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目的 探讨手术治疗复发性椎间盘突出的临床结果与预后.方法 23例复发性腰椎间盘突出患者接受再次手术治疗;手术方式包括单纯后路椎间盘髓核摘除,或同时行椎弓根螺钉内固定植骨融合术.用JOA评分评估术前及术后腰椎功能,按MacNab标准评似术后满意度.分析腰椎间盘突出症术后复发的可能因素与临床治疗效果之间的关系.结果 23例术中I均发现原手术部位有不同程度的粘连.术后随访时间6～40个月.影像学未见椎弓根螺钉内固定松动和断裂情况,植骨均融合.JOA评分临床平均改善率为(80.42±12.56)% ;基于MacNab标准,19例(82.6% )预后优良.结论 椎间盘突出症再次手术治疗,应根据腰椎稳定性及有无椎管狭窄等情况,选择合适的手术方式.“,”Objective To investigate the outcomes of surgical treatment of recurrent lumbar disc herniation.Method The reoperation was performed in 23 patients with recurrent lumbar disc herniation, which included discectomy with or without laminectomy decompression, pediclc screw fixation and spinal fusion.The patients were followed up for 6 to 40 months.JOA score and MacNab criteria were used to evaluate the severity of pain and satisfaction after revision surgery.Results Adhesion in different degrees was seen in the first operated area.The average recovery rate after the second operation was(80.42 ± 12.56) %.Excellent outcomes were noted in 19 patients(82.6%)according to MacNab criteria.There was no loosing and disruption of the internal fixation device according to the radiology examination.Conclusions An appropriate surgical method for thc rccurrent lumbar disc herniatio should be selected on the basis of the stability of the spine and the degrcc of stenosis of the vertebral canal.