頸椎前路手術20例并發癥治療分析_《華西醫學》

作者：

鄭軍 , 楊效寧 , 曹雷

徐州市第一人民醫院骨科（江蘇徐州，221000）;

關鍵詞：

脊髓型頸椎病前路手術并發癥

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【摘要】　目的　探討頸椎手術并發癥原因及預防措施，以提高手術成功率。　方法　對2000年5月-2009年5月實施頸椎前路手術的脊髓型頸椎病患者201例中20例發生并發癥患者的臨床資料及隨訪情況進行回顧性分析。　結果　 20例并發癥患者獲得隨訪時間3個月～10年，平均5.5年。近期并發癥11例，發生率5.47%；遠期并發癥9例，發生率4.48%。　結論　充分認識脊髓的損傷類型，仔細評估患者的全身情況，熟練的手術操作，良好的術后護理是手術成功的關鍵。
【Abstract】　Objective　 To investigate the reasons of and prevention for surgical complications of anterior cervical spine.　Methods　 The clinical data of 20 patients with surgical complications in 201 patients who underwent anterior cervical surgery from May 2000 to May 2009 were analyzed retrospectively.　Results　 The patients with complications were followed up for 3 months to 10 years with an average of 5.5 years. The rate of 11 patients with short-term complications was 15%, and the rate of nine patients with long-term complications was 4.48%.　Conclusion　 The key of a successful surgery for anterior cervical spine inludes full realization of type of cervical spinal cord injury, careful evaluation of the patient’s general condition, skilled operation, and good post-operative care.

引用本文： 鄭軍,楊效寧,曹雷. 頸椎前路手術20例并發癥治療分析. 華西醫學, 2011, 26(1): 51-53. doi: 復制

1.	Kaner T, Sasani M, Okteno?lu T, et al. Clinical outcomes following cervical laminoplasty for 19 patients with cervical spondylotic myelopathy[J]. Turk Neurosurg, 2009, 19(2): 121-126.
2.	Hannallah D, Lee J, Khan M, et al. Cerebrospinal fluid leaks following cervical spine surgery[J]. J Bone Joint Surg Am, 2008, 90(5): 1101-1105.
3.	Phommachanh V, Patil YJ, McCaffrey TV, et al. Otolaryngologic management of delayed pharyngoesophageal perforation following anterior cervical spine surgery[J]. Laryngoscope, 2010, 120(5): 930-936.
4.	Apfelbaum RI, Kriskovich MD, Haller JR. On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery[J]. Spine (Phila Pa 1976), 2000, 25(22): 2906-2912.
5.	Jung A, Schramm J. How to reduce recurrent laryngeal nerve palsy in anterior cervical spine surgery: a prospective observational study[J]. Neurosurgery, 2010, 67(1): 10-15, discussion 15.
6.	Patel NP, Wolcott WP, Johnson JP, et al. Esophageal injury associated with anterior cervical spine surgery[J]. Surg Neurol, 2008, 69(1): 20-24, discission 24.
7.	Kriskovich MD, Apfelbaum RI, Haller JR. Vocal fold paralysis after anterior cervical spine surgery: incidence, mechanism, and prevention of injury[J]. Laryngoscope, 2000, 110(9): 1467-1473.
8.	Hasegawa K, Homma T, Chiba Y. Upper extremity palsy following cervical decompression surgery results from a transient spinal cord lesion[J]. Spine (Phila Pa 1976), 2007, 32(6): E197-202.
9.	Wright IP, Eisenstein SM. Anterior cervical discectomy and fusion without instrumentation[J]. Spine (Phila Pa 1976), 2007, 32(7): 772-774, discussion 775.
10.	Hannallah D, Lee J, Khan M, et al. Cerebrospinal fluid leaks following cervical spine surgery[J]. J Bone Joint Surg Am, 2008, 90(5): 1101-1105.
11.	Nakra D, Bala I, Pratap M. Unilateral postoperative visual loss due to central retinal artery occlusion following cervical spine surgery in prone position[J]. Paediatr Anaesth, 2007, 17(8): 805-808.
12.	Fujibayashi S, Shikata J, Kamiya N, et al. Missing anterior cervical plate and screws: a case report[J]. Spine (Phila Pa 1976), 2000, 25(17): 2258-2261.
13.	陳雄生, 賈連順, 曹師鋒, 等. 頸椎前路手術的并發癥[J]. 中華骨科雜志, 2003, 23(11): 644-649.
14.	Farey ID, McAfee PC, Davis RF, et al. Pseudarthrosis of the cervical spine after anterior arthrodesis. Treatment by posterior nerve-root decompression, stabilization, and arthrodesis[J]. J Bone Joint Surg Am, 1990, 72(8): 1171-1177.
15.	Bohlman HH, Kirkpatrick JS, Delamarter RB, et al. Anterior decompression for late pain and paralysis after fractures of the thoracolumbar spine[J]. Clin Orthop Relat Res, 1994, (300): 24-29.
16.	Schneeberger AG, Boos N, Schwarzenbach O, et al. Anterior cervical interbody fusion with plate fixation for chronic spondylotic radiculopathy: a 2- to 8-year follow-up[J]. J Spinal Disord 1999, 12(3): 215-220, discussion 221.

