University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
Bone Joint J. 2013 Jan;95-B(1):90-4. doi: 10.1302/0301-620X.95B1.30413.
The outcome of surgery for recurrent lumbar disc herniation is debatable. Some studies show results that are comparable with those of primary discectomy, whereas others report worse outcomes. The purpose of this study was to compare the outcome of revision lumbar discectomy with that of primary discectomy in the same cohort of patients who had both the primary and the recurrent herniation at the same level and side.A retrospective analysis of prospectively gathered data was undertaken in 30 patients who had undergone both primary and revision surgery for late recurrent lumbar disc herniation. The outcome measures used were visual analogue scales for lower limb (VAL) and back (VAB) pain and the Oswestry Disability Index (ODI).There was a significant improvement in the mean VAL and ODI scores (both p < 0.001) after primary discectomy. Revision surgery also resulted in improvements in the mean VAL (p < 0.001), VAB (p = 0.030) and ODI scores (p < 0.001). The changes were similar in the two groups (all p > 0.05).Revision discectomy can give results that are as good as those seen after primary surgery.
对于复发性腰椎间盘突出症的手术治疗效果存在争议。一些研究显示其结果与初次椎间盘切除术相当，而其他研究则报告了更差的结果。本研究旨在比较同一组患者的初次和复发性椎间盘突出症的手术治疗效果，这些患者在同一水平和侧别既有初次椎间盘突出症又有复发性椎间盘突出症。对 30 例因迟发性复发性腰椎间盘突出症接受初次和翻修手术的患者进行前瞻性收集数据的回顾性分析。采用下肢视觉模拟评分（VAL）、腰痛视觉模拟评分（VAB）和 Oswestry 功能障碍指数（ODI）进行疗效评估。初次椎间盘切除术后，平均 VAL 和 ODI 评分显著改善（均 p < 0.001）。翻修手术也导致平均 VAL（p < 0.001）、VAB（p = 0.030）和 ODI 评分（p < 0.001）的改善。两组之间的变化相似（均 p > 0.05）。翻修椎间盘切除术可获得与初次手术相似的效果。
