| Object: To observe the long-term effect of the treatment for lumbar disc herniation with total Laminectomy and Replantation.Method: In this study,534 patients with lumbar disc herniation was treated with total Laminectomy and Replantation from 1994 to 2001. Clinical results of 152 patients who were followed up were reported. This group included 86 male and 66 female and age range was 25 to 67 years (mean 43.5y).Postoperative time range was 56 to 122 months (mean 83.0m).Mean course of disease was 35.6 months. All patients include single LDH in 67 cases,LDH and LSS in 64 cases ,LDH and lumbar spondylolysis in 3 cases,LDH and lateral stenosis in 18 cases. Single disc in 92 cases(L3/4,3 case, L4/5,47 cases, L5/S1, 42 cases),two disc in 44 cases (L3/4.L4/5 ,18 cases, L4/5.L5/S1, 26 cases),three disc in 8 cases (L3/4.L4/5.L5/S1 ,8 cases). the operation time was 40～230min ( mean97 min) .The mean blood loss through the procedure was 96ml. Long-time clinic results were analyzed according to letter telephone and results of X-ray and CT and evaluated accoding to Macnab scoring system. Results: The clinical results: 152 patients had results of best in 83 cases,better in 55 cases,good in 9 cases ,poor in 5 cases. 3 cases operated again because of recurrence . We found less adherence under lamina and it was easy to separate lamina and neural capsule. The excellent ratio was 90.8%.For radium needles capsule. 47 cases as healed of replantation, 33 cases reviewing at CT, 2 cases as single unhealed according to CT, the healing of replantation was good and decompression of spinous canal was satisfy.the satisfy ratio of patients was 94.4%.Conclusion: Total laminecotomy and replantation is a good operation mode .This method is beneficial to reconstrustion of spinal stability, which can decrease adherent chance of scar of spinal dura mater and obviously increase the area of the spinal canal. The long-term result is affirm ative, So it is worthy of wide application... |
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