下颈椎再手术的原因分析(附23例报告)
脊髓压迫,,再手术；下颈椎；减压；融合；内固定,1材料和方法,2结果,3讨论,参考文献：
摘要：[目的]回顾分析23例下颈椎患者再手术的原因。[方法]患者23例，其中前路手术12例，后路9例，前后联合入路2例，均行植骨融合内固定。术前评估了病史、影像学、神经功能(Nurick分级)等。[结果]平均随访26 a，Nurick分级，除2例仍为Ⅴ级外，余21例均提高了Ⅰ～Ⅱ级。14例颈前路融合患者均骨性愈合。5例患者术后残留有取骨区不适。[结论]本组再手术的原因分别为减压不彻底或未减压、忽视影像学检查、假关节、内植物并发症、后凸畸形及手术相邻节段的退变性疾病。再手术目的仍为充分减压、植骨融合内固定。关键词：再手术；下颈椎；减压；融合；内固定
Reasons for reoperation in subaxial cervical vertebrae:a 23 cases report
TAN Junming,YE Xiaojian,SHI Jiangang,et al
Department of Orthopaedics,The 98th Hospital of PIA,Huzhou,Zhejiang 313000
Abstract：[Objective]To retrospectively study the reasons for reoperation in subaxial cervical vertebrae in 23 cases[Method]A total of 23 cases of reoperation in subaxial cervical vertebrae were reportedin which 12 cases were operated by anterior approach,9 cases by posterior approach and 2 cases by anteriorposterior approach,internal instrumentation and fusion were used in all of the casesMedical records,imaging studies,and neurological status were graded preoperatively according to Nuricks system[Result]The postoperative followup was averaged 26 years ( ranged,2 ~ 35 years)Except for two cases which remained V grade according to Nuricks grading,21 had one to two grades of improvement,and solid fusions were achieved in fourteen patients who had anterior cervical arthrodesisFive patients complained of the chronic donor site pain and hypoesthesia after reoperation[Conclusion]Reasons of reoperation in subaxial cervical vertebrae in this study include residual nerveroot or spinal cord compression,neglecting of imaging examination,pseudoarticulation formation,implant complications,collapse of the graft and the disc space with kyphosis,and adjacent segment diseasesSuccessful reoperation of subaxial cervical vertebrae depends on adequate decompression with restoration of spinal column stability,and solid fusion ......
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