Sen Rajeev D, White-Dzuro Gabrielle, Ruzevick Jacob, Kim Choll W, Witt Jens-Peter, Telfeian Albert E, Wang Michael Y, Hofstetter Christoph P
Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.
Department of Neurological Surgery, The Spine Institute of San Diego, San Diego, California, USA.
World Neurosurg. 2018 Dec;120:e1054-e1060. doi: 10.1016/j.wneu.2018.09.009. Epub 2018 Sep 11.
To report on intra- and perioperative complications associated with working channel endoscopic spine surgery.
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.
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.
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.
报告工作通道内镜脊柱手术的术中和围手术期并发症。
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。
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。
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。