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112例腰椎间盘突出症手术后发生硬膜外/硬膜内纤维化患者的脊髓刺激治疗

Spinal cord stimulation in 112 patients with epi-/intradural fibrosis following operation for lumbar disc herniation.

作者信息

Probst C

机构信息

Neurosurgical Clinic, Kantonsspital, Aarau, Switzerland.

出版信息

Acta Neurochir (Wien). 1990;107(3-4):147-51. doi: 10.1007/BF01405794.

Abstract

A total of 112 patients with epi-/intradural fibrosis following operation for lumbar disc herniation were treated by spinal cord stimulation. Lumbosacral spinal fibrosis is seen particularly often after extensive and repeated operations. Radicular pain responds better to stimulation than back pain. A favourable long-term effect on radicular pain has been observed in 67% of patients treated by epidural implantation, the corresponding average follow-up period being 4 1/2 years. 40% of these patients needed less analgesics after the operation, while 25% of them showed an improved fitness for work. Among about 5,000 patients who underwent surgical treatment for lumbar disc herniation, an indication for spinal cord stimulation was found in 1.5%. By comparison, the frequency of the "last resort" procedure of microsurgical cordotomy was 0.3%. We no longer use other ablative methods like extirpation of spinal ganglia.

摘要

共有112例腰椎间盘突出症手术后发生硬膜外/硬膜内纤维化的患者接受了脊髓刺激治疗。腰骶部脊髓纤维化在广泛且重复的手术后尤为常见。根性疼痛对刺激的反应比对背痛的反应更好。在接受硬膜外植入治疗的患者中,67%观察到对根性疼痛有良好的长期效果,相应的平均随访期为4.5年。这些患者中有40%术后所需镇痛药减少,25%的患者工作适应能力有所改善。在约5000例接受腰椎间盘突出症手术治疗的患者中,发现1.5%有脊髓刺激的指征。相比之下,显微手术脊髓切断术这种“最后手段”手术的发生率为0.3%。我们不再使用其他诸如切除脊神经节等毁损性方法。

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