Recurrent Causes Of Lumbar Disc Herniation Analysis

BACKGROUND:Operation has become the routine method to cure the lumbar disc herniation.Along with the method's popular and elevate,the effect of cure is satisfactory. Recovery rate is rising.Acompany with patients'rising, ailed back surgery syndrome's report is increasing,the incidence rate is 10%-15%.Need to reoperation rate is 2%-9.2%.Many experters do a lot of study to increase the cure rate of the lumbar disc herniatio, so do the research to the reason of the recur of the lumbar disc herniation is need.Objective:To study recurrent causes of postoperation on lumbar disc herniationMethods:Seventy-four cases of postoperative information form 2000 to 2008 on lumbar disc herniation were adopted for retrospective analysis, the preoperative and postoperative clinical functional results were evaluated according to Macnab and JOA scores,alanysis and discuss the reason of recurrent. By this result to improvement the tream program.Results:All cases, include 46 males and 28 females,were taken vertebral pulp ectomy of intervertebral disc. The recurrent causes aren't single reason.These involved recurrent herniation (44 cases), cohesion of the scar in vertebral canal 29 cases,16 cases postoperative segmental instability, latero-kryptostenosis (6 cases) and 6 cases stenosis of nevre root canal. The time of reoperation was 1 month to 16 years af ter primary operation later, average 4.2 years. Clinic symptom before reoperation showed back pain with/or low limb radioactive pain, intermittent claudication, perineal anaesthesia.Conclusions:These data indicate the major causes of reoperation after lumbar disc surgery:(1) recurrent disc herniation,especially the young patients,their lumbar discs are hard to extirpation thorough; (2) cicatricle syncretio postoperative,; cicatricle form principal because of (3) the coexisting narrow and stenosis of nerve root canal,lateral recess and central spinal canal;(4) postoperative segmental instability.and If the time and surgical approaches are choosen suitably,statisfactory outcome can be gained with the reoperation management for patients who underwent the lumbar disc surgerypreviously. Cutaneous sensation of lateral post sura was paralysis. X-ray performance showed lumbar vertebral degeneration, vertebra space stenosis, hypert rophy of vertebral joint and vertebral slippage. CT & MRI determination showed dura mater cap sule compression, nerveroot canal stenosis. Styles of reoperation included amplificative laminotomy, removal lumbar disc (4 cases) and interverte-bral fusion (38 cases). Average follow-up period was 58 monthes,96.1 percent of patient s were satisfaction after reoperation. The careful determination and reasonable operative procedure are important for t reatment of lumbar disc herniation. The cure of nerve root canal and vertebral stenosis should be t reated with spinal column instability. The stability of spinal column should be reconst-ructed at reoperative procedure.