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腰椎间盘突出症的脊柱内手术并发症

Endospine Surgery Complications in Lumbar Herniated Disc.

作者信息

Nubukpo-Guménu Alëna Améyo, Ségbédji Félix K K, Rué Marjory, Destandau Jean

机构信息

Endospine Surgery Center, Bordeaux, France.

Endospine Surgery Center, Bordeaux, France.

出版信息

World Neurosurg. 2018 Nov;119:e78-e79. doi: 10.1016/j.wneu.2018.07.013. Epub 2018 Jul 17.

Abstract

BACKGROUND AND OBJECTIVE

Spine surgery is entering a new era of evolution, with minimally invasive spine surgery to decompress the neural structures without affecting the stability of the spine. However, complications may occur. The surgeon must have these in mind in order to prevent them. We report on the main intraoperative and postoperative complications of endospine surgery of lumbar disc herniation.

METHODS

It was a retrospective study spread over 22 years (January 1993-December 2015) concerning 10,433 patients who underwent treatment for lumbar disc herniation at the Endospine Surgery Center Bordeaux France. Among them 1189 patients had 1 intraoperative or postoperative complication.

RESULTS

This study comprised 10,433 patients, among whom 1189 had various complications, which represented 11.39%. The average age of this sample was 46 years, and the eldest were 91 years. A male predominance was noted in 6502 of cases with a sex ratio of 6502/3931 = 1.65. The complications were recurrences (6.77%) followed by dural tears (1.91%), facet resection (1.14%), two-level approach instead of one (1.09%), radicular lesion (0.17%) that remained with motor or pain symptoms, wrong level and infections such as spondylodiscitis and wound infection, respectively (0.08%) each, deep vein thrombosis (0.04%), and gauze (0.03%).

CONCLUSIONS

Twenty-two years of follow-up on endospine treatment for lumbar disc herniation showed a low complication rate. An early and efficient management will nevertheless allow a good outcome in the majority of patients operated.

摘要

背景与目的

脊柱外科正进入一个新的发展时代,微创脊柱手术能够在不影响脊柱稳定性的情况下对神经结构进行减压。然而,并发症仍可能发生。外科医生必须牢记这些情况以预防并发症。我们报告腰椎间盘突出症内镜下脊柱手术的主要术中和术后并发症。

方法

这是一项回顾性研究,涵盖22年(1993年1月至2015年12月),涉及在法国波尔多内镜下脊柱手术中心接受腰椎间盘突出症治疗的10433例患者。其中1189例患者发生了1种术中和术后并发症。

结果

本研究包括10433例患者,其中1189例出现各种并发症,占11.39%。该样本的平均年龄为46岁,年龄最大的为91岁。在6502例病例中男性占优势,性别比为6502/3931 = 1.65。并发症包括复发(6.77%),其次是硬脊膜撕裂(1.91%)、小关节切除(1.14%)、采用两级入路而非一级入路(1.09%)、残留运动或疼痛症状的神经根损伤(0.17%)、手术节段错误以及分别为椎间盘炎和伤口感染等感染(各0.08%)、深静脉血栓形成(0.04%)和纱布残留(0.03%)。

结论

对腰椎间盘突出症内镜下治疗22年的随访显示并发症发生率较低。然而,早期有效的处理仍将使大多数接受手术的患者获得良好预后。

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