بررسی ریسک فاکتورهای عود هرنی دیسکال کمری در بیماران مراجعه کننده به بیمارستانهای وابسته به دانشگاه آزاد مشهد طی سالهای 83-90

Subject Areas : علوم پزشکی

Khosro shayan ¹ , Saeed rahighi ² , Sahar Sedigh zadeh Tabasi ³

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Received: 2017-06-05 Accepted : 2017-06-05 Published : 2014-11-22

Keywords: Risk Factors, recurrence, lumbar disk hernia,

Abstract :

Background and aim: Despite improving therapeutic methods of lumbosacral disc herniation , open surgery is still the conventional method . this study was aimed to investigate the risk factors of recurrent lumbar disc herniation in patients referred for second surgery between 1383 – 1390 at hospitals of Mashhad Azad university of medicine. Methods: 60 patients , 30 with repeated discal hernia ( case group ) and 30 without recurrence (control group) were enrolled.in this retrospective case-control study . case group included those who were candidate for second surgery at the same level of both sides which was confirmed by CT scan or MRI . all their medical records were extracted and registered., also some information collected by telephone calls. Then risk factors related to recurrence of hernia were evaluated by comparing two groups. Results: there were 62.5 % men in recurrent lumbar disk hernia and 37.5 % women in group without recurrence . mean age of patients in first and second groups were 35 to 56 and 33 to 60 years respectively. Although there was no significant relationship between age , sex , work load , history of trauma , diabetes mellitus and smoking with recurrence of disk protrusion (p>0.05) but most of recurrences seen in foraminectomy method and in level of L1 _ L2 . Macnab scale was excellent ion 13.3 % ,good in 36.7 % , intermediate in 10 % and weak in 40 % . Conclusion : as distal hernia is a prevalent disease in our country , suitable policies in educating common health to prevent this disorder and recurrence of it seems necessary .    

References:

 

1. gabari M. The study of abundance of lumbar intervertebral hernia in the referred patients to the MRI center of Hamadan city in the year 2002.Medcine magazine , Hamadan university hospital,Hamadan,Iran. 2002 ; (11): 35-36.


2. Joel L. Seres. Approach to the Patient with Chronic Pain. In H. Richard Winn, ed. Youmans Neurological Surgery. 5^th ed. Philadelphia:W.B. Saunders; 2004.P.2937-2952.


3. Jensdottir M, Gudmundsson K, Hannesson B. 20 years follow up after the first surgical lumbar disectomies in Iceland.Department of neurosurgery, landspitali university hospital,Reyjavik,Icland. 2006;(26):51-58.


4. Claudio D, Marius R, Achim E, Marco Z, luerg H, Norvert B. Do MRI finding predict recurrence after surgical disectomy .Department of radiology and spinal surgery,Blagrist university hospital,Zurikh,Alman. 2004;(5):562-567.


5. Lotfy M, Anbar Kh, Sawan M. Recurrent lumbar disc prolapse review of thirty- two cases. Department of  neuro surgery ,Cairo university hospital ,Tagzas,America. 2006;(21):21-22.


6. اعلمی هرندی بهادر. درسنامه ارتوپدی و شکستگیها. چاپ اول. تهران: دانشگاه علوم پزشکی خدمات درمانی تهران؛ 1382.ص. 311-327.


7.  Suk KS, Lee HM, Moon SH, Kim NH. Recurrent lumbar disc herniation: results of operative management. Spine (Phila Pa 1976). 2001; 26(6): 672-76.


8. Roberts S, Evans H, Trivedi J, Menage J. Histology and pathology of the human intervertebral disc. J Bone Joint Surg Am. 2006; 88 (2): 10-14.


9. Olmarker K, Blomquist J, Stromberg J. Inflammatogenic properties of nucleus pulposus. Spine. 1995; 20(6):665-669.


10. Eyre DR, Wu JJ, Fernandes RJ. Recent developments in cartilage research: matrix biology of the collagen II/IX/XI heterofibril network. Biochem Soc Trans. 2002; 30(6): 893-899.


