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在连续1000例犬全髋关节置换术中坐骨神经失用作为一种并发症

Sciatic neurapraxia as a complication in 1000 consecutive canine total hip replacements.

作者信息

Andrews Chad M, Liska William D, Roberts Darryl J

机构信息

Gulf Coast Veterinary Specialists, Houston, TX 77027, USA.

出版信息

Vet Surg. 2008 Apr;37(3):254-62. doi: 10.1111/j.1532-950X.2008.00374.x.

Abstract

OBJECTIVES

To report the frequency of sciatic neurapraxia (SN) associated with total hip replacement (THR), to determine outcome (recovery rate) after SN associated with THR, and to identify potential causes of THR-associated SN in dogs.

STUDY DESIGN

Prospective study.

ANIMALS

Dogs (n=786; 1000 hips) that had THR.

METHODS

Logistic regression was used to determine the association with post-THR SN of the variables age, sex, breed, weight, body condition score, severity of presurgical pain, side (right, left), type of prosthesis fixation (cemented, cementless), duration of surgery, surgeon experience (chronologic order), traumatic presurgical luxation, and primary versus revision arthroplasty.

RESULTS

The frequency of SN after THR was 19/1000 (1.9%). Two explanatory variables, age at surgery and duration of surgery, were significantly (P<.05) associated with increased probability of SN. Body weight (P=.09), traumatic presurgical luxation (P=.11), and revision versus primary surgery (P=.11) were marginally associated with increased probability of SN. All dogs with SN recovered fully.

CONCLUSIONS

SN after THR is not uncommon and complete recovery usually occurs although the recovery time is highly variable.

CLINICAL RELEVANCE

Although SN associated with THR typically resolves, surgeons should avoid iatrogenic sciatic nerve injury during THR.

摘要

目的

报告全髋关节置换术(THR)相关坐骨神经失用症(SN)的发生率,确定THR相关SN后的预后(恢复率),并识别犬类THR相关SN的潜在原因。

研究设计

前瞻性研究。

动物

接受THR的犬(n = 786;1000个髋关节)。

方法

采用逻辑回归确定年龄、性别、品种、体重、身体状况评分、术前疼痛严重程度、侧别(右侧、左侧)、假体固定类型(骨水泥型、非骨水泥型)、手术持续时间、外科医生经验(按时间顺序)、术前创伤性脱位以及初次置换与翻修置换等变量与THR后SN的相关性。

结果

THR后SN的发生率为19/1000(1.9%)。两个解释变量,即手术年龄和手术持续时间,与SN发生概率增加显著相关(P <.05)。体重(P = 0.09)、术前创伤性脱位(P = 0.11)以及翻修手术与初次手术相比(P = 0.11)与SN发生概率增加存在边缘相关性。所有患SN的犬均完全恢复。

结论

THR后SN并不罕见,尽管恢复时间差异很大,但通常会完全恢复。

临床意义

尽管THR相关SN通常会缓解,但外科医生在THR期间应避免医源性坐骨神经损伤。

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