Centre for Spinal Studies and Surgery, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, West Block, D Floor, Derby Road, Nottingham, NG7 2UH, UK.
Centre for Sports Medicine, Queens Medical Centre, University of Nottingham, Derby Road, Nottingham, NG7 2UH, UK.
Eur Spine J. 2019 Apr;28(4):792-797. doi: 10.1007/s00586-018-5797-4. Epub 2018 Oct 27.
Most of the literature on infection after surgery for spinal metastases focuses on incidence and risk factors for surgical site infection (SSI). To the best of our knowledge, there is no report on the influence of infection on neurological outcome and survival in patients undergoing emergent surgery for metastatic spinal cord compression (MSCC).
Our aim was to establish if SSIs adversely affected the neurological outcome and survival in patients with MSCC. We reviewed 318 consecutive patients admitted for surgical intervention for MSCC from October 2005 to October 2012. Morbidity (neurological outcome, length of hospital stay and additional procedures) and survival rates were analysed.
During this study period, the incidence of infection was 29/318 (9.1%). The median length of stay in hospital in the infected group was 25 days compared to 13 days in the non-infected group (p = 0.001). Twenty out of the 29 (69%) infected patients underwent an additional procedure (29 procedures in total) compared to 9/289 (3%) non-infected patients (p = 0.001). There was no statistical difference between the two groups with regard to neurological outcome (p = 0.37) but the survival rate was statistically different between the two groups [infected group: median survival 131 days (19-1558) vs. non-infected group: 258 days (5-2696; p = 0.03)].
Surgical site infection increased the morbidity with considerably longer hospital stay and requirement for additional procedures. Although there was no difference in neurological outcome, the infected group of patients had a significantly shorter survival. These slides can be retrieved under Electronic Supplementary Material.
大多数关于脊柱转移瘤术后感染的文献都集中在手术部位感染（SSI）的发生率和危险因素上。据我们所知，尚无关于感染对接受转移性脊髓压迫症（MSCC）紧急手术患者的神经功能结局和生存的影响的报告。
我们旨在确定 SSIs 是否对 MSCC 患者的神经功能结局和生存产生不利影响。我们回顾了 2005 年 10 月至 2012 年 10 月期间因 MSCC 接受手术干预的 318 例连续患者。分析了发病率（神经功能结局、住院时间和附加程序）和生存率。
在本研究期间，感染发生率为 29/318（9.1%）。感染组的中位住院时间为 25 天，而非感染组为 13 天（p=0.001）。29 例感染患者中有 20 例（69%）接受了额外的手术（共 29 例），而非感染组 289 例中有 9 例（3%）（p=0.001）。两组之间在神经功能结局方面无统计学差异（p=0.37），但两组之间的生存率存在统计学差异[感染组：中位生存时间 131 天（19-1558）与非感染组：258 天（5-2696；p=0.03）]。
手术部位感染增加了发病率，住院时间延长，需要额外的手术。尽管神经功能结局没有差异，但感染组患者的生存时间明显缩短。这些幻灯片可在电子补充材料中检索。
