中国脊柱脊髓杂志
中國脊柱脊髓雜誌
중국척주척수잡지
CHINESE JOURNAL OF SPINE AND SPINAL CORD
2009年
12期
912-915
,共4页
腰椎%后路椎间融合术%神经损伤%并发症
腰椎%後路椎間融閤術%神經損傷%併髮癥
요추%후로추간융합술%신경손상%병발증
Lumbar vertebra%Posterior interbody fusion%Nerve injury%Complication
目的:分析后路腰椎椎间融合术并发神经损伤的原因.方法:2003年3月～2008年5月采用后路腰椎椎间融合术(PLIF)治疗腰椎疾病患者178例,其中腰椎间盘突出症42例,腰椎管狭窄症39例,退变性腰椎滑脱症61例,峡部裂性腰椎滑脱症22例,腰椎椎板/椎间盘切除术后综合征14例:单节段融合130例,其中L3/48例,L4/5 64例,L5/S1 58例,双节段融合46例,其中L3/4、L4/5 19例,L4/5、L5/S1 27例,三节段融合2例,均为L3/4、L4/5、L5/S1,对其发生神经损伤的原因进行分析.结果:共并发神经损伤13例(7.3%),其中L4 1例,L5 7例,S1 5例;神经根牵拉伤6例,器械损伤3例,误伤变异神经根1例,硬膜外血肿致神经根受压1例,椎弓根骨折致神经根受压1例,继发性侧隐窝狭窄致神经根受压1例;完全性损伤2例,不完全性损伤11例.根据ASIA评分标准,神经功能完全恢复7例,部分恢复4例,无恢复2例.结论:后路腰椎椎间融合术并发神经损伤的原因是多方面的,以神经根的牵拉伤最多见.
目的:分析後路腰椎椎間融閤術併髮神經損傷的原因.方法:2003年3月～2008年5月採用後路腰椎椎間融閤術(PLIF)治療腰椎疾病患者178例,其中腰椎間盤突齣癥42例,腰椎管狹窄癥39例,退變性腰椎滑脫癥61例,峽部裂性腰椎滑脫癥22例,腰椎椎闆/椎間盤切除術後綜閤徵14例:單節段融閤130例,其中L3/48例,L4/5 64例,L5/S1 58例,雙節段融閤46例,其中L3/4、L4/5 19例,L4/5、L5/S1 27例,三節段融閤2例,均為L3/4、L4/5、L5/S1,對其髮生神經損傷的原因進行分析.結果:共併髮神經損傷13例(7.3%),其中L4 1例,L5 7例,S1 5例;神經根牽拉傷6例,器械損傷3例,誤傷變異神經根1例,硬膜外血腫緻神經根受壓1例,椎弓根骨摺緻神經根受壓1例,繼髮性側隱窩狹窄緻神經根受壓1例;完全性損傷2例,不完全性損傷11例.根據ASIA評分標準,神經功能完全恢複7例,部分恢複4例,無恢複2例.結論:後路腰椎椎間融閤術併髮神經損傷的原因是多方麵的,以神經根的牽拉傷最多見.
목적:분석후로요추추간융합술병발신경손상적원인.방법:2003년3월～2008년5월채용후로요추추간융합술(PLIF)치료요추질병환자178례,기중요추간반돌출증42례,요추관협착증39례,퇴변성요추활탈증61례,협부렬성요추활탈증22례,요추추판/추간반절제술후종합정14례:단절단융합130례,기중L3/48례,L4/5 64례,L5/S1 58례,쌍절단융합46례,기중L3/4、L4/5 19례,L4/5、L5/S1 27례,삼절단융합2례,균위L3/4、L4/5、L5/S1,대기발생신경손상적원인진행분석.결과:공병발신경손상13례(7.3%),기중L4 1례,L5 7례,S1 5례;신경근견랍상6례,기계손상3례,오상변이신경근1례,경막외혈종치신경근수압1례,추궁근골절치신경근수압1례,계발성측은와협착치신경근수압1례;완전성손상2례,불완전성손상11례.근거ASIA평분표준,신경공능완전회복7례,부분회복4례,무회복2례.결론:후로요추추간융합술병발신경손상적원인시다방면적,이신경근적견랍상최다견.
Objective:To evaluate the neurologic complications associated with posterior lumbar interbody fusion (PLIF).Method:From March 2003 to May 2008,a total of 178 patients experienced PLIF procedure due to lumbar disease.Of these,forty two had lumbar disc herniation,39 had lumbar spine stenosis,61 had degenerative spondylolisthesis, 22 had isthmic spondylolisthesis and 14 had post-laminectomy/discectomy syndrome. One hundred and thirty patients had single level fused,of these,8 at L3/4.64 at L4/5 and 58 at L5/S1.Forty six cases had two levels fused,of these, 19 at L3/4 and L4/5,27 at L4/5 and L5/Sl.Two patients had three levels fused,all at the L3/4.L4/5 and L5/S1.A11 causes possibly related to the neurologic complications were documented.Result: 13 cases(7.3%) were noted to have neurologic complications,of these,one at L4,7 at L5 and 5 at S1.6 cases had nerve root stretch injury,3 cases had nerve root injury from instrument maneuver, 1 case had nerve root deformity, 1 case had developed epidural hematoma, 1 case had nerve root injury from pedicle fracture and 1 case had secondary lateral recess stenosis.2 cases had complete neurological injury,and 11 cases had incomplete injury.According to American Spinal Injury Association (ASIA) criteria,there was complete recovery of neurologic function in 7 cases, incomplete recovery in 4 cases and no change in 2 cas-es.Conclusion: Many causes may be associated with the neurologic complications due to posterior lumbar interbody fusion,nerve root stretch injury is the most common.
