脊柱前路手术髂前嵴取骨并发症相关分析

目的:探讨脊柱前路手术髂前嵴取骨的并发症发生情况。方法:回顾性分析2001年1月-2005年9月取髂骨行脊柱植骨融合术的154例患者,取骨部位均为髂前嵴,统计供骨区并发症,分析其相关因素。结果:术后随访时间均超过1年。28例(18.2%)患者发生不同程度的并发症,其中14例(9.1%)出现轻度并发症,12例(7.8%)出现中度并发症,2例(1.3%)出现重度并发症。127例(82.5%)患者接受了问卷调查,其中17例(13.4%)患者诉取骨处疼痛,疼痛自我感觉评分为1-6分(平均2分),其中3例(2.4%)患者需服用非甾体类抗炎药以减轻疼痛;7例(5.5%)患者诉取骨处有麻木感;无患者诉取骨处的疼痛及麻木感影响其日常活动;122例(96.1%)患者对供骨区切口外观满意。结论:髂前嵴取骨并发症中供骨区疼痛及麻木发生率较高,尤其是疼痛,应引起足够的重视。

Complications of anterior iliac crest bone harvested in spine surgery

Objective:To determine the morbidity associated with anterior iliac crest bone graft in spine surgery.Method:154 consecutive patients underwent spinal surgery with anterior iliac crest bone graft from 2001 to 2005 were reviewed retrospectively.Result:Donor site complications were encountered in 28 of the 154 cases.The minor complication rate was 9.1%(14).The rates of intermediate and major complications were 7.8%(12) and 1.3%(2) respectively.The responses of 127 patients to the interview showed 17(13.4%) patients reporting pain at the iliac crest site.The self-reported pain,on a scale of 1 to 10,ranged from 1 to 6 with a mean of 2.Nonsteroid anti-inflammatory drugs(NSAIDS) were taken by three(2.4%) patients for relieving pain at the bone graft site.7(5.5%) mentioned numbness surrounding the scar.No patients reported problems with daily activities.122(96.1%) patients reported their satisfaction with regard to the cosmetic appearance of the wound and the result of the graft procedure overall.Conclusion:Incision pain and numbness are the chief complications in patients with anterior iliac crest bone graft.This retrospective study confirms that donor site pain will bring a significant postoperative management problem.