Recurrence factors of spinal implant fixation for the treatment of lumbar disc herniation / 中国组织工程研究

ABSTRACT

BACKGROUND:The correct method selected according to the specific type and characteristics of lumbar disc herniation can achieve satisfactory effect, but in clinic, there stil some patients have recurrence symptoms after treatment. OBJECTIVE:To investigate the recurrence factors of spinal implant internal fixation for the treatment of lumbar disc herniation, as wel as the intervention measures. METHODS:Fifty-two patients with recurrence symptoms of lumbar disc herniation after internal fixation from January 2002 to December 2007 in the Department of Orthopedics, the 306th Hospital of PLA were retrospectively analyzed, including 28 male cases and 24 female cases, the average age was 43.2 years, ranged from 25-52 years. The time form first internal fixation to the recurrence was 3-192 months, average 38 months. The patients had the symptoms of lumbar and bilateral/unilateral leg pain and numbness. Al the patients underwent the anteroposterior radiographs of lumbar spine and the hyperextension and flexion lateral X-ray films to evaluate the stability of the lumbar spine. Lumbar magnetic resonance imaging was used to observe the intervertebral disc situation of the segment treated with lumbar internal fixation as wel as the spinal stenosis and disc degeneration. RESUTLS AND CONCLUSION:Among the 52 patients, 22 cases had recurrence lumbar disc herniation on the same segment after first internal fixation;four cases had recurrence symptoms caused by the spondylodiscitis after implant internal fixation;five cases had scar adhesions caused nerve compression on the site treated with internal fixation;10 cases had the symptoms of lateral recess and nerve root canal stenosis on the site treated with internal fixation;11 cases had recurrence symptoms caused by lumbar instability after internal fixation. It has reality clinical significance to analyze the reasons of recurrence of lumbar disc herniation after internal fixation