腰椎间椎间盘椎间椎间盘疾病解剖术后重新手术的危险因素
Cheng-Huan Peng1,2, Ing-Ho Chen1,2, Tzai-Chiu Yu1,2
1Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Tzu chi medical journal
|July 12, 2024
概括
椎间盘切除术后的复发性腰椎间盘 (HIVD) 是常见的. 风险因素包括举重,女性性别和外科医生的经验,突出显示了术后修改和量身定制治疗的必要性.
科学领域:
- 神经外科 神经外科
- 整形外科 整形外科 整形外科
- 脊柱外科手术 脊柱外科手术
背景情况:
- 椎间盘切除术是腰椎间椎间盘 (HIVD) 的首要手术治疗方法.
- 很大一部分患者 (5% - 24%) 需要重新手术,因为椎间盘的复发.
- 确定重新手术的风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 为了确定与HIVD的腰椎间盘切除术后重新手术相关的风险因素.
- 建议对重手术风险较高的患者进行适当的治疗.
- 分析重新手术率与各种患者和手术因素之间的相关性.
主要方法:
- 在2000年至2012年期间,对619名患者进行了单级腰部HIVD切除术的回顾性分析.
- 存活率分析,以评估存活时间和重新操作率.
- 调查因素包括椎间盘切除水平,BMI,手术后举重,性别,年龄和外科医生的经验.
主要成果:
- 八年生存率为92%的8年生存率.
- 手术后重型举重显著增加了重新手术的发生率,特别是在年轻 (<40岁) 和老年 (>60岁) 患者中.
- 女性和经验较少的外科医生与更高的再手术率有关.
结论:
- 手术后的生活方式改变,特别是避免举重,对于预防复发性HIVD至关重要.
- 保守的治疗选择可能更适合与HIVD的老年患者.
- 对于患有腰部多动性或严重退行症的患者,可以考虑进行一次性融合,这些患者接受了广泛的细叶切除术.
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