【摘要】 目的:探讨腰椎间盘突出症术后继发性神经根管狭窄发生的原因及其预防。方法:单纯性腰椎间盘突出症病人 98例 ,分为 2组 ,第 1组 4 4例行标准开窗、髓核摘除术 ,第 2组 5 4例同时行侧隐窝及同水平椎间孔扩大术。 结果 :随访 3～ 7年 ,第 1组中有 2 1例重新出现不同程度的腰腿部症状 ,占 4 8%。第 2组中有 9例出现症状 ,占 17%。 8例 X线腰椎侧位片与术前比较 ,所有摘除髓核的间隙均变窄 ,并有小关节突的增生 ,椎间孔变狭窄。 结论 :髓核摘除术后 ,由于腰椎应力改变 ,腰椎关节与小关节退行性改变所引起的继发性神经根管狭窄 (侧隐窝与同水平椎间孔 )是引起腰腿部症状的主要原因更多还原

【Abstract】 Objective: To discuss the causes and preventive methods of secondary nerve root canal stenosis after the operation of lumbar disc herniation. Methods: 98 patients of simple lumbar disc herniation were followed up. They were separated into two groups. In one group there were 44 patients who were performed the operation of standard windowing and removing nucleus pulposus. In another group there were 54 patients who were performed the operation of enlarging lateral crypt and foramen intervertebrale at the same time and were followed up for more than 3 years. Results: In the first group 21 patients reoccurred lumbar and leg symptoms to varying degrees, constituted 48%. In the second group 9 patients reoccurred symptoms constituted 17%. When following the patients, comparing their lateral radiographs of lumbar vertebrae with that before the operations, it was found that all the spaces of removing nucleus pulposus became narrow and that small procesus articuloris proliferated, foramen intervertebrale became narow. Conclusion: After the operation of removing nucleus pulposus, because of the change of lumbar vertebrae stress and the degenerative change of lumbar vertebrae joints and small joints, secondary nerve root canal stenosis occur. This kind of stenosis is the major cause of symptoms mentioned above.更多还原