腰椎Cage手术并发症分析及其防治

目的:分析后路腰椎椎间cage融合术常见的并发症并探讨对策。方法:对89例腰椎间盘突出症、下腰椎失稳症患者,经临床症状、体征和影像资料明确诊断且具有手术指征,并采用后路cage融合术治疗,对其中出现的并发症进行原因分析。结果:89例中出现并发症的有24例,包括神经症状加重、脑脊液漏、感染等近期并发症和症状缓解不明显、植骨不融合等远期并发症。术后神经症状加重5例,主要与手术适应症选择正确与否、影像学资料阅读能力高低、术者操作技能熟练程度等因素有关。结论:cage融合术是外科治疗椎间盘突出症的一种优良方法,术后神经症状加重和神经根损伤是最常见的并发症,正确把握手术适应症、熟练掌握操作技巧、提高并发症的诊断和处理能力是顺利开展该技术、提高临床疗效的关键。

Complications Associated with Posterior Lumbar Interbody Fusion with Cages and Exploring Countermeasures

Objective:To evaluate the complications associated with posterior lumbar interbody fusion with cages and explore countermeasures.Methods:89 patients who had lumbar disc herniation or lumbar spine instability had a clear diagnosis and surgical indi- cations.They had been treated with posterior fusion cage and the complications were analyzed.Results:The complications were discov- ered in 24 cases,including neurological symptoms increasing,cerebrospinal fluid leak,infection,not obvious releasing symptoms,nonfu- sion,and other long-term complications.The postoperative neurological symptoms were observed heavy in 5 cases inceasing,which were related to follow factors,including choosing the correct operative indications,the level of ability to observe image data and proficient skills.Conclusion:posterior lumbar interbody fusion with cages is a good method.Operation skills and diagnosis of complications are the key of successful posterior lumbar interbody fusion with cages.