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脊髓型颈椎病手术治疗的早期并发症

EARLY COMPLICATIONS OF SURGICAL TREATMENT OF CERVICAL SPONDYLOTIC MYELOPATHY.

作者信息

Saheb Ricardo Lucca Cabarite, Soeira Thabata Pasquini, Moratelli Lucas, Pontes Mariana Demétrio DE Sousa, Herrero Carlos Fernando Pereira DA Silva

机构信息

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto FMRP USP, Departamento de Ortopedia e Anestesiologia, Ribeirão Preto, SP, Brazil.

Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Ortopedia e Traumatologia IOT HCFMUSP, São Paulo, SP, Brazil.

出版信息

Acta Ortop Bras. 2023 Jul 31;31(4):e260397. doi: 10.1590/1413-785220233104e260397. eCollection 2023.

Abstract

OBJECTIVE

To evaluate the early postoperative complications associated with the surgical approach of the cervical spine of patients with cervical spondylotic myelopathy (CSM), comparing the anterior surgical, the posterior surgical, and the combined approaches.

METHODS

This is a retrospective study based on a database with 169 patients. Demographic data, such as gender and age, and surgical data, such as surgical approach, number of segments with arthrodesis, surgical time, and complications, were evaluated. Complications were divided into major (deep surgical wound infection, intercurrence with the implant, early new compression, and heart failure) and minor (dysphagia, superficial infection, pain, urinary intercurrence, neuropraxia of the C5 root, acute confusional state, and surgical wound hematoma).

RESULTS

This included 169 patients, 57 women (33.7%) and 112 men (66.2%). Age ranged from 21 to 87 years, with a mean of 56.48 (± 11) years. Of these, 52 (30.8%) underwent the anterior approach; 111 (65.7%), the posterior approach; and 6 (3.5%), the combined approach.

CONCLUSION

As in the literature, we evinced dysphagia, pain, and superficial infection of the surgical wound as the most frequent postoperative complications. However, it was impossible to establish a statistical relationship between the incidence of complications and surgical time, access route, and number of fixed segments.

摘要

目的

评估脊髓型颈椎病(CSM)患者颈椎手术入路相关的早期术后并发症,比较前路手术、后路手术及联合手术入路。

方法

这是一项基于包含169例患者的数据库的回顾性研究。评估了人口统计学数据,如性别和年龄,以及手术数据,如手术入路、融合节段数、手术时间和并发症。并发症分为严重并发症(深部手术伤口感染、植入物相关并发症、早期新的压迫和心力衰竭)和轻微并发症(吞咽困难、浅表感染、疼痛、排尿障碍、C5神经根神经失用、急性意识模糊状态和手术伤口血肿)。

结果

本研究纳入169例患者,其中女性57例(33.7%),男性112例(66.2%)。年龄范围为21至87岁,平均年龄为56.48(±11)岁。其中,52例(30.8%)接受前路手术;111例(65.7%)接受后路手术;6例(3.5%)接受联合手术入路。

结论

与文献报道一致,我们发现吞咽困难、疼痛和手术伤口浅表感染是最常见的术后并发症。然而,无法在并发症发生率与手术时间、手术入路和固定节段数之间建立统计学关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08ed/10399992/7485ce47ee2b/1809-4406-aob-31-04-e260397-gf1.jpg

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