摘要
[目的]回顾分析23例下颈椎患者再手术的原因.[方法]患者23例,其中前路手术12例,后路9例,前后联合入路2例,均行植骨融合内固定.术前评估了病史、影像学、神经功能(Nurick分级)等.[结果]平均随访2.6 a,Nurick分级,除2例仍为V级外,余21例均提高了Ⅰ～Ⅱ级.14例颈前路融合患者均骨性愈合.5例患者术后残留有取骨区不适.[结论]本组再手术的原因分别为减压不彻底或未减压、忽视影像学检查、假关节、内植物并发症、后凸畸形及手术相邻节段的退变性疾病.再手术目的仍为充分减压、植骨融合内固定.
[ Objective] To retrospectively study the reasons for re-operation in subaxial cervical vertebrae in 23 cases. [Method] A total of 23 cases of re-operation in subaxial cervical vertebrae were reported, in which 12 cases were operated by anterior approach, 9 cases by posterior approach and 2 cases by anterior-posterior approach, internal instrumentation and fusion were used in all of the cases. Medical records, imaging studies, and neurological status were graded preoperatively according to Nuriek＇s system. [ Result] The postoperative follow-up was averaged 2. 6 years （ ranged, 2 ～ 3.5 years）. Except for two cases which remained V grade according to Nurick＇s grading, 21 had one to two grades of improvement, and solid fusions were achieved in fourteen patients who had anterior cervical arthrodesis. Five patients complained of the chronic donor site pain and hypoesthesia after re-operation. [ Conclusion] Reasons of re-operation in subaxial cervical vertebrae in this study include residual nerve-root or spinal cord compression, neglecting of imaging examination, pseudoarticulation formation, implant complications, collapse of the graft and the disc space with kyphosis, and adjacent segment diseases. Successful re-operation of subaxial cervical vertebrae depends on adequate decompression with restoration of spinal column stability, and solid fusion.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2005年第19期1465-1467,共3页
Orthopedic Journal of China
