Li Zheng, Shen Jianxiong, Qiu Guixing, Yu Haiquan, Wang Yipeng, Zhang Jianguo, Zhao Hong, Zhao Yu, Li Shugang, Weng Xisheng, Liang Jinqian, Zhao Lijuan
Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
PLoS One. 2014 Mar 4;9(3):e87172. doi: 10.1371/journal.pone.0087172. eCollection 2014.
No recent studies have analyzed the rates of or reasons for unanticipated revision surgery within 30 days of primary surgery in spinal deformity patients. Our aim was to examine the incidence, characteristics, reasons, and risk factors for unplanned revision surgery in spinal deformity patients treated at one institution. All patients with a diagnosis of spinal deformity presenting for primary instrumented spinal fusion at a single institution from 1998 to 2012 were reviewed. All unplanned reoperations performed within 30 days after primary surgery were analyzed in terms of demographics, surgical data, and complications. Statistical analyses were performed to obtain correlations and risk factors for anticipated revision. Of 2758 patients [aged 16.07 years (range, 2-71), 69.8% female] who underwent spinal fusion surgery, 59 (2.1%) required reoperation within 30 days after primary surgery. The length of follow up for each patient was more than 30 days. Of those that required reoperation, 87.0% had posterior surgery only, 5.7% had anterior surgery, and 7.3% underwent an anteroposterior approach. The reasons for reoperation included implant failure (n = 20), wound infection (n = 12), neurologic deficit (n = 9), pulmonary complications (n = 17), and coronal plane imbalance (n = 1). The risk factors for reoperation were age, diagnosis, and surgical procedure with osteotomy.
近期没有研究分析脊柱畸形患者初次手术后30天内意外翻修手术的发生率或原因。我们的目的是研究在一家机构接受治疗的脊柱畸形患者计划外翻修手术的发生率、特征、原因和危险因素。回顾了1998年至2012年在一家机构接受初次器械辅助脊柱融合术且诊断为脊柱畸形的所有患者。对初次手术后30天内进行的所有计划外再次手术进行了人口统计学、手术数据和并发症方面的分析。进行统计分析以获得预期翻修的相关性和危险因素。在接受脊柱融合手术的2758例患者中(年龄16.07岁,范围2 - 71岁,69.8%为女性),59例(2.1%)在初次手术后30天内需要再次手术。每位患者的随访时间超过30天。在需要再次手术的患者中,87.0%仅接受了后路手术,5.7%接受了前路手术,7.3%接受了前后路联合手术。再次手术的原因包括植入物失败(n = 20)、伤口感染(n = 12)、神经功能缺损(n = 9)、肺部并发症(n = 17)和冠状面失衡(n = 1)。再次手术的危险因素是年龄、诊断和截骨手术方式。