左C5/6頚椎ヘルニアをMacF(マックF)で摘出しています。
志匠会：土屋直人
For those undergoing Microsurgical Anterior Cervical Foraminotomy (MacF)
Naoto Tsuchiya, M.D.
Neurosurgeon
Shinagawa Shisyokai Hospital
Kitashinagawa 1-29-7
Shinagawa Tokyo Japan
140-0001
Tel:81-3-5781-0700
Fax:81-3-5781-0828
What are the complications of surgery?
5. Injury to esophagus
Due to its proximity to the surgical field, the esophagus may be injured. In such a case, the injured section is repaired surgically.
6. Sensory loss in the jaw region
Numbness may occur on the skin of the jaw above the transverse skin incision as a result of injury to small skin sensory nerves while making the incision. This will heal a few months post-surgery.
7. Autonomic nerve disturbance
Dizziness, abnormal sweating, and palpitation, such as that seen in autonomic nerve disturbance, may occur after surgery and last for a few weeks, but will typically disappear. On the contrary, in patients who have symptoms of autonomic nerve disturbance before surgery, their symptoms may disappear or improve after surgery.
8. Disc degeneration at operated disc level
Progressive reduction of the operated disc hight is commonly seen due to disc degeneration, but scoliotic or kyphotic deformity is rarely seen after microsurgical anterior cervical foraminotomy.
9. Second operation on the Luschka joint on the opposite side
Pain, numbness, and tingling of the arms and hands may occur on the opposite side of surgery shortly after surgery. These radicular symptoms are thought to be provoked by increased narrowing of the nerve root canal induced by increased stress to the Luschka joint of the opposite side. In most such cases, conservative care can address these symptoms, but some patients may need a second MacF operation on the opposite side. This complication appears more commonly among patients whose preoperative diagnostic images show narrowing of the nerve canal.
10. Injury of vertebral artery (VAI)
Because the vertebral artery runs very close to the nerve root to be decompressed, injury can occur. But in my series of 1000 patients, the incidence of VAI was 0.2%. In all cases of VAI, this could be successfully controlled by applying a hemostatic agent together with pressure for 15 min. There have been no cases that were unable to be controlled in my personal experience.
11. Infection
The rate of surgical site infection in our institution has been approximately 1 %. Infection can occur in cervical surgery, particularly among elderly patients with decreased immune strength as a result of diabetes or poor renal function. Early surgical intervention is recommended in our institution to minimize risk of infection.
12. Delayed healing of surgical wound
Some patients may have allergic reactions to suture material and the wound may not heal properly. If this is the case, the surgical wound will be resutured.
13. Pulmonary embolism and deep vein thrombosis
Blood clots may appear in deep veins in the legs, travel into large veins in the abdomen, and finally reach the lungs, cutting off blood circulation to the lung. To prevent blood clot formation in the legs, patients should arise from the bed as early as possible wearing elastic stockings on the legs. I have not seen any of those complications in my series of 1000 patients.
14. Postoperative disorientation or dementia
This is common among elderly patients and appears temporarily immediately after surgery.
15. Medical complications
Many other complications, such as cardiac infarct, cerebral vascular accidents, or pulmonary embolisms, may occur during or after surgery and may be fatal in some elderly patients.
頚椎ヘルニア手術：For those undergoing Microsurgical Anterior Cervical Foraminotomy (MacF) open subtitle | |
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| Age-restricted video (based on Community Guidelines) Science & Technology | Upload TimePublished on 12 Jul 2018 |
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