흉요추부 척추 수술 후 재수술의 원인과 시기

국문 초록 (Abstract)

목적: 흉요추부 수술받은 환자에서 재수술이 필요했던 경우에, 원인 및 시기별 양상, 과거력 및 재수술 후 임상적 결과에 대해 조사하였다.
대상 및 방법: 흉요추부 질환으로 본원에서 1988-2011년 동안 척추 수술을 받은 2,198명 중 재수술을 받은 환자 193명을 대상으로 하였다. 첫 수술의 원인과 수술 방법, 재수술 시기에 따른 원인과 재수술의 결과에 대해 알아보았다.
결과: 흉요추부 수술 환자들의 재수술률은 8.7%였다. 6주 이내 재수술을 시행한 경우는 혈종이나 신경증상에 의한 진단적 수술 18명(26.8%), 추간판 탈출증이 18명(26.8%), 수술 부위 감염 17명(25.4%)으로 많았고, 6주 이상 6개월 이내는 추간판 탈출증 10명(47.6%), 수술 부위 감염 7명(33.3%)으로 많았고, 6개월 이후는 인접 분절 질환 38명(35.7%), 재발성 추간판 탈출증 26명(23.2%), 기구 관련 문제 17명(16.0%)으로 많았다.
결론: 흉요추부 재수술 원인으로, 합병증(2.8%)은 감염, 혈종 및 신경학적 손상, 불충분한 감압술 등이 있었으며, 자연사(natural course) (5.9%)는 인접 분절 질환, 재발성 추간판 탈출증, 기구 관련 문제, 감압술 후 불안정성, 종양 재발, 척추 변형의 진행 등이 있었다.

다국어 초록 (Multilingual Abstract)

Purpose: We analyzed the patients who needed reoperation after undergoing a thoracolumbar spine operation and investigated the causes, pattern of timing, medical history and clinical outcome after reoperation.
Materials and Methods: Out of 2,198 patients who underwent spine surgery for thoracolumbar spine disease from 1988 to 2011, we targeted 193 patients who underwent reoperation. We studied the causes, operative method of initial surgery, time-variant causes and outcome of reoperation.
Results: The number of patients who underwent thoracolumbar spine reoperation was 193 out of 2,198 and the reoperation rate was 8.7%. We researched time-variant causes of reoperation. In six weeks after the initial operation, exploration for hematoma and neurologic deficit was 18 (26.8%), recurred heniated intervertebral disc (HIVD) was 18 (26.8%), and surgical site infection was 17 (25.4%). From six weeks to six months, recurred HIVD was 10 (47.6%), surgical site infection was 7 (33.3%), and after six months, adjacent segmental disease (ASD) was 38 (35.7%), recurred HIVD was 26 (23.2%), and implant related problem was 17 (16.0%).
Conclusion: Causes of thoracolumbar spine reoperation included complications (2.8%); infection, hematoma, neurologic deficit, incomplete decompression, and natural courses (5.9%); ASD, recurred HIVD, implant related problem, instability after decompression, tumor recur, progression of deformity.

목차 (Table of Contents)

• 서론
• 대상 및 방법
• 결과
• 고찰
• 결론
• 참고문헌

참고문헌 (Reference)

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