Imajo Yasuaki, Taguchi Toshihiko, Yone Kazunori, Okawa Atsushi, Otani Koji, Ogata Tadanori, Ozawa Hiroshi, Shimada Yoichi, Neo Masashi, Iguchi Tetsuhiro
Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1 Minami-kogushi, Ube, Japan,
J Orthop Sci. 2015 Jan;20(1):38-54. doi: 10.1007/s00776-014-0656-6. Epub 2014 Dec 5.
The Japanese Society for Spine Surgery and Related Research (JSSR) previously carried out two nationwide surveys in 1994 and 2001 on complications from spine and spinal cord surgery. More than 10 years have now elapsed since 2001. Rapidly ageing populations have major impacts on society, particularly in the medical field. The purpose of this study was therefore to examine the present situation for spine surgery in Japan.
The JSSR research team prepared a computerized questionnaire made up of two categories in order to capture clinicopathological information and surgical information. A recordable optical disc for data storage was sent to surgeons who were certified for spine surgery by JSSR. The data was analyzed.
The JSSR carried out a nationwide survey of complications of 31,380 patients. Patients aged 60 years or older comprised 63.1 % of the overall cohort. This was considerably higher than observed in previous surveys. Degenerative spinal diseases increased 79.7 %. With regard to surgical approach, the incidence of anterior surgery has decreased, while that of posterior surgery has increased compared to the earlier surveys (both p < 0.05). Spinal instrumentation was applied in 30.2 % cases, compared to 27.0 and 34.0 % cases in the 1994 and 2001 surveys, respectively. Intraoperative and postoperative complications were reported in 10.4 % and were slightly increased compared to 8.6 % in the earlier surveys (both p < 0.05). Diseases associated with a high incidence of complication included intramedullary tumor (29.3 %) and primary malignant tumor (22.0 %). The highest incidence of complication was dural tear (2.1 %), followed by neurological complication (1.4 %).
日本脊柱外科学会及相关研究组织（JSSR）曾于1994年和2001年在全国范围内开展了两项关于脊柱和脊髓手术并发症的调查。自2001年以来，已过去10多年。人口迅速老龄化对社会产生了重大影响，尤其是在医疗领域。因此，本研究旨在调查日本脊柱手术的现状。
JSSR研究团队准备了一份由两类组成的计算机化问卷，以获取临床病理信息和手术信息。一张用于数据存储的可记录光盘被发送给获得JSSR脊柱手术认证的外科医生。对数据进行了分析。
JSSR对31380例患者的并发症进行了全国性调查。60岁及以上的患者占总队列的63.1%。这一比例明显高于之前的调查。退行性脊柱疾病增加了79.7%。关于手术方式，与早期调查相比，前路手术的发生率有所下降，而后路手术的发生率有所上升（两者p<0.05）。30.2%的病例应用了脊柱内固定器械，而在1994年和2001年的调查中，这一比例分别为27.0%和34.0%。术中及术后并发症报告率为10.4%，与早期调查的8.6%相比略有增加（两者p<0.05）。并发症发生率较高的疾病包括髓内肿瘤（29.3%）和原发性恶性肿瘤（22.0%）。并发症发生率最高的是硬脑膜撕裂（2.1%），其次是神经并发症（1.4%）。
