Objective To analyze the causes of
surgical errors and
complications of lumbar degenerative
diseases treated by transforaminal endoscopic
spine system(TESSYS),and explore the
treatment and prevention
measures.
Methods From July 2012 to January 2016,the data of 660
patients with lumbar degenerative
diseases who treated with TESSYS were analyzed retrospectively,of which 528
patients were lumbar
disc herniation with 192 cases of single segment(L4/L5) and 336 cases of multi-segment.Lumbar
spinal stenosis in 132 cases,were lateral recess and nerve
root canal stenosis.
Surgical errors and
complications were recorded,and analyzed the reasons and the
treatment and preventive
measures.Results Intraoperative errors1 case of sterile
film with the dilating
catheter went into the surgical area;1 case with wire fracture,and stump retention in vivo;for discography
staining,the proportion of mixed
solution was not enough,the
leakage of excess concentration of
methylene blue caused caudal nerve
injury in 3 cases;expansion of the intervertebral foramen,the drilling part of the articular process was too deep and too close to the medial wall of the articular process,which caused cutting
injury of
nerve fiber sheath in 2 cases;after the
rupture of the
dura mater,the rinse
solution was perfused,caused bloating,
elevated intracranial pressure,elevated
blood pressure and other symptoms of
spinal cord hypertension in 3 cases;low
dose of
local anesthetic into the
blood caused toxic reaction in 2 cases;total
spinal cord anesthesia with paravertebral nerve root block in 1 case.
Postoperative complications3 cases of nerve root
edema;2 cases of free
nucleus pulposus tissue;2 cases of local
hematoma led to
nerve root compression;1 case of intervertebral space
infection and 3 cases of local
skin neuritis in the
puncture area.Conclusion In the process of intervertebral foramen
surgery,there are some
deficiency on instruments or operating skill.Therefore,rigorous
treatment of each link in the
perioperative period,is the guarantee of successful
surgery.