Cervellini P, Curri D, Bernardi L, Volpin L, Benedetti A
Department of Neurosurgery, City Hospital, Vicenza, Italy.
Acta Neurochir Suppl (Wien). 1988;43:44-7. doi: 10.1007/978-3-7091-8978-8_11.
The evaluation of patients with recurrent symptoms after lumbar disc surgery, is a difficult diagnostic problem. The causes of failure may include recurrent disc herniation, postoperative scarring, arachnoiditis, spinal stenosis, infection and mechanical instability. The most common causes are recurrent herniation and postoperative scarring; the routine x-ray and myelographic differentiation between them is difficult or impossible. High resolution CT has shown some results in the evaluation of the postoperative patients. It requires some knowledge of CT findings of "normal" pictures of the physiologic healing and scarring after disc surgery. We scanned 30 asymptomatic operated patients and 30 patients with recurrent sciatic nerve pain after disc surgery. From our observations result that it is quite impossible to distinguish "normal" scar from asymptomatic fibrosis. The degree and type of fibrosis are not related to recurrent symptoms.
腰椎间盘手术后出现复发症状患者的评估是一个棘手的诊断问题。手术失败的原因可能包括椎间盘复发突出、术后瘢痕形成、蛛网膜炎、椎管狭窄、感染和机械性不稳定。最常见的原因是复发突出和术后瘢痕形成；常规X线和脊髓造影很难或无法区分二者。高分辨率CT在评估术后患者方面已取得了一些成果。这需要了解椎间盘手术后生理愈合和瘢痕形成的“正常”影像的CT表现。我们对30例无症状的手术患者和30例椎间盘手术后复发性坐骨神经痛患者进行了扫描。根据我们的观察结果，区分“正常”瘢痕与无症状纤维化是完全不可能的。纤维化的程度和类型与复发症状无关。
