文章简介

出版社:World Neurosurgery

作   者:Amy Li, Christian Swinney, Anand Veeravagu, Inderpreet Bhatti, John Ratliff

编   号:10.1016/j.wneu.2015.08.030

年   份:2015    点击量:842

文章摘要 全文翻译

BACKGROUND:

Postoperative visual loss (POVL) is a potentially devastating complication of lumbar spine surgery that may lead to significant functional impairment. Although POVL is rare, a review of the literature shows that it is being reported with increasing frequency. A systematic analysis detailing the etiology and prognosis of the 3 main types of POVL has yet to be published. We reviewed potential preoperative and intraoperative risk factors for ischemic optic neuropathy (ION), central retinal artery occlusion (CRAO), and cortical blindness (CB) after lumbar spine surgery.

背景:
       术后视力丧失(POVL)是腰椎手术后潜在危害性极强的并发症,可导致明显功能障碍。尽管POVL较为罕见,但文献回顾显示有关POVL的文献报道正在增加。尚无详细描述POVL三种主要类型病因和预后的系统分析类文章发表。本文综述了腰椎手术后缺血性视神经病变(ION)、视网膜中央动脉阻塞(CRAO)和皮质盲(CB)的潜在术前和术中危险因素。

 

METHODS:

A PubMed and Google literature search was completed in the absence of time constraints. Relevant articles on POVL after spine surgery were identified and reviewed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

方法:
       采用PubMed和谷歌,在无时间限制的情况下完成文献检索。依据系统综述和荟萃分析优先报告的条目对手术后POVL的相关文章进行筛选及回顾。


RESULTS:

We identified 4 large-scale studies that statistically analyzed risk factors for POVL. ION, CRAO, and CB were the most frequently reported POVL types in the literature. Data were abstracted from 19 ION case reports, 3 CRAO case reports, and 5 CB case reports.

结果:
       我们确定4项大规模研究,统计分析了POVL的风险因素。ION、CRAO和CB是文献报道POVL最常见的类型。数据来源于19篇ION病例报告、3篇CRAO病例报告、以及5 篇CB病例报告。
 

CONCLUSIONS:

We reviewed the preoperative and intraoperative risk factors for each of the 3 main POVL types, using several published case reports to supplement the limited large-scale studies available. ION risks may be influenced by a longer operative time in the prone position with anemia, hypotension, and blood transfusion. The risk for CRAO is usually due to improper positioning during the surgery. Prone positioning and obesity were found to be most commonly associated with CB development. The prognosis, prevention techniques, and treatment of each POVL type can vary considerably.

总结:
       本文引用已发表的病例报告对已获得的有限的大规模研究进行补充,综述了三种POVL主要类型术前和术中的风险因素。ION的风险因素可能来自卧姿状态下长时间手术引起的贫血、低血压以及输血。CRAO的风险因素通常是术中不恰当的体位。卧姿和肥胖被认为是诱发CB的最常见因素。POVL每种类型的预后、预防技术和治疗可能会有很大差别。