Clinical Retrospective Study On Early Complications Associated With Anterior Approach Thoracic And Lumbar Spine Surgery

Objectives:To explore the causes and related factors of the early complications associated withthe anterior approach of thoracic and lumber vertebrae, and summarise some measures toprevent and treat them, and reduce the ocurrence of complications.Patients and methods:416 cases of primary anterior approach of thoracic and lumber spine operation wereanalyzed retrospectively, including 218 fracture cases, 176 TB(tuberculosis)cases, and22 tumor cases. The statistical indexes include sex, age, operative time, operativeapproach, blood loss, blood transfusion, complications and so on. Standardized databasewas built and analyzed by SPSS (version 13.0)Data are presented as the mean±standard deviation(SD) or as the median and inter-guartile range, as appropriate.Results:61 out of 416 cases with complications and the total incidence rate was 14.7％. Inthe fracture group, 42 out of 218 cases had early complications and the incidence ratewas 19.3％. In the TB group, 16 out of 176 cases had early complications and theincidence rate was 19.3％. In the tumor group,3 out of 22 cases had early complicationsand the incidence rate was 13.6％. Among these cases who had complitions, 3 cases had spinal cord injurydeterioration, 4 cases had pneumothorax, 3 cases of bedsore, 2 cases of left 11th ribfracture, 12 of CSF (cerebrospinal fluid) leakage, 10 of stomach intestinecomplications, 13 of inadequate reduction or lateral scoliosis, 1 of cerebral infarction, 6 ofnonspecific infection, 9 of pleural effusion, 1 of deep venous thrombosis, 4 of delayedunion of the incision and 10 of injury to nerve root.The operative time, blood loss, complications rate of the fracture group are higherthan the TB group, and the difference has statistical significance(P＜0.05); thenon-specific infection rate, the delayed union of the incision rate, nerve root injury, rateand stomach intestine complication rate are higher than the TB group, but the differencehas no the statistical significance (P＞0.05).Conclusions:1. The anterior approach has been widely used in surgery of the thoracic and lumbarspine deseases. Under proper conditions, the anterior approach is relatively safe andsevere complications are rare.2. The anterior approach thoracic and lumbar spine surgery has a variety ofcomplications, and the basic condition of the patient and the category of the diseaseswere correlated with its early total complications.3. The occurrence rate of early complications can be reduced by the methods suchas dealing with perioperatively treatment carefully, effectively controlling the basiccondition, efficient evaluation before surgery, precise manipulation and the postoperativeprophylactic treatment and nursing.