated with second operation,discitis in106treated with con-servative therapy for 67and second operative management for 39,canal hematoma compression in76treated surgi cally,multi-level herniation and leakage in21and mislocalization in59re-operated,injury of nerve root or cauda equina in85treated with nerve exploration,release and anastomosis,residual materials in canal in17with removal of foreign body,venous thrombus in2,and arachnoiditis in3.The total424cases with middle to long term complications were185cases primarily treated in our hospital and239cases in other hospitals,including of nerve root adhesion in159,recurred disc herniation in122,segmental instability in81,and ia-trogenic spinal stenosis in62.Conclusion Many factors may influence the outcome of herniated lum bar disc which can be abolished by sufficient preparation,careful operation and proper managememt.
