腰椎翻修手术的临床研究

Clinical research of lumbar reoperation

目的探讨行腰椎翻修手术患者的常见原因,手术方式选择,预防失败的措施。方法 2014年1月—2016年12月郑州大学第一附属医院行二次手术的患者共65例。对该组患者进行疗效评价,分析失败的原因及预防策略。结果手术时间1.5~6 h,平均(4.34±1.08)h。术中出血量50~2 650 ml,平均(886.17±1 507.16)ml。术前术后ODI评分和VAS评分有统计学意义(P<0.05)。翻修术后椎间隙高度,术后3~5 d与术后6个月无统计学意义(P>0.05)。术后6个月CT示融合率100%。结论腰椎二次手术过程困难且复杂,术后效果良好。多种原因为导致腰椎手术失败,应从术前、术中及术后等多方面预防手术失败的发生。

Objective To study the main reasons,operation methods,and preventive actions of the lumbar reoperation.Methods From January 2014 to Decemeber 2016 totally 65 patients underwent the lumbar reoperaion. The effects were evaluated. The reasons and preventive actions were discussed. Results The reoperaion time was 1. 5-6 hours,（average 4. 34 ± 1. 08 hours）. The bleeding volumn was 50-2 650 ml,average（886. 17 ± 357. 74） ml. There were significant statistical differences in ODI and VAS scores between the pre-operation and the post-operation（P〈0. 05）. There was no significant statistical difference in the disc height between 3-5 days and 6 months after the reoperation. The fusion rate after 6 month was 100% illustrated by CT scan. Conclusion The reoperaion process is complicated and the result is satisfied. Various reasons can lead to the fail of lumbar operation. Many actions from pre-operaion to the post-operation can prevent the lumbar operation from failure.