远距离结合失败:多层次后脊柱融合的一个可怕的并发症
Soufiane Ghailane1, Houssam Bouloussa2, Manuel Fernandes Marques3
1Department of Spinal Surgery Unit, Hôpital Privé Francheville, 24000 Périgueux, France.
Journal of clinical medicine
|September 14, 2024
概括
脊髓融合后的远端结节衰竭 (DJF) 与斜腰平衡不良,女性性别,骨质疏松症和使用L5或S1作为最低的仪器脊椎 (LIV) 有关. 恢复平衡和合并构造基可以防止DJF.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 整形外科 整形外科 整形外科
- 脊柱形是因为脊柱形.
背景情况:
- 远端结缺陷 (DJF) 是后脊髓融合后的一个未被认可的并发症,特别是在成年脊髓形 (ASD) 手术中.
- 了解DJF的风险因素对于改善手术结果和降低修订率至关重要.
研究的目的:
- 描述一个病例系列的患者经历DJF后后脊柱融合.
- 分析了松脊骨皮层对齐和DJF之间的关联.
- 在成年脊柱形手术中识别DJF的潜在风险因素.
主要方法:
- 在2009年至2019年期间,对19名接受DJF修复手术的患者进行了回顾性评估.
- 收集人口统计和手术数据,包括上仪器脊椎 (UIV) 和下仪器脊椎 (LIV).
- 在手术前和手术后,对沙吉塔和冠状线对齐的放射性评估.
主要成果:
- 84.2%的患者至少有一种已知的DJF风险因素.
- 最常见的最低的仪器脊椎 (LIV) 是L5 (n=10) 或S1 (n=2).
- 造成DJF的原因包括脊椎骨折,螺丝拉出,狭窄和不稳定;修改并发症涉及类似的机械故障.
结论:
- 足够的松平衡,女性性别,骨质疏松症和长结构中的L5/S1 LIV与DJF有关.
- 恢复脊柱平衡和在构造基部实现周边融合是关键的预防策略.
- 这些发现有助于优化手术规划,以尽量减少DJF和修复手术的需要.
关键词:
远端连接失效 远端连接失效硬件故障硬件故障 硬件故障机械并发症 机械并发症修复手术是修复手术的一种.脊椎变形症是指脊椎的变形.胸部腰部仪器仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪器仪表仪表仪表仪表仪表仪表仪表仪表仪器仪表仪表仪器仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪器仪表仪表仪表仪表仪表仪器仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表仪表相关概念视频
Herniated Intervertebral Disc l: Introduction
45
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
45
Degenerative Disc Disease I: Introduction
29
Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
29
Degenerative Disc Disease ll: Pathophysiology
36
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
36
Secondary Spinal Cord Injury llI: Pathophysiology
72
Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
72