11. Humphries CD, Eck JC. Clinical Evaluation and Treatment Options for Herniated Lumbar Disc. Am J Family Physician. 1999; 12: 575–587.


12. Battie MC, Videman T, Parent E. Lumbar disc degeneration: epidemiology and genetic influences. Spine. 2004; 29(23): 2679-1690.


13. Smith JW, Walmsley R. Experimental incision of the intervertebral disc. J Bone Joint Surg Br. 1951; 33 (4): 612-625.


14.  Malfair D, Beall DP. Imaging the degenerative diseases of the lumbar spine. Magn Reson Imaging Clin N Am. 2007;15(2): 221-38.


15. Chen C, Cavanaugh JM, Ozaktay AC, Kallakuri S, King AI. Effects of phospholipase A2 on lumbar nerve root structure and function. Spine. 1997; 22(10): 1057-64.


16. Ogawa T, Matsuzaki H, Uei H, Nakajima S, Tokuhashi Y, Esumi M. Alteration of gene expression in intervertebral disc degeneration of passive cigarette- smoking rats: separate quantitation in separated nucleus pulposus and annulus fibrosus. Pathobiology. 2005; 72(3): 146-51.


17. Markwalder T,SaagerC,Reulan HJ.Surgical treatment of far lateral herniated lumbar disc. Yomans neurosurgery.chapter45.2005:835-873


18. Carragee EJ, Han MY, Suen PW, Kim D. Clinical outcomes after lumbar discectomy for sciatica: the effects of fragment type and anular competence. J Bone Joint Surg Am. 2003; 85-A(1): 102-108.


19.  Wenger M, Mariani L, Kalbarczyk A, Gröger U. Long-term outcome of 104 patients after lumbar sequestrectomy according to Williams. Neurosurgery. 2001; 49(2): 329-34; discussion 334-35.


20.  Vishteh AG, Dickman CA. Anterior lumbar microdiscectomy and interbody fusion for the treatment of recurrent disc herniation. Neurosurgery. 2001; 48(2): 334-38.


21.  Epstein N.Far lateral and foraminal lumbar disc herniations. Yomans  neurosurgery .Chapter 147.2005:1661-1667.


22. .Raffo C,Wisel S,layerman W.Determining resons for failed lumbar spine surgery.Chapter47.2005:945-952.


23. .Zeidman S.Failed back surgery syndrome.Yomans neurosurgery. Chapter 148.2005:1668-1676.


24. Aizawa T, Ozawa H, Kusakabe T, Nakamura T, Sekiguchi A, Takahashi A, Sasaji T, Tokunaga S, Chiba T, Morozumi N, Koizumi Y, Itoi E. Reoperation for recurrent lumbar disc herniation: a study over a 20-year period in a Japanese population. J Orthop Sci. 2012 Mar;17(2):107-13.


25. Sun HL, Li CD, Wang SJ. China. [Retrospective analysis of effect of type 2 diabetes mellitus on lumbar intervertebra disc herniation]. Beijing Da Xue Xue Bao. 2011 Oct 18;43(5):696-8.


26. Meredith DS, Huang RC, Nguyen J, Lyman S. Obesity increases the risk of recurrent herniated nucleus pulposus after lumbar microdiscectomy. Spine J. 2010 Jul;10(7):575-80.


27. Moliterno JA, Knopman J, Parikh K, Cohan JN, Huang QD, Aaker GD, Grivoyannis AD, Patel AR, Härtl R, Boockvar JA. Results and risk factors for recurrence following single-level tubular lumbar microdiscectomy. J Neurosurg Spine. 2010 Jun;12(6):680-6.


28. Kim KT, Park SW, Kim YB. Disc height and segmental motion as risk factors for recurrent lumbar disc herniation. Spine (Phila Pa 1976). 2009 Nov 15;34(24):2674-8.


