328例颈椎前路手术并发症的分析

Analysis of the complication of anterior approach for surgery of the cervical spine

目的 总结颈椎前路手术的并发症 ,分析原因并提出预防措施。方法 1 989年 5月～2 0 0 0年 3月颈椎前路手术 (减压 +椎间融合术 ) 32 8例 ,其中颈椎病 1 75例 ,颈椎间盘突出症 97例 ,颈椎骨折、脱位 56例。结果 随访 6个月～ 1 1年 (平均 32个月 ) ,发生并发症 38例 ,其中喉上神经损伤 5例 ,喉返神经损伤 4例 ,植骨块部分滑出 5例 ,植骨不融合 1 9例 ,BAK沉降 3例 ,颈动脉窦综合征 1例 ,睡眠性窒息 1例。结论 熟悉颈椎前路手术解剖 ,操作轻柔 ,植骨、内固定合理 。

Objective To summarize the complications of anterior approach for cervical spinal surgery and analyse the causes and the method of prevention Methods From May 1989 and March 2000,328 cases of cervical spinal diseases were treated with anterior decompression and interbody fusion.There were 175 cases of cervical spondylosis,97 cervical disc herniation,56 cervical spinal fracture or dislocation.Results All of the cases have been followed up for 6 months to 11 years (average 32 months),there were 38 cases with complications:superior laryngeal nerve injury 5 cases,recurrent laryngeal nerve injury 4 cases,bone graft dislodgement 5 cases,bone graft non fusion 19 cases,BAK subsidence 3 cases,carotid sinus syncope 1 case and obstructive schlafen apnoe syndrome 1 case.Conclusion Familiarization of the cervical anatomy,careful manipulation,proper bone graft and internal fixation may reduce or avoid the complications.