[Long-term results in revision surgery following lumbar disk nucleotomy]].
[Long-term results in revision surgery following lumbar disk nucleotomy]].
复制标题
[腰椎间盘核摘除术后翻修手术的长期结果]]。
DOI：
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发表时间：
1996
期刊：
影响因子：
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通讯作者：
W. Castro
中科院分区：
文献类型：
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作者：
J. Jerosch;W. Castro
在846例腰椎间盘手术患者中，有6.26%的患者需要再次手术。共有93例患者接受了翻修手术，包括在其他地方进行初次手术的患者组。68例患者进行了1次再次手术，22例患者进行了2次手术，2例患者进行了3次手术，1例患者甚至进行了4次翻修。随访时间为19 - 42年，平均31年。53例患者在随访时接受了临床检查，另外15例患者回答了问卷调查。只有16%的患者可以达到无投诉和患者能够工作的良好结果。结果良好，无神经根痛，但有24%的患者出现轻微背痛和感觉和工作能力丧失。在40%的患者中，结果仅为一般，伴有一些神经根疼痛和工作能力受限。20%的患者只有一个不好的结果，症状不变，继续治疗。这些病人不能工作。年轻和女性患者预后较好。另一个积极的预测因素是短期的术前疼痛。阴性预测因素为多次手术史以及翻修时的瘢痕组织。此外，Cloward认为脊柱固定术也与负面的临床结果相关。
In 6.26% of 846 patients with lumbar disc surgery a reoperation was necessary. A total of 93 patient had undergone a revision surgery inclusive a patient group with primary surgery performed elsewhere. 68 patient had 1 reoperation, 22 patients 2, 2 patients 3, and one patient had even 4 revisions. Follow-up ranged between 19 and 42 years with an average of 31 years. 53 patients were clinically examined at a time of follow up and another 15 patients answered a questionnaire. An excellent result with no complaints and patients able to work could be achieved in only 16%. A good result with no radicular pain, but some minor back pain and some loss of sensibility and ability to work was found in 24%. In 40% of the patients the result was only fair with some radicular pain and limited capability for work. 20% of the patients had only a poor result with unchanged symptoms and continued therapy. Those patients were not able to work. Young and female patients had a better prognosis. Another positive predictor was a short period of preoperative pain. Negative predictors were multiple prior operation as well as scar tissue at time of revision. Also spondylodesis according to Cloward correlated also with a negative clinical outcome.