复发性腰椎间盘突出症危险因素及其治疗的研究进展

Research progress on risk factors and treatment of recurrent lumbar disc herniation

摘要:

腰椎间盘突出症 (lumbar disc herniation, LDH) 是临床常见疾病，可采用保守及手术治疗，其中随着手术治疗的发展及其适应证的扩大，并发症也相应增加，较为常见的术后并发症为复发性腰椎间盘突出症 (recurrent lumbar disc herniation, rLDH)，疼痛严重者仍需再次手术。目前已有研究表明手术术式、病人年龄、性别、肥胖情况、椎间盘高度、吸烟、糖尿病、负重、Modic改变及椎间盘突出性质等为rLDH的危险因素。针对rLDH目前治疗方式主要为翻修椎间盘切除术、腰椎融合术、微创介入治疗。本文对上述rLDH的危险因素及其治疗进行综述，为进一步研究及临床先期判断可能有rLDH的风险及术后预防提供参考。

Abstract:

Lumbar disc herniation (LDH) is a common clinical disease, which can be treated with conservative and surgical treatment. With the development of surgical methods and the expansion of indications, complications also increase correspondingly. The more common postoperative complication is recurrent lumbar disc herniation (rLDH). Patients with severe pain still need to be re-operated. Current studies have shown that the risk factors for rLDH include surgery type, patient age, gender, obesity, disc height, smoking, diabetes, weight bearing, Modic change and the type of disc degeneration. The current treatment methods for rLDH mainly include revision discectomy, lumbar fusion and minimally invasive surgery. In this paper, the risk factors and treatment of rLDH were reviewed，providing reference for further research and clinical preliminary judgment of possible risk of rLDH and postoperative prevention.