1. 　Kaner T, Sasani M, Okteno?lu T, et al. Clinical outcomes following cervical laminoplasty for 19 patients with cervical spondylotic myelopathy[J]. Turk Neurosurg, 2009, 19(2): 121-126.
2. 　Hannallah D, Lee J, Khan M, et al. Cerebrospinal fluid leaks following cervical spine surgery[J]. J Bone Joint Surg Am, 2008, 90(5): 1101-1105.
3. 　Phommachanh V, Patil YJ, McCaffrey TV, et al. Otolaryngologic management of delayed pharyngoesophageal perforation following anterior cervical spine surgery[J]. Laryngoscope, 2010, 120(5): 930-936.
4. 　Apfelbaum RI, Kriskovich MD, Haller JR. On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery[J]. Spine (Phila Pa 1976), 2000, 25(22): 2906-2912.
5. 　Jung A, Schramm J. How to reduce recurrent laryngeal nerve palsy in anterior cervical spine surgery: a prospective observational study[J]. Neurosurgery, 2010, 67(1): 10-15, discussion 15.
6. 　Patel NP, Wolcott WP, Johnson JP, et al. Esophageal injury associated with anterior cervical spine surgery[J]. Surg Neurol, 2008, 69(1): 20-24, discission 24.
7. 　Kriskovich MD, Apfelbaum RI, Haller JR. Vocal fold paralysis after anterior cervical spine surgery: incidence, mechanism, and prevention of injury[J]. Laryngoscope, 2000, 110(9): 1467-1473.
8. 　Hasegawa K, Homma T, Chiba Y. Upper extremity palsy following cervical decompression surgery results from a transient spinal cord lesion[J]. Spine (Phila Pa 1976), 2007, 32(6): E197-202.
9. 　Wright IP, Eisenstein SM. Anterior cervical discectomy and fusion without instrumentation[J]. Spine (Phila Pa 1976), 2007, 32(7): 772-774, discussion 775.
10. 　Hannallah D, Lee J, Khan M, et al. Cerebrospinal fluid leaks following cervical spine surgery[J]. J Bone Joint Surg Am, 2008, 90(5): 1101-1105.
11. 　Nakra D, Bala I, Pratap M. Unilateral postoperative visual loss due to central retinal artery occlusion following cervical spine surgery in prone position[J]. Paediatr Anaesth, 2007, 17(8): 805-808.
12. 　Fujibayashi S, Shikata J, Kamiya N, et al. Missing anterior cervical plate and screws: a case report[J]. Spine (Phila Pa 1976), 2000, 25(17): 2258-2261.
13. 　陳雄生, 賈連順, 曹師鋒, 等. 頸椎前路手術的并發癥[J]. 中華骨科雜志, 2003, 23(11): 644-649.
14. 　Farey ID, McAfee PC, Davis RF, et al. Pseudarthrosis of the cervical spine after anterior arthrodesis. Treatment by posterior nerve-root decompression, stabilization, and arthrodesis[J]. J Bone Joint Surg Am, 1990, 72(8): 1171-1177.
15. 　Bohlman HH, Kirkpatrick JS, Delamarter RB, et al. Anterior decompression for late pain and paralysis after fractures of the thoracolumbar spine[J]. Clin Orthop Relat Res, 1994, (300): 24-29.
16. 　Schneeberger AG, Boos N, Schwarzenbach O, et al. Anterior cervical interbody fusion with plate fixation for chronic spondylotic radiculopathy: a 2- to 8-year follow-up[J]. J Spinal Disord 1999, 12(3): 215-220, discussion 221.

《華西醫學》

頸椎前路手術20例并發癥治療分析

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《華西醫學》

頸椎前路手術20例并發癥治療分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料