CAJ | 학술논문

髓核摘除术作为治疗腰椎间盘突出症的传统术式获得了较高的短、长期优良率，但临床仍可见部分患者因疗效不佳需再次手术治疗。术前未仔细查体、合理影像学检查及对特殊类型腰椎间盘突出症、神经根变异认识不足导致腰腿痛定性、“责任区”定位错误，术中椎间盘切除不彻底致术后再突出，减压不当致术后腰椎不稳及继发性腰椎管狭窄，侧隐窝减压不彻底，术中神经根及脊髓损伤，术后硬膜外瘢痕粘连等因素与术后疗效不佳呈正相关。
수핵적제술작위치료요추간반돌출증적전통술식획득료교고적단、장기우량솔，단림상잉가견부분환자인료효불가수재차수술치료。술전미자세사체、합리영상학검사급대특수류형요추간반돌출증、신경근변이인식불족도치요퇴통정성、“책임구”정위착오，술중추간반절제불철저치술후재돌출，감압불당치술후요추불은급계발성요추관협착，측은와감압불철저，술중신경근급척수손상，술후경막외반흔점련등인소여술후료효불가정정상관。
Discectomy is a traditional operation of treating lumbar disc herniation ,most patients are satis-fied with the short-term and long-term treatment results.However,some of the surgical patients still need reo-peration because of the poor curative effect.Preoperative factors,including uncareful physical and imaging examination,lack of understanding of special types of lumbar disc herniation and nerve root anomalies which leads to qualitative error of pain in waist and lower extremities and locating error of responsible segments;intraoperative factors,including incomplete remove of denaturated intervertebral disc which leads to palindro-mia,instability of lumbar spinal and secondary lumbar spinal stenosis following surgery , inadequate lateral recess decompression,nerve root and spinal cord injuries;postoperative factors,including epidural fibrosis are the factors that positively correlated with the poor curative effect of discectomy .