Imajo Yasuaki, Taguchi Toshihiko, Neo Masashi, Otani Koji, Ogata Tadanori, Ozawa Hiroshi, Miyakoshi Naohisa, Murakami Hideki, Iguchi Tetsuhiro
Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Japan.
Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Japan.
J Orthop Sci. 2017 Jan;22(1):10-15. doi: 10.1016/j.jos.2016.08.014. Epub 2016 Sep 16.
The Japanese Society for Spine Surgery and Related Research (JSSR) performed a third study on complications in spinal surgery in 2011. The purpose was to present information about surgery and complications in a large amount of elderly patients aged 65 years with lumbar spinal stenosis (LSS) without coexisting spondylolisthesis, spondylolysis, or scoliosis, and to compare patients aged ≥80 years to those aged 65-79 years.
A recordable optical disc for data storage was sent by JSSR in January 2012 to 1105 surgeons certified by the JSSR in order to collect surgical data. Data were returned by the end of May 2012.
Data were accumulated for 8033 patients aged 65 years. The incidence of surgical complications was 10.8%, and did not differ significantly between age groups. The incidence of general complications was 2.7%, and differed significantly between age groups (p < 0.005). The highest incidence of surgical complications was for dural tear (DT) (3.6%), followed by deep wound infection (DWI) (1.4%), neurological complications (1.3%), and epidural hematoma (1.3%). Spinal instrumentation was applied in 30.3%. Incidences of surgical complications in instrumented and noninstrumented surgery were 17.3% and 8.8%. In instrumented surgery, incidences of surgical and general complications were higher in the ≥80 year age group than in the 65-79 year age group. Logistic regression analyses showed patients with microendoscopic surgery at increased risk of DT. Patients with diabetes mellitus and instrumented surgery showed increased risks of DWI.
Incidences of surgical complications did not differ significantly between age groups. Attention should be paid to both surgical and general complications, particularly for postoperative mental disease in instrumented surgery for patients≥80 years old.
日本脊柱外科学会及相关研究学会（JSSR）于2011年开展了第三项脊柱手术并发症研究。目的是呈现大量65岁无腰椎滑脱、椎弓根峡部裂或脊柱侧弯并存的老年腰椎管狭窄症（LSS）患者的手术及并发症信息，并比较80岁及以上患者与65 - 79岁患者的情况。
2012年1月，JSSR向1105名经其认证的外科医生发送了用于数据存储的可记录光盘，以收集手术数据。数据于2012年5月底返回。
积累了8033名65岁患者的数据。手术并发症发生率为10.8%，各年龄组间无显著差异。一般并发症发生率为2.7%，各年龄组间差异显著（p < 0.005）。手术并发症发生率最高的是硬脊膜撕裂（DT）（3.6%），其次是深部伤口感染（DWI）（1.4%）、神经并发症（1.3%）和硬膜外血肿（1.3%）。30.3%的患者应用了脊柱内固定。内固定手术和非内固定手术的手术并发症发生率分别为17.3%和8.8%。在内固定手术中，80岁及以上年龄组的手术和一般并发症发生率高于65 - 79岁年龄组。逻辑回归分析显示，接受显微内镜手术的患者发生DT的风险增加。患有糖尿病且接受内固定手术的患者发生DWI的风险增加。
各年龄组间手术并发症发生率无显著差异。应关注手术和一般并发症，尤其是80岁及以上患者接受内固定手术时的术后精神疾病。
