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对接受后路固定的腰椎管狭窄症患者术后感染原因的回顾性、人口统计学和临床调查

Retrospective, Demographic, and Clinical Investigation of the Causes of Postoperative Infection in Patients With Lumbar Spinal Stenosis Who Underwent Posterior Stabilization.

作者信息

Yaldiz Can, Yaldiz Mahizer, Ceylan Nehir, Kacira Ozlem Kitiki, Ceylan Davut, Kacira Tibet, Kizilcay Gokhan, Tanriverdi Taner

机构信息

From the Departmant of Neurosurgery (CY, DC, TK, GK); Departmant of Dermatology (MY); Departmant of Internal Medicine (NC); Departmant of Radiology (OKK), Sakarya University Training and Research Hospital, Sakarya; and Department of Neurosurgery (TT), Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

出版信息

Medicine (Baltimore). 2015 Jul;94(29):e1177. doi: 10.1097/MD.0000000000001177.

Abstract

Owing to the increasing population of elderly patients, a large number of patients with degenerative spondylosis are currently being surgically treated. Although basic measures for decreasing postoperative surgical infections (PSIs) are considered, it still remains among the leading causes of morbidity and mortality. The aim of this retrospective analysis is to present possible causes leading to PSI in patients who underwent surgery for lumbar degenerative spondylosis and highlight how it can be avoided to decrease morbidity and mortality. The study included 540 patients who underwent posterior stabilization due to degenerative lumbar stenosis between January 2013 and January 2014. The data before and after surgery was retrieved from the hospital charts. Patients with degenerative lumbar stenosis who were operated upon in this study had >2 levels of laminectomy and facetectomy. For this reason, posterior stabilization was performed for all the patients included in this study. Determining the causes of postoperative infection (PI) following spinal surgeries performed with instrumentation is a struggle. Seventeen different parameters that may be related to PI were evaluated in this study. The presence of systemic diseases, unknown glove perforations, and perioperative blood transfusions were among the parameters that increased the prevalence of PI. Alternatively, prolene sutures, double-layered gloves, and the use of rifampicin Sv (RIS) decreased the incidence of PI. Although the presence of systemic diseases, unnoticed glove perforations, and perioperative blood transfusions increased PIs, prolene suture material, double-layered gloves, and the use of RIS decreased PIs.

摘要

由于老年患者人口不断增加,目前有大量退行性脊柱病患者正在接受手术治疗。尽管考虑了降低术后手术感染(PSI)的基本措施,但它仍然是发病和死亡的主要原因之一。这项回顾性分析的目的是呈现腰椎退行性脊柱病手术患者发生PSI的可能原因,并强调如何避免以降低发病率和死亡率。该研究纳入了2013年1月至2014年1月期间因退行性腰椎管狭窄接受后路固定手术的540例患者。手术前后的数据从医院病历中获取。本研究中接受手术的退行性腰椎管狭窄患者进行了超过2节段的椎板切除术和小关节切除术。因此,本研究纳入的所有患者均进行了后路固定。确定器械辅助脊柱手术后的术后感染(PI)原因颇具难度。本研究评估了17个可能与PI相关的不同参数。全身疾病的存在、未知的手套穿孔和围手术期输血是增加PI发生率的参数。相反,聚丙烯缝线、双层手套和利福平Sv(RIS)的使用降低了PI的发生率。尽管全身疾病的存在、未注意到的手套穿孔和围手术期输血增加了PI,但聚丙烯缝合材料、双层手套和RIS的使用降低了PI。

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