Christiansen Peter A, LaBagnara Michael, Sure Durga R, Shaffrey Christopher I, Smith Justin S
Department of Neurosurgery, University of Virginia Medical Center, PO Box 800212, Charlottesville, VA, 22908, USA.
Curr Rev Musculoskelet Med. 2016 Sep;9(3):281-9. doi: 10.1007/s12178-016-9357-4.
If nonoperative measures are unsuccessful in managing the pain and disability of adult spinal deformities, surgical correction may provide the potential for significant improvement in a patient's quality of life. However, these procedures have a relatively high risk of complications. Identifying patients that may benefit from surgical intervention requires a thorough understanding of potential complications and managing the risks of any individual patient. Complications do not necessarily result in poor outcomes, and good outcomes are not always complication free. Higher risk patients potentially have more to gain, even if they experience complications. With the rapidly expanding senior population and expanded capabilities to manage high-risk patients, it is helpful to consider the lessons provided by ever expanding databases of outcome measures to refine the surgical decision-making process.
如果非手术措施在治疗成人脊柱畸形的疼痛和残疾方面不成功,手术矫正可能会显著改善患者的生活质量。然而,这些手术有相对较高的并发症风险。确定可能从手术干预中受益的患者需要全面了解潜在并发症并管理任何个体患者的风险。并发症不一定会导致不良后果,良好的结果也不总是没有并发症。高风险患者即使经历并发症,也可能有更多收获。随着老年人口的迅速增加以及管理高风险患者能力的提升,考虑不断扩大的结果测量数据库所提供的经验教训以完善手术决策过程是有帮助的。