斜外侧腰椎椎间融合术后交感神经链功能障碍的危险因素研究  

Clinical Study of Risk Factor of Postoperative Sympathetic Chain Dysfunction Following OLIF

作　　者：侯伟[1] 万趸[1] 邓轩赓[1] 石华刚[1] 赵龙 Hou Wei;Wan Dun;Deng Xuangeng(Department of Spine,Sichuan Orthopedic Hospital,Chengdu,Sichuan 610041,China)

机构地区：[1]四川省骨科医院脊柱科,四川成都610041

出　　处：《四川医学》2023年第8期830-834,共5页Sichuan Medical Journal

摘　　要：目的探究斜外侧腰椎椎间融合术(OLIF)后交感神经链功能障碍的危险因素。方法回顾性分析2018年2月至2022年11月于我院行L4/5 OLIF手术病例的临床及影像学资料。根据术后有无交感神经链功能障碍的临床表现将纳入病例分为术后交感神经链功能障碍组和无术后交感神经链功能障碍组,对两组患者的临床及影像学资料进行二元Logistic回归分析,以确定术后交感神经链功能障碍的独立危险因素。结果共180例患者纳入本研究,其中10例患者出现术后交感神经链功能障碍,发生率为5.6%。两组患者在性别、年龄及既往史(既往腰椎手术、腹部手术和糖尿病)及腰椎前凸角度等方面,差异无统计学意义(P>0.05)。两组患者在BMI、手术时间、Cage放置位置及腰椎右侧弯占比等方面差异有统计学意义(P<0.05)。多因素二元Logistic回归分析显示腰椎右侧弯(OR=7.612,P=0.015)是OLIF术后交感神经链功能障碍的危险因素。结论腰椎右侧弯畸形是OLIF术后发生交感神经链功能障碍的危险因素之一,术前腰椎排列检查对于预防OLIF术后交感神经链功能障碍的发生具有重要意义。Objective To explore risk factors of postoperative sympathetic nerve chain dysfunction following OLIF.Methods From February 2018 and November 2022,consecutive patients who underwent OLIF at L4/5 level at a single institution were retrospectively reviewed and divided into two groups:patients with postoperative sympathetic nerve chain dysfunction and patients without postoperative sympathetic nerve chain dysfunction.Binary logistic regression analyses were performed on patients’demographic,comorbidities,radiological datum and perioperative factors to identify independent risk factors for postoperative sympathetic nerve chain dysfunction.Results Total 180 patients were included in this study.10 patients experienced sympathetic nerve chain injury after surgery,with an incidence of 5.6%.There was no significant difference in gender,age and medical comorbidities or lumbar lordosis between patients with postoperative sympathetic nerve chain dysfunction and patients without postoperative sympathetic nerve chain dysfunction(P>0.05).There was significant difference between two groups in BMI,surgical duration,cage position and presence of dextroscoliosis.Multivariate logistic regression analysis identified identification of lumbar dextroscoliosis(OR=7.612,P=0.015)as an independent risk factor for the postoperative sympathetic nerve chain dysfunction following OLIF.Conclusion The lumbar dextroscoliosis would be one of the risk factors for sympathetic chain injury following OLIF.Lumbar alignment examination preoperatively is important for preventing sympathetic chain injury following OLIF.

关 键 词：斜外侧腰椎椎间融合术 交感神经链功能障碍 腰椎侧弯畸形 体质指数 危险因素 

分 类 号：R687.3[医药卫生—骨科学]