退变性脊柱侧弯翻修原因分析

Reasons of revision following primary degenerative scoliosis surgery

目的回顾性分析本院退变性脊柱侧弯手术治疗的翻修率及翻修原因。方法回顾性分析2000年1月至2013年1月在本院行手术治疗的381例退变性脊柱侧弯患者的临床资料,平均随访4.5年（1-12年）。统计翻修原因、翻修率及处理方法。结果 381例退变性脊柱侧弯患者中,获得完整随访为321例。32例（9.97%,32/321）术后行翻修术,其中6例（1.87%,6/321）行1次以上翻修术。翻修原因有感染、内植物相关性疼痛或凸起、假关节形成、临近节段退变、神经根损伤和脑脊液漏。结论本院长达12年所行脊柱侧弯手术翻修率相对较低（9.97%）。最常见的翻修原因是感染、侧弯继续进展以及内植物相关性疼痛或凸起、神经根损伤、假关节形成等。

Objective To investigate the reasons and the revision rates following primary degenerative scoliosis（ DS）treated with surgery. Method 381 consecutive adult DS surgical procedures（ 2000 - 2013） were identified and the records were reviewed and followed-up for 1 - 12 years（ mean 4. 5 years） to determine the rates and reasons for revision operation. Result 321 patients were followed-up. 32 of 321 patients underwent further surgical procedures for a revision rate of 9. 97%. 6 patients（ 1. 87%） underwent more than one revision procedure. The reasons include infection,curve progression,implant prominence pain,pseudarthrosis,adjacent segment disease,neurologic deficit and cerebrospinal fluid leakage. Conclusion Revison surgery following DS surgery performed at our institution demonstrated a relatively low rate of 9. 97%. The common reasons for revision are infection,curve progression,implant prominence or pain,neurologic deficit and pseudarthrosis.