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内镜脊柱手术相关的术中和围手术期并发症:一项多机构研究

Intra- and Perioperative Complications Associated with Endoscopic Spine Surgery: A Multi-Institutional Study.

作者信息

Sen Rajeev D, White-Dzuro Gabrielle, Ruzevick Jacob, Kim Choll W, Witt Jens-Peter, Telfeian Albert E, Wang Michael Y, Hofstetter Christoph P

机构信息

Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.

Department of Neurological Surgery, The Spine Institute of San Diego, San Diego, California, USA.

出版信息

World Neurosurg. 2018 Dec;120:e1054-e1060. doi: 10.1016/j.wneu.2018.09.009. Epub 2018 Sep 11.

Abstract

OBJECTIVE

To report on intra- and perioperative complications associated with working channel endoscopic spine surgery.

METHODS

This study is a retrospective chart review of a multi-institutional patient cohort operated on by surgeons within the Endoscopic Spine Study Group between May 2010 and June 2017.

RESULTS

Our study cohort consists of a total of 553 consecutive cases with an average age of 57 years. The most common procedure was an endoscopic discectomy (n = 377, 68%) followed by foraminotomy (n = 156, 28.2%), unilateral laminotomy for bilateral decompression (n = 55, 9.9%), and lateral recess decompression (n = 29, 5.2%). Overall, the rate of intra- and perioperative complications was 2.7%. There were 3 durotomies (0.54%), 2 epidural hematomas (0.36%), 2 patients developed a complex pain disorder (0.36%), 4 recurrent disc herniations within 3 months (1.1%), 4 systemic complications (1.1%), and no wound infections. No risk factors were identified with regards to age, sex, approach, or number of segments.

CONCLUSIONS

Endoscopic spine surgery is associated with a favorable rate of intra- and perioperative complications compared with reported rates of minimally invasive ortraditional open spine surgeries. Our report proposes safe and effective strategies for management of these complications.

摘要

目的

报告工作通道内镜脊柱手术的术中和围手术期并发症。

方法

本研究是一项对多机构患者队列的回顾性病历审查,该队列由内镜脊柱研究组的外科医生在2010年5月至2017年6月期间进行手术。

结果

我们的研究队列共有553例连续病例,平均年龄57岁。最常见的手术是内镜下椎间盘切除术(n = 377,68%),其次是椎间孔切开术(n = 156,28.2%)、单侧椎板切开术用于双侧减压(n = 55,9.9%)和侧隐窝减压术(n = 29,5.2%)。总体而言,术中和围手术期并发症发生率为2.7%。有3例硬脊膜切开(0.54%),2例硬膜外血肿(0.36%),2例患者出现复杂性疼痛障碍(0.36%),4例在3个月内复发椎间盘突出(1.1%),4例全身并发症(1.1%),且无伤口感染。未发现与年龄、性别、手术入路或节段数相关的危险因素。

结论

与微创或传统开放脊柱手术的报告发生率相比,内镜脊柱手术的术中和围手术期并发症发生率较低。我们的报告提出了处理这些并发症的安全有效策略。

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