tailieunhanh - Các biến chứng thần kinh sau khi phẫu thuật cột sống thắt lưng

Với sự phức tạp ngày càng tăng và số lượng các hoạt động cột sống thắt lưng đang được thực hiện, số lượng tiềm năng của bệnh nhân sẽ duy trì các biến chứng chu phẫu, bao gồm cả những người liên quan đến cấu trúc thần kinh, cũng đã tăng lên. Biến chứng thần kinh sau khi phẫu thuật cột sống thắt lưng | Neurologic Complications After Lumbar Spine Surgery M. Darryl Antonacci MD and Frank J. Eismont MD Abstract With the increasing complexity and number of lumbar spine operations being performed the potential number of patients who will sustain perioperative complications including those that involve neural structures has also increased. Neurologic complications after lumbar spine surgery can be categorized by the perioperative time period during which they occur and by their mechanism of injury. Although the overall incidence of neurologic complications after lumbar surgery is low the severity of these injuries mandates careful preoperative planning awareness of risk and meticulous attention to perioperative details. J Am Acad Orthop Surg 2001 9 137-145 Neurologic complications after lumbar spine surgery may be broadly classified by the mechanism of injury and by the time period during which they occur. The causes of injury are generally either indirect or direct with the latter including laceration compression traction and avulsion injuries to the neural elements. Such direct causes are most commonly the result of a technical mishap by the surgeon. Indirect injuries are due to the disruption of the blood supply to the spinal cord and nerve roots or to the gradual compression of the neural elements as by correction of deformity or by a postoperative hematoma. This type of injury is usually the result of ischemia or the disruption of axoplasmic flow which provides neural nutrition. Its causes are more difficult to define and are often inexplicable. Neurologic injuries categorized by the time period during which the insult occurs may be intraoperative early postoperative 1 to 14 days or delayed postoperative after 14 days events. Intraoperative events are generally related to complications arising from anesthesia patient positioning surgical technique or procedure-specific risks. Early in the postoperative period and up to 2 weeks after surgery neurologic injuries are