经肌间隙入路通道腰椎固定融合术的并发症Complications of lumbar instrumented fusion through intermuscular channel
王正安;曾忠友;宋永兴;籍剑飞;张建乔;裴斐;金辉;宋国浩;
摘要(Abstract):
[目的]总结肌间隙入路通道显露下腰椎固定融合术的并发症。[方法] 2012年6月~2015年12月共治疗腰椎疾病467例,男203例,女264例;平均年龄(57.63±9.16)岁;单节段病变415例,两节段病变52例。采用肌间隙入路通道下单侧椎弓根螺钉固定并椎间融合术治疗58例,肌间隙入路通道下单侧椎弓根螺钉联合对侧椎板关节突螺钉固定并椎间融合术治疗192例,肌间隙入路通道下双侧椎弓根螺钉固定并椎间融合术治疗217例。观察其临床结果及并发症。[结果]术中并发症:异常出血2例、腰椎病变节段定位错误6例、椎弓根骨折7例、终板损伤4例、硬脊膜撕裂和脑脊液漏3例、神经损伤9例、椎弓根螺钉位置不正确12例、椎板关节突螺钉位置不正确15例。术后并发症:切口表皮部分坏死19例、切口愈合不良3例、切口深部感染1例、椎间排斥反应1例、血肿2例、再次手术6例。共446例获得6~36个月,平均(19.65±5.87)个月的随访。随访期内未发现内固定松动或断裂现象,出现融合器向后移位2例,融合器沉降19例。随访病例中除23例不能明确外均获得椎间融合,JOA评分均获得明显改善。[结论]肌间隙入路通道下固定融合治疗腰椎病变临床效果良好,但也存在较高的并发症,特别在早期开展阶段。
关键词(KeyWords): 腰椎退行性疾病;肌间隙入路通道;固定融合术;并发症
基金项目(Foundation): 浙江省卫生厅科研项目资助(编号:2010KYB112)
作者(Author): 王正安;曾忠友;宋永兴;籍剑飞;张建乔;裴斐;金辉;宋国浩;
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