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脊柱创伤中微创手术的应用:概念综述

The use of minimally invasive surgery in spine trauma: a review of concepts.

作者信息

Camacho Jael E, Usmani M Farooq, Strickland Ashely R, Banagan Kelley E, Ludwig Steven C

机构信息

Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.

出版信息

J Spine Surg. 2019 Jun;5(Suppl 1):S91-S100. doi: 10.21037/jss.2019.04.13.

Abstract

Traumatic injuries to the spine can be common in the setting of blunt trauma and delayed diagnosis can have a deleterious effect on patients' health. The goals of treatment in managing spine trauma are prevention of neurological injury, providing stability to the spine, and correcting post-traumatic deformity. Minimally invasive spine surgery (MISS) techniques are an alternative to open spine surgery for treatment of spine fractures. MISS is also a viable treatment in the setting of damage control orthopedics, when patients with multiple traumatic injuries may be unable to tolerate a traditional open approach. MISS techniques have been used in the treatment of unstable fractures with or without spinal cord injury, flexion and extension-distraction injuries, and unstable sacral fractures. Traditional open surgeries have been associated with increased blood loss, longer operative times, and a higher risk for surgical site infection (SSI). MISS techniques have the potential to reduce open approach-associated morbidity, and improve postoperative care and rehabilitation. MISS techniques for spine trauma are an indispensable option in the treatment armamentarium of spine surgeons.

摘要

脊柱创伤在钝性创伤情况下较为常见,延迟诊断会对患者健康产生有害影响。脊柱创伤治疗的目标是预防神经损伤、为脊柱提供稳定性以及纠正创伤后畸形。微创脊柱手术(MISS)技术是治疗脊柱骨折的一种替代开放性脊柱手术的方法。在损伤控制骨科的情况下,当患有多处创伤的患者可能无法耐受传统的开放手术时,MISS也是一种可行的治疗方法。MISS技术已用于治疗伴有或不伴有脊髓损伤的不稳定骨折、屈伸牵张损伤以及不稳定骶骨骨折。传统的开放性手术与失血增加、手术时间延长以及手术部位感染(SSI)风险较高相关。MISS技术有可能降低与开放手术相关的发病率,并改善术后护理和康复。脊柱创伤的MISS技术是脊柱外科医生治疗手段中不可或缺的选择。

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