青少年特发性脊柱侧凸患者后路髂棘处取骨植骨并发症

目的探讨青少年特发性脊柱侧凸患者后路髂棘处取骨并发症的发生率。方法对1999～2002年201例后路取髂骨行脊柱植骨融合术的青少年特发性脊柱侧凸患者进行回顾性研究。其中85例患者获得随访，最短随访时间为2年。结果住院期间有2例发生局部感染，通过灌洗引流和清创得到恢复。1例发生髂骨内板穿透，未引起临床症状。3例发生持续性疼痛，1例发生麻木。总的并发症发生率为3。5％。在随访的85例患者中，21例(24。7％)有髂棘取骨处疼痛，其中13例(15．3％)影响日常生活。7例(8．2％)需要服用非甾体类抗炎药以缓解取骨部位疼痛。6例(7.1％)瘢痕周围的皮肤感觉过敏，15例(17．6％)有瘢痕周围皮肤麻木。结论尽管青少年脊柱侧凸患者住院期间髂棘取骨处并发症较低，但经过长期随访，疼痛及麻木的并发症明显增高，应值得更多关注。

Complications of posterior iliac crest bone graft in spinal surgery in adolescent idiopathic scoliosis

Objective To explore the morbidity of the complications of posterior iliac crest bone graft in adolescent idiopathic scoliosis. Methods Retrospective study was performed on 201 cases of adolescent idiopathic scoliosis who underwent spinal fusion with posterior iliac crest bone graft from 1999 to 2002. A follow up was conducted to 85 cases with a minimum of 2 years (mean 37 months). Results During the hospitalization, 2 cases sufferred infection, and got recovered by irrigation and debridement. There were 1 case with iliac penetration without clinical symptoms, 3 cases with persistent pain and 1 case with numbness. The morbidity of complications of iliac crest bone graft was 3.5%. In the 85 cases, there were 21 cases ( 24.7% ) with pain at the iliac crest site, 13 cases (15.3%) with problems affecting daily activities, 7 cases (8.2%) needing take nonsteroidal anti inflammatory drugs (NSAIDS) to remit the pain at the iliac crest site, 6 cases (7.1%) with skin hyperesthesia around the scar, and 15 cases (17.6%) with skin numbness around the scar. Conclusion Although the morbidity of complications of iliac crest bone graft in adolescent idiopathic scoliosis is low during the hospitalization, but after a long follow up, the morbidity of complications of pain and numbness will be obviously heightened. So much more attention should be paid to this phenomenon.