Stundner Ottokar, Taher Fadi, Pawar Abhijit, Memtsoudis Stavros G
Ottokar Stundner, Stavros G Memtsoudis, Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY 10021, United States.
World J Orthop. 2012 Oct 18;3(10):156-61. doi: 10.5312/wjo.v3.i10.156.
Spine surgery is one of the fastest growing branches of orthopedic surgery. Patients often present with a relatively high acuity and, depending on surgical approach, morbidity and mortality can be comparatively high. Among the most prevalent and most frequently fatality-bound perioperative complications are those affecting the pulmonary system; evidence of clinical or subclinical lung injury triggered by spine surgical procedures is emerging. Increasing burden of comorbidity among the patient population further increases the likelihood of adverse outcome. This review is intended to give an overview over some of the most important causes of pulmonary complications after spine surgery, their pathophysiology and possible ways to reduce harm associated with those conditions. We discuss factors surrounding surgical trauma, timing of surgery, bone marrow and debris embolization, transfusion associated lung injury, and ventilator associated lung injury.
脊柱外科是骨科手术中发展最快的分支之一。患者通常病情较为严重，并且根据手术方式的不同，发病率和死亡率可能相对较高。在最常见且最常导致围手术期死亡的并发症中，有一些是影响肺部系统的；脊柱手术引发临床或亚临床肺损伤的证据正在不断涌现。患者群体中合并症负担的增加进一步提高了不良后果的可能性。本综述旨在概述脊柱手术后肺部并发症的一些最重要原因、其病理生理学以及减少与这些情况相关危害的可能方法。我们讨论了围绕手术创伤、手术时机、骨髓和碎片栓塞、输血相关肺损伤以及呼吸机相关肺损伤的因素。
