- 期刊
Management of Complications after Posterior Lumbar Interbody Fusion with Cages and Posterior Instrumentation: Report of Seven Cases
並列摘要
Purpose: Inserting interbody fusion cages to treat lumbar spinal degenerative disease may lead to complications. The purpose of this retrospective study was to assess methods for treating complications after posterior lumbar interbody fusion (PLIF) and posterior instrumentation. Methods: From November 2006 to July 2007, seven patients who developed complications after PLIF were treated in our hospital. Of these, four exhibited posterior cage migration and three developed infection around the fusion site. Revision surgery was performed and type of complication and time to revision surgery were recorded. Results: No complications occurred during or after revision surgery. In four patients with posterior cage migration, back pain and neurological deficits subsided after surgery. In two patients receiving revision surgery via the posterior approach, no further cage migration was noted during follow-up. In two patients receiving revision surgery via the anterior approach, solid fusion of the spine was observed during follow-up. In patients with infection around the cage implant, the infection was controlled after revision surgery, and solid fusion of the spine was achieved. Conclusion: Revision surgery for complications after cage implantation is technically challenging. In posterior cage migration, revision surgery should be performed via the posterior approach if less than 2 months and via the anterior approach if more than 2 months after initial surgery. Radical debridement, cage removal and reconstruction using an autogenous tricortical iliac strut bone graft via the anterior approach is recommended for patients who develop infection around the cage implant site.
延伸閱讀
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