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土耳其 130 例患者的回顾性研究:影响腰椎间盘切除术复发率和手术结果的因素。

Factors Influencing Recurrence Rates and Surgical Outcomes in Lumbar Microdiscectomy: A Retrospective Study of 130 Patients in Turkey.

机构信息

Department of Neurosurgery, Elazig Fethi Sekkin Training and Research Hospital, Elazig, Turkey.

Department of Neurosurgery, İstanbul Training and Research Hospital, Istanbul, Turkey.

出版信息

Med Sci Monit. 2023 Dec 30;29:e942012. doi: 10.12659/MSM.942012.

Abstract

BACKGROUND Lumbar disc herniation surgery, specifically lumbar microdiscectomy, shows recurrence in 3-24% of patients, necessitating potential re-operations. This study focuses on the outcomes and recurrence causes in 130 cases of lumbar disc herniations. These cases were managed by a single surgeon at a single center, offering a unique perspective on a common issue in neurosurgery. MATERIAL AND METHODS The study involved 130 patients treated for lumbar disc herniations. Analysis considered various factors: age, sex, symptoms, surgical level, complications, pre- and postoperative pain levels, and quality of life indices. RESULTS Of the 130 cases analyzed, all underwent initial surgery by the same surgeon or sought treatment from this surgeon after recurrence. Inclusion criteria were based on radiologic and clinical indications for re-operation. The demographic split was 76 males (56.4%) and 54 females (43.6%). A notable finding was a higher recurrence rate in males and patients under 45 years, although the sex difference was not statistically significant. The average age was 47.5 years. Significant changes were noted in the Oswestry Disability Index (ODI) levels during follow-ups (P<0.001). CONCLUSIONS This study underscores the effectiveness of lumbar microsurgery in treating recurrent lumbar disc herniations. Techniques such as medial facet utilization and laminectomy border expansion show promise. However, determining instability rates requires long-term patient follow-up. Our findings contribute valuable insights into surgical approaches and patient outcomes in recurrent lumbar disc herniation cases.

摘要

背景

腰椎间盘突出症手术,特别是腰椎微创手术,在 3%-24%的患者中会出现复发,需要再次手术。本研究关注 130 例腰椎间盘突出症患者的结果和复发原因。这些病例由一位外科医生在一个中心进行管理,为神经外科的一个常见问题提供了独特的视角。

材料与方法

本研究纳入了 130 例接受腰椎间盘突出症治疗的患者。分析考虑了各种因素:年龄、性别、症状、手术水平、并发症、术前和术后疼痛水平以及生活质量指数。

结果

在分析的 130 例病例中,所有患者均由同一位外科医生进行初次手术,或在复发后向该外科医生寻求治疗。纳入标准基于放射学和临床再次手术的指征。患者的性别比例为 76 名男性(56.4%)和 54 名女性(43.6%)。一个显著的发现是男性和 45 岁以下患者的复发率较高,尽管性别差异无统计学意义。平均年龄为 47.5 岁。在随访期间,Oswestry 残疾指数(ODI)水平有显著变化(P<0.001)。

结论

本研究强调了腰椎微创手术治疗复发性腰椎间盘突出症的有效性。内侧关节突的利用和椎板切除术边界扩大等技术显示出一定的前景。然而,确定不稳定率需要对患者进行长期随访。我们的研究结果为复发性腰椎间盘突出症患者的手术方法和患者结局提供了有价值的见解。

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