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经前路腹膜后入路行全腰椎间盘置换术后小腿间隔综合征:一种少见的前路脊柱手术并发症。

Compartment syndrome of leg following total lumbar disc replacement via anterior retroperitoneal approach: a rare complication of anterior spinal surgery.

机构信息

Queens Medical Centre, Nottingham, United Kingdom.

出版信息

Spine (Phila Pa 1976). 2010 Feb 1;35(3):E74-6. doi: 10.1097/BRS.0b013e3181ca7331.

Abstract

STUDY DESIGN

Observational study of a case with a rare complication of lower limb compartment syndrome following total lumbar disc replacement via anterior retroperitoneal approach.

OBJECTIVE

To describe a patient with lower limb compartment syndrome, following total lumbar disc replacement via anterior retroperitoneal approach.

SUMMARY OF BACKGROUND DATA

Compartment syndrome is a rare complication of spinal surgery. Previously, there were very few reported cases of compartment syndrome following posterior approach through a knee chest position. We are reporting the first case of lower limb compartment syndrome following total lumbar disc replacement through anterior retroperitoneal approach.

METHODS

Case report and literature review.

RESULT

Total lumbar disc replacement through anterior retroperitoneal approach led to a vascular complication (left iliac vein injury) with failed attempt at surgical repair. At 48 hours, the patient developed left lower limb compartment syndrome. Surgical decompression of the compartment prevented serious sequel with a successful outcome.

CONCLUSION

Total disc replacement in the lumbar spine complicated with an acute compartment syndrome due to the left common iliac vein injury is reported for the first time. A vigilant postoperative work-up in an unconscious patient resulted in the diagnosis and decompression with a successful outcome.

摘要

研究设计

通过腹膜后前路全腰椎间盘置换术治疗下肢间隔综合征罕见并发症的病例观察研究。

研究目的

描述一例通过腹膜后前路全腰椎间盘置换术治疗后发生下肢间隔综合征的患者。

背景资料概要

间隔综合征是脊柱手术的罕见并发症。以前,只有少数几例通过膝胸位后路报道的间隔综合征病例。我们报告首例通过腹膜后前路全腰椎间盘置换术后发生下肢间隔综合征的病例。

研究方法

病例报告和文献复习。

结果

通过腹膜后前路全腰椎间盘置换导致血管并发症(左侧髂静脉损伤),手术修复失败。48 小时后,患者出现左下肢间隔综合征。通过间隔减压防止了严重的后果,取得了成功的结果。

结论

首次报道全腰椎间盘置换术引起的急性间隔综合征合并左髂总静脉损伤。对无意识患者进行警惕的术后检查可及时诊断并减压,取得成功的结果。

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