Surgical treatment of lumbar disc herniation _2231 -

e054831577

Surgical treatment of lumbar disc herniation

As follows. The clinical data of 146 cases of male and female 64 cases, aged 21 to 69 years. 2O ~ 30 years in which 25 cases, 31 ~ 4O-year-old 52 cases, 41 ~ 5O-year-old in 70 cases. 63 cases of 51 to 69 years. The average age of 40.1 years of age minimum 2 months duration, the longest 15 years. History of significant injury and 112 down. 108 cases of hysteria in the left leg, right side of the 93 cases, both sides of the 9 cases. L. ~. 9 cases. L. ~ 172 cases, L5 ~ s29 cases. 5 cases of central prominence, there is incomplete paralysis, Pai feces barriers, saddle area numbness. 4 side of the two operations. Does not match the preoperative diagnosis in 2 cases, 1 case as the cauda equina neurofibromas, and 1 case of epidural blood arsenic. 4 cases of intraoperative positioning errors. Blood loss was 2 down. Discectomy is not complete, there are residues in 1. Spinal injury in 1. Treatment outcomes. Were followed up 1 to 9 years, an average of 4 and a half years. Good: There was no any symptoms and restore back the original work 187 (89) good: most of the symptoms disappeared, remains outside of the lower leg numbness in 17 ( Super

,[link widoczny dla zalogowanych], good rate of 97. Postoperative symptoms improved,[link widoczny dla zalogowanych], but still low back pain in 6 cases, the acupuncture and epidural closed, the symptoms disappeared. On one or surgical indications. First, the diagnosis, surgical indications strictly. The indication is a huge highlight the nucleus, the symptomatic treatment effect was not significant, the lesions did not improve for 3 months, recurrent years of education, age older than 45 years, signs apparent. May be considered provided that they meet the above three operations. 1 case of cauda equina in this group of neurofibroma, female patients, aged 55, had breast cancer surgery. Instant pain 1 year, x-ray no bone destruction, tenderness at the spinous process L asked. Surgical exploration was no prominent edge marrow, epidural no pulse for total laminectomy, palpable mass, and by the removal of the cauda equina nerve sheath pathology, postoperative transient leg pain disappeared. Down to 855 * and 1 epidural hematoma, CT examination revealed a mild disc highlight. Preparation for surgery, but does not match with the history of signs and found that patients had appendectomy surgery two months ago. Postoperative low back pain worse. Myelography again, see an irregular epidural pressure, by surgery for hematoma, postoperative neurological recovery poor. Second,[link widoczny dla zalogowanych], the group of positioning error in 4 cases. Preoperative diagnosis of L. ~ Prominent. The cases of procedure for the L ~ s2, L1 cases, L ~ s for the L1 case. No nucleus are prominent due to surgery, bite than half of the lamina, and then space exploration or the next will discectomy, postoperative recovery was good. Analyze the reasons for the sacral spinal positioning of the error. Therefore, carefully read preoperative lumbar radiographs, correct positioning during surgery, if necessary, before surgery to mark the day with a metal radiography positioning. Third, the group of bleeding in 2 cases. See the epidural venous plexus filling the fat layer,[link widoczny dla zalogowanych], slightly bleeding injury, affecting surgery. Immediately re-adjusted abdominal cushions, venous plexus immediately thinner, and bleeding stopped. Fourth,[link widoczny dla zalogowanych], there discectomy residue in 1. Preoperative diagnosis of central disc, saddle area numbness, surgery to remove part of the nucleus pulposus. No improvement of symptoms a week after surgery, further CT examination revealed a left nucleus. Reoperation, postoperative symptoms. 1 year follow-up, without any symptoms. V. dural rupture, cerebrospinal fluid outflow of a fall. Further surgical repair, planing and mouth filled with muscle recovery. Sixth, in order to prevent scarring around the spinal cord and nerve root adhesions, nerve re-used free fat transfer, is better than gelatin sponge, easy to re-operation. Fat transplantation is also used to prevent leakage of cerebro-spinal possession. Method is to suture wounds El before, take a large piece of subcutaneous fat pad into the laminectomy defect, this paper 5 cases, achieved good results. On a different level of response, indicating a small amount of ascites with portal hypertension may try, but more moderate effect of ascites is very Xi, unfit for use. Our experience is: the front door vein treatment in the performance of 17mm or more markedly in efficiency or long-term use of propranolol may prevent upper gastrointestinal bleeding on the performance of 15mm or less inefficient or ineffective without propranolol in order to avoid large doses of propranolol side effects caused by the unnecessary rejection.

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