摘要
目的:统计分析采用椎间融合器(cage)行后路腰椎间融合术(PLIF)的并发症,并提出预防措施。方法:对1996年10月～2004年10月145例置入cage的PLIF病例进行随访,统计各种术中、术后并发症,分析其发生的原因。结果:145例患者中16例(11.0%)发生术中并发症,其中手术操作导致硬脊膜撕裂11例(7.6%),神经根损伤5例(3.4%)。在平均20.3个月随访期内,32例(22.1%)出现术后并发症,其中椎间不愈合5例(3.5%),粘连性蛛网膜炎5例(3.5%),cage沉陷4例(2.8%),术后切口感染2例(1.4%),其中1例为浅表感染,另1例由浅表感染发展为椎间隙感染;cage后移位16例(11.0%),其中13例(8.9%)接受再手术治疗。结论:采用cage行PLIF的并发症并不少见,其发生与适应证选择、手术操作、固定方式以及cage的型号等因素有关。
Objective：To evaluate the complications associated with posterior lumbar interbody fusion （PLIF） with cages and the related risk factors.Method：One hundred and forty five patients underwent PLIF with cage implantation were reviewed retrospectively from Oct 1996 to Oct 2004.Both intraoperative and postoperative related complications,including dural tear,never root injury,instrument failure,infection and postolaminectomy adhesive arachnoiditis were observed.Subsequently,all risk factors favoring the complications were analyzed respectively.Result：No vascular injury was documented in all patients intra and postoperatively.Intraoperative complications occurred in 16 patients（11.0%） including of dural tear（11 patients,7.6%） and never root injury （5 patients,3.4%）. Within 12 to 44 months （mean 20.3 months） follow-up,postoperative complications were present in 32 patients（22.1%） which included nonunion（5 patients,3.5%）,postolaminectomy adhesive arachnoiditis（5 patients,3.5%）,cage subsidence （4 patients,2.8%） and postoperative infection（2 patients, 1.4%）.Un- fortunately 16 patients （11.0% ） suffered cage migration,of which 13 patients （8.9%） received revision surgery due to worsened neurological deficit during follow-up.Conclusion：PLIF with cage implantation is demanding technically.The potential risks and complications are correlated with surgical manipulation and preoperative thorough review of patients.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2006年第7期493-497,共5页
Chinese Journal of Spine and Spinal Cord
