直视下微创经椎间孔腰椎体间融合术的并发症分析

肖波; 毛克亚; 王岩; 肖嵩华; 张永刚; 张西峰; 张雪松; 王征; 崔庚; 陆宁; 朱守荣

doi:10.3969/j.issn.2095-5227.2013.05.007

直视下微创经椎间孔腰椎体间融合术的并发症分析

Complications of minimally invasive transforaminal lumbar interbody fusion under straight view

摘要

摘要: 目的总结直视下微创经椎间孔腰椎体间融合术(MIS-TLIF)的并发症并探讨其发生原因和相关对策。方法对我院2008年1月-2011年7月间行MIS-TLIF 术的连续105例下腰椎退变性疾病患者进行回顾分析，记录患者的手术时间、术中出血量、术后下地时间、各种并发症情况，并进行影像学和术后疗效评价。结果随访12～30个月，平均16个月。7 人次(6.67%)出现并发症：硬膜囊破裂3例(2.86%)，为减压和髓核摘除时造成的撕裂；神经损伤1例(0.95%)，为术中牵拉性损伤；切口感染1例(0.95%)，为浅部感染；椎间融合器下沉2例(1.90%)，因骨质疏松造成。结论微创经椎间孔腰椎体间融合术并发症的发生主要与微创手术的特点、学习曲线和适应证的选择有关。

Abstract: Objective To study the reasons for the complications of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF) under straight view and their countermeasures. Methods One hundred and five patients who underwent MIS-TLIF in our hospital from January 2008 to July 2011 were retrospectively analyzed.Their operation time, intra-operative blood loss, postoperative ambulation time, and complications were recorded and assessed according to their postoperative radiographic images and clinical outcomes. Results The patients were followed up for 12-30 months (mean 16 months).Among the 7 patients (6.67%)with complications, dural cyst rupture due to decompression and removal of pulpiform nucleus, nerve injury due to intra-operative traction, superficial incision infection, and inter-vertebral cage subsidence due to osteoporosis occurred in 3 (2.86%), 1(0.95%), 1(0.95%), and 2 (1.90%), respectively. Conclusion Complications of MIS-TLIF are mainly correlated with the features of MISTLIF, learning curves, and indications for MIS-TLIF.Operation under straight view can reduce the development of complications.

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