From the Department of Orthopaedic Surgery, Lenox Hill Hospital Northwell Health, New York, NY (Butler), the Department of Orthopaedic Surgery, University of Miami, Miami, FL (Mohile), and the Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL (Phillips).
J Am Acad Orthop Surg. 2023 Sep 1;31(17):908-913. doi: 10.5435/JAAOS-D-22-01022. Epub 2023 Apr 14.
Fluid collections after spine surgery are rare complications, although potentially grave, and may be broadly grouped into two major categories. Symptomatic postoperative epidural hematomas have some known risk factors and can present with a widely variable profile of signs and symptoms. Treatment involves emergent surgical evacuation to reduce the risk of permanent neurologic deficit. Postoperative seroma may lead to disruption of wound healing and deep infection and has been associated with the use of recombinant human bone mineral protein. These diagnoses may present diagnostic challenges; thorough understanding of the involved pathophysiology, meticulous clinical evaluation, and radiographic interpretation are critical to appropriate management and optimal outcome.
脊柱手术后出现液体聚集是罕见的并发症,尽管可能很严重,但可以大致分为两类。有症状的术后硬脊膜外血肿有一些已知的危险因素,其表现的体征和症状差异很大。治疗方法是紧急手术清除,以降低永久性神经功能缺损的风险。术后血清肿可能导致伤口愈合不良和深部感染,并与重组人骨矿物质蛋白的使用有关。这些诊断可能存在诊断挑战;深入了解相关的病理生理学、细致的临床评估和影像学解读对于进行适当的管理和获得最佳结果至关重要。