颈前路椎间盘切除植骨融合术后一过性瘫痪分析  

Transient paralysis after anterior cervical discectomy and fusion

作　　者：吴兵[1] 朱守荣[1] 张永刚[1] 王岩[1] 肖嵩华[1] 

机构地区：[1]解放军总医院骨科,北京100853

出　　处：《解放军医学院学报》2015年第4期348-350,共3页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨颈前路椎间盘切除植骨融合术（anterior cervical discectomy and fusion,ACDF）后一过性瘫痪的原因、治疗方法。方法回顾性分析我科2009年1月-2013年12月收治的行ACDF患者1 550例。男性992例,女性558例,平均年龄43.2（23-84）岁。所有患者均随访10个月以上。将病例资料按手术节段数、性别、年龄、颈椎病类型分组并进行统计学分析。结果 14例出现一过性瘫痪,男性10例,女性4例,平均年龄50.6（35-61）岁。总发生率为0.90%。男性发生率高于女性,中年患者、双节段及多节段手术患者发生率较高。结论 ACDF术后一过性瘫痪是少见且严重的并发症。血肿压迫、脊髓水肿、缺血再灌注损伤是可能的致病原因。早诊断、早干预可望获得良好的预后。Objective To discuss the cause and treatment of transient paralysis after anterior cervical discectomy and fusion （ACDF）.MethodsClinical data about 1 550 cases who underwent ACDF in our hospital from January 2009 to December 2013 were retrospectively analyzed, including 992 males and 558 females with an average age of 43.2 years old （range from 23-84 years old）. All patients were followed up for 10 months. Statistical analysis was used to analyze the segmental resection operation, gender, age and cervical spondylosis types.ResultsFourteen cases suffered from transient paralysis, including 10 males and 4 females with an average age of 50.6 years old （range from 35-61 years old）. Incidence rate of transient paralysis was 0.903%. Male, middle-aged patients with multiple segmental cervical spine surgery had higher incidence of postoperative transient paralysis.Conclusion Postoperative transient paralysis is a rare and serious complication after ACDF. Hematoma oppression, spinal cord edema, ischemia-reperfusion injury may be possible causes. Good prognosis can be obtained by early diagnosis and intervention.

关 键 词：椎间盘切除术 颈椎病 手术后并发症 

分 类 号：R687.3[医药卫生—骨科学]