Fandiño J, Botana C, Viladrich A, Gomez-Bueno J
Servicio de Neurocirugía del Hospital General de Vigo, España.
Acta Neurochir (Wien). 1993;122(1-2):102-4. doi: 10.1007/BF01446994.
Out of a series of 1850 cases operated upon for lumbar disc herniation 130 underwent re-operation because of persistent or recurrent symptoms. Re-operation was successful in 62%. The prognosis of re-operation was not related to special clinical symptoms and signs but only to the operative findings. Herniations at other levels and recurrences of lumbar disc herniations had the best results (excellent in 98% respectively 54%), but scar formations alone came out much less satisfactory (only 38% excellent results). Computed tomography (CT) findings were less reliable in distinguishing between disc prolapse and fibrosis than magnet resonance imaging (MR). Therefore MR is the diagnostic method of choice in these conditions, and scar formations alone should be considered a contra-indication for re-operation.
在1850例接受腰椎间盘突出症手术的病例中，有130例因症状持续或复发而接受了再次手术。再次手术的成功率为62%。再次手术的预后与特殊的临床症状和体征无关，仅与手术所见有关。其他节段的椎间盘突出和腰椎间盘突出复发的手术效果最佳（分别为98%和54%的优良率），但仅瘢痕形成的效果则差得多（优良率仅为38%）。在区分椎间盘脱垂和纤维化方面，计算机断层扫描（CT）的结果不如磁共振成像（MR）可靠。因此，在这些情况下，MR是首选的诊断方法，仅瘢痕形成应被视为再次手术的禁忌证。
