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病例报告:在后腰部减压手术后,急性常见经神经损伤

Peng Wei Wang^1,2, Ming Hsuan Chung², Dueng Yuan Hueng²

¹Department of Surgery, Taoyuan Armed Forced General Hospital, Taoyuan, Taiwan.

Frontiers in surgery

|February 27, 2024

概括

这种案例研究突出了脊柱手术的罕见并发症:右常见腹神经陷神经病变. 早期检测和干预对于管理外科外围神经损伤和改善患者结果至关重要.

科学领域:

神经外科神经外科
整形外科手术整形外科手术
神经学神经学

背景情况:

脊柱手术很常见,可能会出现与年龄相关的并发症.
脊柱手术期间不常见的并发症可能来自非生理学患者定位.
了解这些并发症的病因是预防的关键.

研究的目的:

报告在选择性腰部减压手术后发生的右常见经神经陷神经病变.
讨论外科外围神经损伤 (PPNI) 的病因,诊断和管理.

主要方法:

一名76岁的女性患者接受了选择性减压,以治疗脊柱狭窄和根系病变.
外科手术包括椎间盘切除术和单侧拉美切除术.
通过神经传导研究和电肌学,对右常见腹腔神经陷神经病变进行了术后诊断.

主要成果:

患者在最初成功的手术后出现了右小腿疼痛和落脚.
手术后的MRI排除了复发的磁盘或血液瘤.
神经传导研究证实了正确的常见经神经陷神经病变,在保守的管理下部分改善.

结论:

周围外科外围神经损伤 (PPNI) 可能是由于压力或拉伸引起的神经缺血引起的,由低血压加剧.
诸如微血管疾病和解剖学变异等因素增加了对PPNI的易感性.
早期检测,干预和手术内神经监测对于减少PNI发病率和严重程度至关重要.

关键词:

常见的经神经神经病变在手术内进行神经监测 (IONM)在外科手术期间,外围神经受伤.在俯卧的位置上.脊柱外科手术不良事件不良事件

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