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[脊柱手术后并发症的高峰时间]

[Peak timing for complications after spine surgery].

作者信息

Pepke W, Wantia C, Almansour H, Bruckner T, Thielen M, Akbar M

机构信息

Klinik für Orthopädie und Unfallchirurgie, Zentrum für Wirbelsäulenchirurgie, Universitätsmedizin Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland.

Institut für Medizinische Biometrie und Informatik, Universität Heidelberg, Heidelberg, Deutschland.

出版信息

Orthopade. 2020 Jan;49(1):39-58. doi: 10.1007/s00132-019-03770-1.

DOI:10.1007/s00132-019-03770-1
PMID:31346644
Abstract

BACKGROUND

Spine surgeries can pose many complications; however, peak timing of post-operative complications in the field of spine surgery is still not sufficiently delineated in the literature as yet. Nevertheless the determination of peak timing of post-operative complications has a significant influence on patient education and post-operative follow-up.

MATERIALS AND METHODS

This single-center study analyzed the medical records of 1179 patients that underwent spinal instrumentation between 2010 and 2015 at 3, 6, 12, 24 and 36 months postoperatively. Complications were analyzed according to their time of onset.

RESULTS

Of the 1179 patients included, 199 (16.9%) underwent revision surgery due to a complication. Peak timing for complications (72.9%) occurred within the first 3 months after surgery. Infection was the most common reason for revision surgery (42.7%) and most infections occurred within the first 3 months after surgery (early infections) (91.8% of infections). Peak timing for material failure occurred in the second post-operative year (46% of all detected prosthesis failures) (2.5% of all complications).

DISCUSSION

Peak timing of post-operative complications post spinal instrumentation occurs as early on as within the first 3 months after surgery and post-operative infections remain the most common post-operative complication overall. Nonetheless, regular and long-term postoperative clinical and radiological follow-up is crucial, since in particular prosthesis failure has its peak timing in the second post-operative year.

摘要

背景

脊柱手术可能引发多种并发症;然而,脊柱手术领域术后并发症的高峰发生时间在文献中仍未得到充分界定。尽管如此,确定术后并发症的高峰发生时间对患者教育和术后随访具有重大影响。

材料与方法

这项单中心研究分析了2010年至2015年间接受脊柱内固定手术的1179例患者在术后3个月、6个月、12个月、24个月和36个月的病历。根据并发症的发病时间进行分析。

结果

在纳入的1179例患者中,199例(16.9%)因并发症接受了翻修手术。并发症的高峰发生时间(72.9%)出现在术后前3个月内。感染是翻修手术最常见的原因(42.7%),且大多数感染发生在术后前3个月内(早期感染)(占所有感染的91.8%)。材料故障的高峰发生时间在术后第二年(占所有检测到的假体故障的46%)(占所有并发症的2.5%)。

讨论

脊柱内固定术后并发症的高峰发生时间最早在术后前3个月内,术后感染仍然是总体上最常见 的术后并发症。尽管如此,定期和长期的术后临床及影像学随访至关重要,因为特别是假体故障在术后第二年达到高峰发生时间。

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Accuracy of Tissue and Sonication Fluid Sampling for the Diagnosis of Fracture-Related Infection: A Systematic Review and Critical Appraisal.组织和超声处理液采样用于诊断骨折相关感染的准确性:一项系统评价与批判性评估
J Bone Jt Infect. 2018 Aug 10;3(4):173-181. doi: 10.7150/jbji.27840. eCollection 2018.
2
Surgical Infection after Posterolateral Lumbar Spine Arthrodesis: CT Analysis of Spinal Fusion.腰椎后外侧脊柱融合术后的手术感染:脊柱融合的CT分析
Orthop Surg. 2018 May;10(2):89-97. doi: 10.1111/os.12371. Epub 2018 May 16.
3
Impact of frailty on complications in patients with thoracic and thoracolumbar spinal fracture.
衰弱对胸段及胸腰段脊柱骨折患者并发症的影响。
Clin Neurol Neurosurg. 2018 Jun;169:161-165. doi: 10.1016/j.clineuro.2018.04.014. Epub 2018 Apr 9.
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Peak Timing for Complications After Adult Spinal Deformity Surgery.成人脊柱畸形手术后并发症的高峰时间
World Neurosurg. 2018 Jul;115:e509-e515. doi: 10.1016/j.wneu.2018.04.084. Epub 2018 Apr 22.
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Eur Spine J. 2018 Oct;27(10):2529-2535. doi: 10.1007/s00586-018-5592-2. Epub 2018 Apr 13.
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