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首页> 外文期刊>Asian spine journal. >Precautions for Combined Anterior and Posterior Long-Level Fusion for Adult Spinal Deformity: Perioperative Surgical Complications Related to the Anterior Procedure (Oblique Lumbar Interbody Fusion)
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Precautions for Combined Anterior and Posterior Long-Level Fusion for Adult Spinal Deformity: Perioperative Surgical Complications Related to the Anterior Procedure (Oblique Lumbar Interbody Fusion)

机译：成人脊柱畸形的前，后联合长期融合的预防措施：与前路手术相关的围手术期手术并发症（Oblique腰椎椎体间融合术）

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Study Design Retrospective, single-center study. Purpose We aimed to determine the perioperative complications of oblique lumbar interbody fusion (OLIF) as a first-stage procedure in combined anterior and posterior operation for adult spinal deformity (ASD) along with sagittal imbalance. Specifically, we aimed to identify the radiological and clinical types of perioperative surgical complications and the factors affecting these complications. Overview of Literature OLIF has recently gained popularity, and there are several reports of good outcomes and only a few of complications with OLIF; however, a few studies have focused on the perioperative surgical complications of ASD along with sagittal imbalance. Methods The perioperative period was a 1-week interval between the anterior and posterior procedures. All patients underwent simple radiography and magnetic resonance imaging preoperatively and postoperatively. Cage placement was evaluated for displacement (i.e., subsidence and migration) and vertebral body fracture. Clinical patient complaints were evaluated perioperatively. Student t-test was used for data analysis. Results A total of 46 patients were included, totaling 138 fusion segments. A week after OLIF, 14 patients/33 segments (30.4%/23.9%) demonstrated endplate injury-associated cage placement change. Subsidence was the most common cage placement-related complication. As compared with patients without endplate injury, those with endplate injuries showed significantly larger correction angles and a higher proportion of them had larger height cages than the disk height in the full-extension lateral view. Although 32.6% of the patients experienced perioperative clinical complications, they were relatively minor and transient. The most common complication was severe postoperative pain (Visual Analog Scale score of 7), and hip flexor weakness spontaneously resolved within 1 week. Conclusions OLIF yielded more than expected endplate injuries from treatment modalities for ASD along with sagittal imbalance. Therefore, surgeons should be cautious about endplate injury during OLIF procedures. It is difficult to accomplish lordosis correction via OLIF alone; therefore, surgeons should not attempt this impractical correction goal and insert an immoderate cage.
机译：研究设计回顾性，单中心研究。目的我们旨在确定斜腰椎间融合术（OLIF）作为成人脊柱畸形（ASD）合并矢状面不平衡的前，后联合手术的第一阶段手术的围手术期并发症。具体而言，我们旨在确定围手术期手术并发症的放射学和临床类型以及影响这些并发症的因素。文献综述OLIF最近获得了广泛的欢迎，并且有一些报道称OLIF疗效良好且并发症很少。然而，一些研究集中在ASD的围手术期并发症以及矢状面不平衡方面。方法围手术期为前后手术间隔1周。所有患者在术前和术后均接受了简单的放射线照相和磁共振成像。评估笼子放置的位移（即下沉和移动）和椎体骨折。围手术期评估临床患者的主诉。学生t检验用于数据分析。结果共纳入46例患者，共138个融合段。 OLIF一周后，有14例患者/ 33个节段（30.4％/ 23.9％）表现出了终板损伤相关的笼形放置改变。下陷是最常见的笼放置相关并发症。与没有终板损伤的患者相比，有终板损伤的患者显示出更大的矫正角，并且在全伸侧侧视图中，有更大比例的人具有比椎间盘高的高度笼。尽管32.6％的患者经历了围手术期的临床并发症，但相对较小且短暂。最常见的并发症是严重的术后疼痛（视觉模拟量表评分> 7），并且髋屈肌无力在1周内自发解决。结论OLIF因ASD的治疗方式以及矢状不平衡而导致的终板损伤超过预期。因此，外科医生在OLIF手术过程中应谨慎对待终板损伤。仅靠OLIF很难完成脊柱前凸矫正。因此，外科医生不应该尝试这个不切实际的矫正目标，也不宜插入不适当的笼子。

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