Nagoshi Narihito, Fehlings Michael G, Nakashima Hiroaki, Tetreault Lindsay, Gum Jeffrey L, Smith Zachary A, Hsu Wellington K, Tannoury Chadi A, Tannoury Tony, Traynelis Vincent C, Arnold Paul M, Mroz Thomas E, Gokaslan Ziya L, Bydon Mohamad, De Giacomo Anthony F, Jobse Bruce C, Massicotte Eric M, Riew K Daniel
Toronto Western Hospital, Toronto, Ontario, Canada.
Keio University, Tokyo, Japan.
Global Spine J. 2017 Apr;7(1 Suppl):96S-102S. doi: 10.1177/2192568216687753. Epub 2017 Apr 1.
A multicenter, retrospective cohort study.
To evaluate clinical outcomes in patients with reintubation after anterior cervical spine surgery.
A total of 8887 patients undergoing anterior cervical spine surgery were enrolled in the AOSpine North America Rare Complications of Cervical Spine Surgery study. Patients with or without complications after surgery were included. Demographic and surgical information were collected for patients with reintubation. Patients were evaluated using a variety of assessment tools, including the modified Japanese Orthopedic Association scale, Nurick score, Neck Disability Index, and Short Form-36 Health Survey.
Nine cases of postoperative reintubation were identified. The total prevalence of this complication was 0.10% and ranged from 0% to 0.59% across participating institutions. The time to development of airway symptoms after surgery was within 24 hours in 6 patients and between 5 and 7 days in 3 patients. Although 8 patients recovered, 1 patient died. At final follow-up, patients with reintubation did not exhibit significant and meaningful improvements in pain, functional status, or quality of life.
Although the prevalence of reintubation was very low, this complication was associated with adverse clinical outcomes. Clinicians should identify their high-risk patients and carefully observe them for up to 2 weeks after surgery.
一项多中心回顾性队列研究。
评估颈椎前路手术后再次插管患者的临床结局。
共有8887例接受颈椎前路手术的患者纳入北美脊柱外科学会颈椎手术罕见并发症研究。纳入术后有或无并发症的患者。收集再次插管患者的人口统计学和手术信息。使用多种评估工具对患者进行评估，包括改良日本骨科学会量表、努里克评分、颈部功能障碍指数和简明健康调查问卷。
确定9例术后再次插管病例。该并发症的总发生率为0.10%，各参与机构的发生率在0%至0.59%之间。6例患者术后出现气道症状的时间在24小时内，3例患者在5至7天之间。虽然8例患者康复，但1例患者死亡。在最后随访时，再次插管患者在疼痛、功能状态或生活质量方面未表现出显著且有意义的改善。
虽然再次插管的发生率很低，但该并发症与不良临床结局相关。临床医生应识别高危患者，并在术后仔细观察他们长达2周。
