■2013年在日本引入了外侧腰椎椎间融合术(LLIF)。尽管这个程序有效,已经报道了一些相当大的并发症。这项研究报告了日本脊柱外科和相关研究协会(JSSR)在日本进行的与LLIF相关的并发症的全国性调查结果。
■JSSR成员在2015年至2020年期间根据LLIF进行了一项基于网络的调查。符合以下标准的并发症包括:(1)主要血管,(2)泌尿道,(3)肾,(4)内脏器官,(5)肺,(6)椎体,(7)神经,(8)前纵韧带损伤;(9)腰大肌无力;(10)运动和(11)感觉缺陷;(12)手术部位感染;(13)其他并发症。分析所有LLIF患者的并发症,比较了经肌(TP)和前肌(PP)方法在发生率和并发症类型上的差异。
■在13,245名LLIF患者中(TP6,198名患者[47%]和PP7,047名患者[53%]),366例患者发生并发症389例(2.76%)。最常见的并发症是感觉障碍(0.5%),其次是运动障碍(0.43%)和腰大肌肌无力(0.22%)。在患者队列中,在调查期间,有100例患者(0.74%)需要进行翻修手术。几乎一半的并发症发生在脊柱畸形患者中(183例患者[47.0%])。4例患者(0.03%)死于并发症。在统计学上,TP方法比PP方法发生更频繁的并发症(TP与PP,220例患者[3.55%]vs.169例患者[2.40%];p<0.001)。
■总并发症发生率为2.76%,0.74%的患者因并发症需要进行翻修手术。4例患者死于并发症。LLIF可能是有益的退行性腰椎疾病与可接受的并发症;然而,脊柱畸形的适应症应根据外科医生的经验和畸形的程度仔细确定。
UNASSIGNED: Lateral lumbar interbody fusion (
LLIF) has been introduced in Japan in 2013. Despite the effectiveness of this procedure, several considerable complications have been reported. This study reported the results of a nationwide survey performed by the Japanese Society for Spine Surgery and Related Research (JSSR) on the complications associated with
LLIF performed in Japan.
UNASSIGNED: JSSR members conducted a web-based survey following
LLIF between 2015 and 2020. Any complications meeting the following criteria were included: (1) major vessel, (2) urinary tract, (3) renal, (4) visceral organ, (5) lung, (6) vertebral, (7) nerve, and (8) anterior longitudinal ligament injury; (9) weakness of psoas; (10) motor and (11) sensory deficit; (12) surgical site infection; and (13) other complications. The complications were analyzed in all LLIF patients, and the differences in incidence and type of complications between the transpsoas (TP) and prepsoas (PP) approaches were compared.
UNASSIGNED: Among the 13,245
LLIF patients (TP 6,198 patients [47%] and PP 7,047 patients [53%]), 389 complications occurred in 366 (2.76%) patients. The most common complication was sensory deficit (0.5%), followed by motor deficit (0.43%) and weakness of psoas muscle (0.22%). Among the patient cohort, 100 patients (0.74%) required revision surgery during the survey period. Almost half of the complications developed in patients with spinal deformity (183 patients [47.0%]). Four patients (0.03%) died from complications. Statistically more frequent complications occurred in the TP approach than in the PP approach (TP vs. PP, 220 patients [3.55%] vs. 169 patients [2.40%]; p<0.001).
UNASSIGNED: The overall complication rate was 2.76%, and 0.74% of the patients required revision surgery because of complications. Four patients died from complications.
LLIF may be beneficial for degenerative lumbar conditions with acceptable complications; however, the indication for spinal deformity should be carefully determined by the experience of the surgeon and the extent of the deformity.