重复切除术用于管理相同水平的复发性椎间板:一项对50名患者的研究
Gerald Musa1,2, Serik K Makirov3, Sergey V Susin4
1Neurological Surgery, Peoples' Friendship University of Russia (RUDN University) Named After Patrice Lumumba, Moscow, RUS.
Cureus
|July 17, 2023
概括
重复切割是相同水平的复发性磁盘的可行外科选择,提供一种不那么侵入性的方法. 然而,患者应该意识到潜在的风险,如皮质切除和复发,特别是退行性变化.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 脊柱外科手术 脊柱外科手术
背景情况:
- 同一级的复发性椎间盘,在脊髓外科手术中是一个重大挑战.
- 虽然磁带切除是初级的标准,但复发病例缺乏明确的管理协议.
- 由于侵入性和成本较低,重复切割术往往比融合更受青.
研究的目的:
- 评估重复切割术对相同水平的复发性腰椎间盘的疗效和安全性.
- 分析手术结果,包括手术时间,血液损失,住院和并发症.
- 通过使用奥斯韦斯特里残疾指数 (ODI) 评估对患者报告的功能结果的影响.
主要方法:
- 对50名患者进行了回顾性分析,这些患者经历了重复切除椎间盘,因为相同水平的复发性腰椎间盘,而没有融合.
- 收集的数据包括手术前和手术后的奥斯韦斯特里残疾指数 (ODI) 分数.
- 记录了手术的参数,如手术的持续时间,血液损失,住院时间和并发症.
主要成果:
- 该研究包括50名患者 (54%为女性),平均随访时间为2.81年.
- 平均住院时间为4.06天,手术时间平均为104.60分钟,血液损失为85.40毫升.
- 观察到ODI的显著改善 (p=0.04),但在16%的患者中发生了硬膜切除术,复发率为26%和36%的进展到融合.
结论:
- 重复切除椎间盘是相同水平的复发性椎间盘的可行管理选择,其特点是血液损失最小,手术时间短.
- 显著的风险包括乳腺切除术和显著的复发率,特别是晚期退行性变化 (Modic-2).
- 讨论这些好处和风险的患者知情同意对于管理期望和结果至关重要.
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