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首页> 外文期刊>Journal of Medical Sciences >Etiologies of Recurrent Low Back Pain after Laminectomy with Emphasis on Segmental Instability
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Etiologies of Recurrent Low Back Pain after Laminectomy with Emphasis on Segmental Instability

机译：椎板切除术后复发性下腰痛的病因，强调节段性不稳定性

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Laminectomy is a surgical treatment for lumbar stenosis. In some patients, however, back pain may recur after this operation. This study was performed to determine underlying causes of recurrent back pain after laminectomy and examine the possibility of an association between axial rotation and segmental instability after laminectomy. A total of 35 patients with previous laminectomy with and without discectomy and recurrent back pain were recruited. Etiologies of recurrent back pain were investigated. An axially rotated lumbar vertebra was reported, when at extreme parasagittal sections the posterior borders of two successive vertebral bodies were not aligned. The frequency of this image finding was compared before and after laminectomy. An axially rotated lumbar vertebra was present in two patients before operation and in four patients after it. Only two new cases with axial vertebral rotation were identified after laminectomy (p = 0.50). The underlying causes of recurrent low back pain after laminectomy were disc reherniation (57.1%), spondylolisthesis (20%), scarring (8.6%), new axial rotation (5.7%), ligamentum flavum hypertrophy (5.7%) and diastematomyelia (2.9%). According to these findings, recurrent disc herniation and spondylolisthesis are two major causes of recurrent back pain after laminectomy. Axial lumbar vertebral rotation is not associated with instability.
机译：椎板切除术是腰椎狭窄的外科手术治疗。但是，在某些患者中，该手术后可能会出现背部疼痛。这项研究的目的是确定椎板切除术后复发性背痛的根本原因，并检查椎板切除术后轴向旋转与节段性不稳定性之间的联系。总共招募了35名既往有椎板切除术，有无椎间盘切除术和复发性背痛的患者。研究了复发性背痛的病因。据报道有一个轴向旋转的腰椎，当在极矢状旁切面时，两个连续椎体的后边界未对齐。在椎板切除术之前和之后比较该图像发现的频率。术前有两名患者和术后有四名患者存在轴向旋转的腰椎。椎板切除术后仅发现两个新的椎骨轴向旋转病例（p = 0.50）。椎板切除术后复发性下腰痛的根本原因是椎间盘再狭窄（57.1％），腰椎滑脱（20％），瘢痕形成（8.6％），新的轴向旋转（5.7％），黄韧带肥大（5.7％）和红皮病（2.9％） ）。根据这些发现，反复椎间盘突出症和腰椎滑脱是椎板切除术后复发性背痛的两个主要原因。轴向腰椎旋转与稳定性不相关。

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