Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
J Arthroplasty. 2010 Jan;25(1):31-4. doi: 10.1016/j.arth.2008.11.101. Epub 2009 Jun 13.
Sciatic nerve palsy after revision hip arthroplasty is rare, but can have substantial impacts. The purpose of this study is to report the safety and reliability of limited sciatic nerve exposure during revision surgery. A retrospective case series of 350 revision hip surgeries performed by a single surgeon underwent sciatic nerve identification. In each case, the sciatic nerve was identified and tagged loosely with a Penrose drain. Three hundred forty-eight of 350 patients (99.4%) underwent successful revision hip arthroplasty. One patient developed a transient sensory palsy; and another patient, a delayed palsy. Both nerve palsies recovered by the 1-year visit. We advocate visual nerve identification and tagging in revision hip surgery as 1 possible method to potentially reduce the risks of sciatic nerve injury.
在髋关节翻修术后发生坐骨神经麻痹较为罕见，但可能会产生重大影响。本研究的目的在于报告在翻修手术中进行有限坐骨神经显露的安全性和可靠性。对单名外科医生进行的 350 例髋关节翻修手术进行了回顾性病例系列研究，这些手术均对坐骨神经进行了识别。在每种情况下，均对坐骨神经进行识别并使用多孔引流管松散地标记。350 例患者中有 348 例（99.4%）成功进行了髋关节翻修手术。1 例患者出现短暂的感觉麻痹，另 1 例患者出现迟发性麻痹。这两种神经麻痹在 1 年就诊时均已恢复。我们提倡在髋关节翻修手术中进行视觉神经识别和标记，这是一种可能降低坐骨神经损伤风险的方法。
