摘要
目的评价与分析Coflex椎板间动态稳定系统术后并发症的发生率及原因,分析并发症发生的危险因素。方法回顾性分析2007~2015年于我院接受单节段减压后Coflex椎板间动态稳定装置植入患者,收集相关人口统计资料、临床相关资料及影像学资料。记录并发症发生情况,总结各类并发症的发生率、发生原因及再手术情况。运用单因素与多因素Logisitic回归分析对所有纳入患者的各类临床与影像学参数的进行性统计学分析,确定并发症发生的独立危险因素。结果研究共纳入164例,其中男72例,女92例,平均年龄(57.70±12.29)岁,平均随访时间(31.11±20.44)个月。患者入院诊断腰椎管狭窄症90例(54.9%),腰椎间盘突出症68例(41.5%),腰椎滑脱6例(3.7%)。手术节段包括L4~5节段148例(90.2%),L3~4节段5例(3%),L2~3节段1例(0.6%),L5~S1节段10例(6.1%)。术中平均手术时间(124.02±24.12)min,平均出血量(178.48±111.85)ml。26例(15.9%,26/164)发生28例次并发症,并发症原因包括2例次(7.1%)手术一般并发症,6例次(14.3%)内固定直接并发症,19例次(67.9%)内固定间接并发症,1例次(3.6%)其它并发症。最终10例(6.1%,10/164)接受再手术。手术时间,体质量指数(body mass index,BMI),Coflex节段终板Modic改变,Coflex节段间盘压迫椎管占比均为并发症发生的独立危险因素。结论 Coflex椎板间动态稳定系统的术后并发症发生率为15.9%,再手术率为6.1%,安全性良好。主要并发症原因为原手术节段与邻近节段退变。并发症发生的独立危险因素包括手术时间、BMI、手术节段椎间盘压迫椎管占比、手术节段终板Modic改变。
Objective To summarize the incidence and causes of postoperative complications in patients who underwent Coflex interlaminar dynamic stabilization surgery, and to analyze the risk factors of complications. MethodsA retrospective study was conducted. Patients who underwent single-segment decompression and Coflex interlaminar dynamic stabilization implantation from 2007 to 2015 were included. Demographic, clinical and imaging data were collected. The incidence of complications was recorded. Causes and reoperations due to all kinds of complications were summarized. Univariate analysis and multivariate Logistic analysis of all possible factors were used to determine the independent risk factors for the occurrence of complications. Results A total of 164 patients were enrolled in this study. There were 72 males and 92 females with an average age of（ 57.70 ± 12.29） years. The mean follow-up time was（ 31.11 ± 20.44） months. Lumbar spinal stenosis was diagnosed in 90 cases（ 54.9%）, lumbar disc herniation in 68 cases（ 41.5%）, lumbar spondylolisthesis in 6 cases（ 3.7%）. Surgical segments： 148 cases（ 90.2%） were of L4-5 segments, 5 cases（ 3%） of L3-4 segments, 1 case of L2-3 segments（ 0.6%）, 10 cases of L5-S1 segments（ 6.1%）. The average operation time was（ 124.02 ± 24.12） min. The average bleeding volume was（ 178.48 ± 111.85） ml. Complications occurred in 26 patients（ 15.9%, 26/164）： 2 cases（ 7.1%） were of general surgical complications, 6 cases（ 14.3%） of direct device-related complications, 19 cases（ 67.9%） of indirect device-related complications, 1 case（ 3.6%） of other complications. Ten patients（ 6.1%, 10/164） underwent revision surgeries. Risk factor analysis showed that the operation time, body mass index（ BMI）, Modic change of Coflex segment＇s end plate, disc compression of the spinal canal accounted for independent risk factors of the complication occurrence. ConclusionsThe complication rate of Coflex interlaminar dynamic stabilizati
出处
《中国骨与关节杂志》
CAS
2018年第2期103-109,共7页
Chinese Journal of Bone and Joint
关键词
脊柱疾病
腰椎
手术后并发症
再手术
危险因素
非融合技术
Spinal diseases
Lumbar vertebrae
Postoperative complications
Reoperation
Risk factors
Non-fusion technique
