Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, Gyeonggi-do, Republic of Korea.
Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
Spine (Phila Pa 1976). 2020 May 1;45(9):E533-E541. doi: 10.1097/BRS.0000000000003315.
MINI: Postsurgical foot complaints occurred frequently in 853 degenerative lumbar surgeries (prevalence, 20.6%; n = 176). Risk factor analysis showed that the incidence of postsurgical foot complaint was significantly higher in patients with preoperative foot symptoms (adjusted odds ratio, 5.532) and in those with preoperative sensory deficits on the leg (adjusted odds ratio, 1.904).
Retrospective.
To investigate the prevalence and risk factors of postsurgical foot complaints (PFCs) following spinal surgery by using a modified pain drawing (PD) instrument.
Although many patients report nonspecific foot symptoms with various clinical presentation, there is not a well defined diagnostic criterion. PDs are essential for measuring spinal surgery outcomes. We created a modified patient-physician communication-based PD instrument to overcome the limitations of the previous system.
We included 853 consecutive patients who underwent decompression with or without fusion. PFCs were defined as sensory foot symptoms, including ambiguous sensations that were not clearly due to spinal pathology. Patients who complained of postoperative foot symptoms at more than two consecutive visits were assigned to the PFC group. The remaining patients were assigned to the asymptomatic group. We collected medical records using our PD instrument and compared variables between the two groups.
In total, 176 (20.6%) of the 853 patients had PFCs. The duration of preoperative leg pain was significantly longer in the PFC group than in the asymptomatic group (2.8 vs. 2.2 years; P = 0.048). The proportions of preoperative foot symptoms (82.9% vs. 43.3%) and sensory deficits on the leg (48.6% vs. 27%) were significantly greater in the PFC group than in the asymptomatic group (P < 0.001). Multivariable logistic regression analysis revealed two independent risk factors: the presence of preoperative foot symptoms (adjusted odds ratio, 5.532) and preoperative sensory deficits on the leg (adjusted odds ratio, 1.904).
PFCs occurred frequently after degenerative lumbar spinal surgery (prevalence, 20.6%). Based on our data using PD instrument, it can help reduce the incidence of PFCs if patients are informed and educated that preoperatively existing foot symptom and sensory deficits on the leg are significant risk factors for PFC development.
MINI：在 853 例退行性腰椎手术中（患病率，20.6%；n=176）经常出现术后足部投诉。风险因素分析显示，术前足部症状（调整后的优势比，5.532）和术前腿部感觉缺陷（调整后的优势比，1.904）的患者术后足部投诉的发生率明显更高。
回顾性。
使用改良疼痛图（PD）仪器调查脊柱手术后术后足部投诉（PFC）的患病率和危险因素。
尽管许多患者报告了各种临床表现的非特异性足部症状，但没有明确的诊断标准。PD 是衡量脊柱手术结果的关键。我们创建了一种改良的基于医患沟通的 PD 仪器，以克服先前系统的局限性。
我们纳入了 853 例连续接受减压术或减压融合术的患者。PFC 定义为足部感觉症状，包括不明确的感觉，而不是明确的脊髓病理。在连续两次就诊时均抱怨术后足部症状的患者被分配到 PFC 组。其余患者被分配到无症状组。我们使用 PD 仪器收集病历，并比较两组之间的变量。
共有 176 例（20.6%）患者出现 PFC。PFC 组术前腿部疼痛持续时间明显长于无症状组（2.8 年比 2.2 年；P=0.048）。PFC 组术前足部症状（82.9%比 43.3%）和腿部感觉缺陷（48.6%比 27%）的比例明显高于无症状组（P<0.001）。多变量逻辑回归分析显示两个独立的危险因素：术前足部症状（调整后的优势比，5.532）和术前腿部感觉缺陷（调整后的优势比，1.904）。
退行性腰椎脊柱手术后 PFC 发生率较高（患病率，20.6%）。根据我们使用 PD 仪器的数据，如果告知和教育患者术前存在足部症状和腿部感觉缺陷是 PFC 发展的重要危险因素，则有助于降低 PFC 的发生率。
4 级。
