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连续30年的神经肌肉型脊柱侧弯脊柱手术并发症发生率

Rate of complications due to neuromuscular scoliosis spine surgery in a 30-years consecutive series.

作者信息

Turturro Francesco, Montanaro Antonello, Calderaro Cosma, Labianca Luca, Di Sanzo Vincenzo, Ferretti Andrea

机构信息

Department of Orthopaedic and Traumatology, S. Andrea Hospital, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Rome, Italy.

出版信息

Eur Spine J. 2017 Oct;26(Suppl 4):539-545. doi: 10.1007/s00586-017-5034-6. Epub 2017 Mar 17.

Abstract

PURPOSE

The aim of this study was to evaluate the rate of intraoperative and postoperative complications in a large series of patients affected by neuromuscular scoliosis.

METHODS

It was a monocentric retrospective study. In this study have been considered complications those events that significantly affected the course of treatment, such as getting the hospital stay longer, or requiring a subsequent surgical procedure, or corrupting the final result of the treatment.

RESULTS

Of the 358 patients affected by neuromuscular scoliosis treated from January 1985 to December 2010, 185 that met the inclusion criteria were included in the study. There were recorded 66 complications in 55/185 patients. Of that 66 complications, 54 complications occurred in 46/120 patients with Luque's instrumentation, while only 12 complications occurred in 9/65 patients with hybrid instrumentation and this difference was statistically significant (p < 0.05); 11/126 patients with pelvic fixation and 5/59 without pelvic fixation, as well as 45/156 patients treated by posterior approach alone and 10/29 patient that underwent combined anterior-posterior approach suffered complications but both this did not result in a statistical significant difference (p > 0.05).

CONCLUSIONS

The surgical treatment in neuromuscular scoliosis is burdened by a large number of complications. An accurate knowledge of possible complications is mandatory to prepare strategies due to prevent adverse events. A difference in definitions could completely change results in good or bad as well as in our same series the adverse events amounted at almost 30% of cases, but complications that due to complete failure would amount at 9.19% of patients.

摘要

目的

本研究旨在评估大量神经肌肉型脊柱侧凸患者的术中和术后并发症发生率。

方法

这是一项单中心回顾性研究。在本研究中,并发症被定义为那些显著影响治疗进程的事件,例如延长住院时间、需要后续手术、破坏治疗的最终结果等。

结果

在1985年1月至2010年12月接受治疗的358例神经肌肉型脊柱侧凸患者中,185例符合纳入标准并被纳入研究。共记录到55/185例患者发生66例并发症。在这66例并发症中,54例发生在120例接受Luque器械固定的患者中的46例,而仅12例发生在65例接受混合器械固定的患者中的9例,这种差异具有统计学意义(p < 0.05);126例接受骨盆固定的患者中有11例,59例未接受骨盆固定的患者中有5例发生并发症,以及仅采用后路手术治疗的156例患者中有45例,接受前后联合手术的29例患者中有10例发生并发症,但这两组均未产生统计学显著差异(p > 0.05)。

结论

神经肌肉型脊柱侧凸的手术治疗存在大量并发症。准确了解可能的并发症对于制定预防不良事件的策略至关重要。定义上的差异可能会完全改变结果的好坏,在我们的同一系列研究中,不良事件几乎占病例的30%,但完全失败导致的并发症仅占患者的9.19%。

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