Omidi-Kashani Farzad, Hejrati Hamid, Ariamanesh Shahrara
Orthopedic Research Center, Department of Orthopedic, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Orthopedic, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Asian Spine J. 2016 Oct;10(5):955-963. doi: 10.4184/asj.2016.10.5.955. Epub 2016 Oct 17.
Lumbar disc herniation is a common spinal disorder that usually responds favorably to conservative treatment. In a small percentage of the patients, surgical decompression is necessary. Even though lumbar discectomy constitutes the most common and easiest spine surgery globally, adverse or even catastrophic events can occur. Appropriate patient selection and effective neural decompression constitute the most important points for better surgical outcomes and avoidance of unpleasant complications. Other important tips include timely performance of magnetic resonance imaging, correct interpretation of scan data, preoperative detection of underlying instability, exclusion of non-discogenic sciatica, determination of the main cause of clinical pathology, avoidance of the wrong side or level, and being sure that the more detailed procedure does not necessarily mean the more effective procedure.
腰椎间盘突出症是一种常见的脊柱疾病,通常对保守治疗反应良好。在一小部分患者中,手术减压是必要的。尽管腰椎间盘切除术是全球最常见且最简单的脊柱手术,但仍可能发生不良甚至灾难性事件。合适的患者选择和有效的神经减压是获得更好手术效果及避免不良并发症的最重要要点。其他重要提示包括及时进行磁共振成像、正确解读扫描数据、术前检测潜在的不稳定情况、排除非椎间盘源性坐骨神经痛、确定临床病理的主要原因、避免手术部位或节段错误,以及要明确更详细的手术操作不一定意味着更有效的手术。