29. McGirt MJ, Eustacchio S, Varga P, Vilendecic M, Trummer M, Gorensek M, Ledic D, Carragee EJ. A prospective cohort study of close interval computed tomography and magnetic resonance imaging after primary lumbar discectomy: factors associated with recurrent disc herniation and disc height loss. Spine (Phila Pa 1976). 2009 Sep 1;34(19):2044-51.


30. Ruetten S, Komp M, Merk H, Godolias G. Recurrent lumbar disc herniation after conventional discectomy: a prospective, randomized study comparing full-endoscopic interlaminar and transforaminal versus microsurgical revision.   J Spinal Disord Tech. 2009 Apr;22(2):122-9.


31. Häkkinen A, Kiviranta I, Neva MH, Kautiainen H, Ylinen J. Reoperations after first lumbar disc herniation surgery; a special interest on residives during a 5-year follow-up. BMC Musculoskelet Disord. 2007 Jan 9;8(1):2.


32. Kim JM, Lee SH, Ahn Y, Yoon DH, Lee CD, Lim ST. Recurrence after successful percutaneous endoscopic lumbar discectomy. Minim Invasive Neurosurg. 2007 Apr;50(2):82-5.


33. Jensdottir M, Gudmundsson K, Hannesson B, Gudmundsson G. 20 years follow-up after the first microsurgical lumbar discectomies in Iceland. Acta Neurochir (Wien). 2007 Jan;149(1):51-8; discussion 57-8.


34. Lotfy M, Anbar Kh, Sawan M. Recurrent lumbar disc prolapse review of thirty- two cases.EJNS. Jan 2006;21(1):75-82.


35. Saftić R, Grgić M, Ebling B, Splavski B. Case-control study of risk factors for lumbar intervertebral disc herniation in Croatian island populations. Croat Med J. 2006 Aug;47(4):593-600.


36. Lotfy M, Anbar Kh, Sawan M. Recurrent lumbar disc prolapse review of thirty- two cases.EJNS. Jan 2006;21(1):75-82.


37.  Tsai Ch, Chaungttsu H, Jenchen Y, Jynlin Ch, Techen H. Clinical result of repeated disectomy and analysis of factors Affecting surgical outcome.Department of  orthopedics, China medical university hospital. Taichung, Taiwane. 2005;11(2):125-126.


38. Yorimitsu E, Chiba K, Toyama Y, Hirabayashi K. Long-term outcomes of standard discectomy for lumbar disc herniation: a follow-up study of more than 10 years. Spine (Phila Pa 1976). 2001 Mar 15;26(6):652-7.


39. امیرجمشیدی عباس,صادقی صادق,روزبه هادی. بررسی عوامل موثر بر نتیجه درمان جراحی در بیماران مبتلا به دیسکوپاتی و یا تنگی کانال نخاع در بیماران دیابتی و غیر دیابتی. نشریه جراحی ایران. تابستان 1389; 18(2):9-16.


40. مشهدی نژاد حسین,ثمینی فریبرز,مشهدی نژاد سارا. مقایسه یافته های بالینی و نتایج روش جراحی باز در درمان فتق اولیه با عود دیسک بین مهره ای لومبوساکرال. مجله علمی دانشگاه علوم پزشکی بیرجند. زمستان 1389; 17(4 (پیاپی 45)):288-295.


41. لطفی نیا ایرج,صمدمطلق پرویز,صدیقی علی . بررسی موارد عمل جراحی مجدد فتق دیسک در بیمارستان شهدای تبریز و راهکارهای کاهش آن . مجله پزشکی دانشگاه علوم پزشکی تبریز. تابستان 1384; 27(2):71-75.

42. Ralph J,Raymand L.Lumbar discectomy and diabetic patient incidence and out come.Canberra hospital,Woden,Australia.2011;(2):10-13.