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成人脊柱畸形手术后症状性脊柱硬膜外血肿的临床研究。

A clinical study regarding the outcomes of symptomatic spinal epidural haematoma after adult spinal deformity surgery.

机构信息

Department of Spine Surgery, Fuzhou Second Hospital Affiliated to Xiamen University, China.

Department of Orthopedics, Peking University Third Hospital, China.

出版信息

J Pak Med Assoc. 2020 Dec;70(12(B)):2472-2475. doi: 10.47391/JPMA.951.

Abstract

Symptomatic spinal epidural haematoma (SSEH) is a rare but serious postoperative complication. This study aimed to assess the prevalence, causes and treatment of SSEH after adult spinal deformity (ASD) surgery. The patients admitted from August 2012 till August 2016 were retrospectively reviewed using case notes. During these four years, 102 patients were admitted with adult spinal deformity, out of which 3 (2.9%) developed post-operative SSEH. The duration between surgery to onset of SSEH was 10-13 hours (average 11.7 hours) post-operatively. Three patients were treated by haematoma evacuation at 8.5-14 hour (average 11.4 hours) after the symptoms appeared. One patient had improved by 2 Frankel grades, and two patients had improved by1 Frankel grade at the last followup. The results concluded that post-operative SSEH occurred in 2.9% of ASD patients who underwent corrective spinal procedures. Improvement in neurological deficits can be achieved by early haematoma evacuation.

摘要

症状性硬脊膜外血肿(SSEH)是一种罕见但严重的术后并发症。本研究旨在评估成人脊柱畸形(ASD)手术后 SSEH 的发生率、原因和治疗方法。通过病历回顾,对 2012 年 8 月至 2016 年 8 月收治的患者进行了回顾性分析。在这四年中,有 102 例成人脊柱畸形患者入院,其中 3 例(2.9%)发生术后 SSEH。SSEH 从手术到发病的时间为术后 10-13 小时(平均 11.7 小时)。术后出现症状后 8.5-14 小时(平均 11.4 小时)对 3 例患者进行血肿清除术。1 例患者的 Frankel 分级提高了 2 级,2 例患者的 Frankel 分级提高了 1 级。研究结果表明,接受矫形脊柱手术的 ASD 患者中有 2.9%发生术后 SSEH。早期血肿清除可改善神经功能缺损。

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