与侧方椎间融合术相关的并发症：日本使用该技术的头 2 年全国范围内 2998 例病例的调查。
Complications Associated With Lateral Interbody Fusion: Nationwide Survey of 2998 Cases During the First 2 Years of Its Use in Japan.
机构信息
Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin Kawahara-cho, Sakyo-ku, Kyoto, Japan.
Department of Orthopedics and Spine Surgery, Meijo Hospital, Sannomaru, Naka-ku, Nagoya, Japan.
出版信息
Spine (Phila Pa 1976). 2017 Oct 1;42(19):1478-1484. doi: 10.1097/BRS.0000000000002139.
STUDY DESIGN
Retrospective nationwide questionnaire-based survey of complications.
OBJECTIVE
To elucidate the incidence of complications and risk factors associated with lateral interbody fusion (LIF).
SUMMARY OF BACKGROUND DATA
After its introduction to Japan in February 2013, the numbers of LIF cases have increased substantially because of the advantages of this minimally invasive procedure. However, LIF has the potential risk of several complications unique to the procedure. Although there are many reports of complications, no nationwide survey has been conducted.
METHODS
Questionnaires were sent to all Japanese Society for Spine Surgery and Related Research (JSSR) members. Questionnaires requested information about surgical procedures (XLIF or OLIF), patient characteristics, preoperative diagnosis, complications, salvage procedures, final outcomes, and the surgeon's experience of LIF. The data from replies received between March 2013 and April 2015 were recorded on a web site and the details of complications were analyzed by a JSSR research team.
RESULTS
Seventy-one institutions (12.3%) answered "yes" to LIF experience and 2998 cases (1995 XLIF and 1003 OLIF) were enrolled in this study. The response rate was 86.1%. A total of 540 complications were reported, of which 474 (84.8%) could be further analyzed. The overall complication rate was 18.0%. The most frequent complications were sensory nerve injury (5.1%) and psoas weakness (4.3%) and the majority resolved spontaneously. The rates of major vascular injury, bowel injury, and surgical site infection were 0.03%, 0.03%, and 0.7%, respectively. The overall reoperation rate was 2.2%. Higher rates of sensory nerve injury and psoas weakness were reported for XLIF and higher rates of peritoneal laceration and ureteral injury were reported for OLIF.
CONCLUSION
A nationwide survey of complications associated with LIF was conducted. Although the majority of complications were minor, a relatively high rate of complications was reported. Approach-related specific features of the two procedures were identified.
LEVEL OF EVIDENCE
研究设计
回顾性全国问卷调查并发症。
目的
阐明与侧方椎间融合术（LIF）相关的并发症发生率和危险因素。
背景资料总结
2013 年 2 月该技术引入日本后，由于其微创优势，LIF 病例数量显著增加。然而，LIF 存在该手术特有的多种潜在并发症风险。虽然有很多关于并发症的报道，但尚未进行全国性调查。
方法
向日本脊柱外科学会及相关研究学会（JSSR）的所有成员发送了问卷。问卷要求提供手术程序（XLIF 或 OLIF）、患者特征、术前诊断、并发症、抢救程序、最终结果以及外科医生的 LIF 经验等信息。2013 年 3 月至 2015 年 4 月期间收到的回复数据记录在一个网站上，JSSR 研究小组对并发症的详细信息进行了分析。
结果
71 个机构（12.3%）回答有 LIF 经验，共有 2998 例（1995 例 XLIF 和 1003 例 OLIF）纳入本研究。应答率为 86.1%。共报告了 540 例并发症，其中 474 例（84.8%）可进一步分析。总并发症发生率为 18.0%。最常见的并发症是感觉神经损伤（5.1%）和腰大肌无力（4.3%），大多数并发症可自发缓解。大血管损伤、肠损伤和手术部位感染的发生率分别为 0.03%、0.03%和 0.7%。总的再次手术率为 2.2%。XLIF 报告的感觉神经损伤和腰大肌无力发生率较高，OLIF 报告的腹膜切开和输尿管损伤发生率较高。
结论
对 LIF 相关并发症进行了全国性调查。虽然大多数并发症是轻微的，但报告的并发症发生率相对较高。确定了两种手术方法相关的特定特征。
证据水平
4。
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