Phan Kevin, Ramachandran Vignesh, Tran Tommy, Phan Steven, Rao Prashanth J, Mobbs Ralph J
NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia.
Baylor College of Medicine, Houston, Texas, USA.
World Neurosurg. 2017 Sep;105:503-509. doi: 10.1016/j.wneu.2017.05.056. Epub 2017 May 19.
Anterior lumbar interbody fusion (ALIF) is a surgical technique used to treat patients with a variety of lumbar pathologies. Identification of risk factors leading to complication following ALIF surgery may allow surgeons to better judge candidacy and optimize care for high-risk patients.
A retrospective analysis was conducted on a prospectively collected database of 137 patients who all underwent ALIF surgery by a single primary spine surgeon. Patients were separated into age-based cohorts (≤49, 50-63, and ≥64 years of age). Chi-squared, Fisher exact test, and multivariate logistic regression models were used to identify independent risk factors.
A total of 137 patients met the inclusion criteria. Patients were divided into age-based tertiles as follows: Group 1 (<49 years old, n = 45, 32.8%), Group 2 (50-63 years old, n = 46, 33.6%), and Group 3 (64 years old, n = 46, 33.6%). Univariate analysis revealed increasing age (relative to Group 1) to be an independent risk factor for postoperative hematoma and delayed subsidence at 6 weeks and 12 weeks postoperatively compared with immediately post operation (all P < 0.05). No significant differences were found among the groups in terms of clinical outcome. Multivariate analysis also demonstrated increased age to be independently associated with greater prevalence of delayed subsidence (odds ratio 9.174, P = 0.029).
Increased age was not associated with adverse perioperative outcomes and complications of ALIF. However, there was an increased incidence of delayed subsidence in patients ≥64 years old.
腰椎前路椎间融合术（ALIF）是一种用于治疗多种腰椎疾病患者的手术技术。识别导致ALIF手术后并发症的危险因素，可能有助于外科医生更好地判断患者是否适合手术，并为高危患者优化治疗方案。
对一位脊柱外科医生前瞻性收集的137例行ALIF手术患者的数据库进行回顾性分析。患者按年龄分为不同队列（≤49岁、50 - 63岁和≥64岁）。采用卡方检验、Fisher精确检验和多因素逻辑回归模型来识别独立危险因素。
共有137例患者符合纳入标准。患者按年龄分为三个三分位数组，如下：第1组（<49岁，n = 45，32.8%），第2组（50 - 63岁，n = 46，33.6%），第3组（≥64岁，n = 46，33.6%）。单因素分析显示，与术后即刻相比，年龄增加（相对于第1组）是术后血肿以及术后6周和12周延迟沉降的独立危险因素（所有P < 0.05）。各组间临床结局无显著差异。多因素分析还表明，年龄增加与延迟沉降的发生率更高独立相关（比值比9.174，P = 0.029）。
年龄增加与ALIF围手术期不良结局和并发症无关。然而，≥64岁患者延迟沉降的发生率有所增加。
