颈椎前路手术并发症及原因分析

目的：总结分析颈椎前路手术并发症原因并提出相应防治措施。方法：对2000年6月～2006年12月行颈椎前路手术的228例病人的临床资料进行总结和分析。结果：出现手术相关并发症25例，发生率为10．9％，其中颈部切口血肿、感染3例，喉返神经损伤3例，喉上神经损伤2例，迟发性食管瘘1例，脊髓神经根损伤损害5例，脑脊液漏3例，植骨块部分滑脱3例，钢板移位2例，螺钉误入椎间隙2例，呼吸衰竭肺部感染致死亡1例。结论：熟悉颈部解剖结构、提高手术操作技巧和详尽的术前准备可降低颈椎前路手术并发症。

The causes of complications related to anterior cervical spinal surgery

Objective: To analyze the causes of complications related to anterior cervical spinal surgery and to explore the methods of prevention and management.Methods: Two hundred and twenty eighty patients were performed operation by cervical anterior approach from June 2000 to December 2006.Clinical materials of patients were collected and analyzed retrospectively.Results: The complications related to surgery were 25 cases in 228 patients,accounted for 10.9%,including haematoma and infections in 3 cases,recurrent laryngeal nerve injuries in 3 cases,superior laryngeal nerve injuries in 2 cases,tardive esophageal fistula in 1 case,spinal cord and/or nerve root injuries in 5 cases,cerebrospinal fluid leakages in 3 cases,graft extrusions partially in 3 cases,plate displacements in 2 cases,screw enter to intervertebral spaces in 2 cases and death in 1 case who suffered from pulmonary infection and respiratory failure.Conclusion: A thorough understanding of cervical anatomic structure,meticulous surgical technique and adequate preoperative preparation are necessary to prevent or avoid the complications related to anterior cervical spinal surgery.