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題名 | Spongostan-induced Cauda Equina Syndrome after Lumbar Discectomy: Report of a Case=斯龐嘉止血棉導致的腰椎椎間盤切除手術後馬尾症候群:病例報告 |
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作者 | 陳偉健; 廖文瑞; 劉榮東; | 書刊名 | 臺灣外科醫學會雜誌 |
卷期 | 41:3 2008.05-06[民97.05-06] |
頁次 | 頁99-103 |
分類號 | 416.61 |
關鍵詞 | 椎間盤切除; 馬尾症候群; Spongostan; Gelatin sponge; Postoperative cauda equina syndrome; Complication; |
語文 | 英文(English) |
中文摘要 | 可吸收性明膠海綿(gelatin sponge)的止血功能常應用在脊椎手術。很多外科醫生也在腰椎手術後使用它來隔離硬腦膜和軟組織之問以及防止腦脊椎液的滲漏。雖然它的併發症很少,但是當空問有限時,明膠海綿可能因吸水漲大而壓迫臨近的神經組織。一位50歲的男性病人在接受第二、三腰椎椎間盤手術後發生馬尾症候群。在術後追蹤的腰椎核磁共震掃描發現疑似術後的血腫或殘留的椎間盤。因此安排再次手術,術中竟然發現多片沾滿血的可吸收性明膠海綿壓迫神經組織。術後病患的神經學功能逐漸恢復。雖然使用斯龐嘉止血棉(Spongostan)在腰椎手術通常是安全的,但是外科醫生也必須小心避免使用大片的可吸收性明膠海綿,尤其避免術後遺留在密閉空間內。 |
英文摘要 | Absorbable gelatin sponges have been used very often for hemostatic purpose in spinal surgery. Many surgeons also use such sponges during lumbar surgery as a barrier between the dura and soft tissue and for sealing the dura to prevent cerebrospinal fluid leakage. Although complications due to gelatin sponges are rare, there is a potential risk that they inflat and compress the adjacent neural structures especially when the space is limited. A 50 year-old man suffered from the cauda Lumbar MRI was done, and it was felt that postoperative hematoma and residual discs could not be ruled out. So reoperation was performed and several pieces of large, blood-containing Spongostan were found and removed. Neurological function of the patient recovered well after operation. Although the use of Spongostan is relatively safe, the surgeon must take care not to use a large piece of such material and left it in a closed space. |
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