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Does Prophylactic Administration of TXA Reduce Mean Operative Time and Postoperative Blood Loss in Posterior Approach Lumbar Spinal Fusion Surgery Performed for Degenerative Spinal Disease?预防性使用氨甲环酸是否能减少因退行性脊柱疾病行后路腰椎融合手术的平均手术时间和术后失血?
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2
A prediction model of surgical site infection after instrumented thoracolumbar spine surgery in adults.成人后路脊柱内固定手术后手术部位感染的预测模型。
Eur Spine J. 2019 Apr;28(4):775-782. doi: 10.1007/s00586-018-05877-z. Epub 2019 Jan 7.
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The Efficacy and Safety of Intravenous Tranexamic Acid in Reducing Surgical Blood Loss in Posterior Lumbar Interbody Fusion for the Adult: A Systematic Review and a Meta-Analysis.成人后路腰椎椎间融合术中静脉注射氨甲环酸减少手术失血的疗效与安全性:一项系统评价和荟萃分析
World Neurosurg. 2019 Feb;122:559-568. doi: 10.1016/j.wneu.2018.09.115. Epub 2018 Oct 16.
4
Improving spine surgical access, appropriateness and efficiency in metropolitan, urban and rural settings.在大都市、城市和农村地区改善脊柱手术的入路、合理性和效率。
Can J Surg. 2017 Oct;60(5):342-348. doi: 10.1503/cjs.016116.
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Accelerating surgical quality improvement in Ontario through a regional collaborative: a quality-improvement study.通过区域合作加速安大略省外科手术质量提升:一项质量改进研究
CMAJ Open. 2018 Aug 28;6(3):E353-E359. doi: 10.9778/cmajo.20170166. Print 2018 Jul-Sep.
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A National Analysis on Predictors of Discharge to Rehabilitation After Corrective Surgery for Adolescent Idiopathic Scoliosis.全国性分析预测青少年特发性脊柱侧凸矫正手术后康复出院的影响因素。
Spine (Phila Pa 1976). 2019 Jan 15;44(2):118-122. doi: 10.1097/BRS.0000000000002758.
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Comparative outcomes of epidural steroids versus placebo after lumbar discectomy in lumbar disc herniation: a systematic review and meta-analysis of randomized controlled trials.腰椎间盘突出症患者行腰椎间盘切除术后硬膜外注射类固醇与安慰剂的比较结果:一项随机对照试验的系统评价和荟萃分析
Eur J Orthop Surg Traumatol. 2018 Dec;28(8):1589-1599. doi: 10.1007/s00590-018-2229-4. Epub 2018 May 29.
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Predictors for Non-Home Patient Discharge Following Elective Adult Spinal Deformity Surgery.成人择期脊柱畸形手术后非回家患者出院的预测因素。
Global Spine J. 2018 May;8(3):266-272. doi: 10.1177/2192568217717971. Epub 2017 Jul 20.
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A systematic review of clinical outcomes in surgical treatment of adult isthmic spondylolisthesis.成人峡部裂性脊柱滑脱症手术治疗的临床疗效的系统评价
Spine J. 2018 Aug;18(8):1441-1454. doi: 10.1016/j.spinee.2018.04.022. Epub 2018 May 7.
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The efficacy and safety of topical administration of tranexamic acid in spine surgery: a meta-analysis.氨甲环酸局部应用于脊柱手术的疗效与安全性:一项荟萃分析。
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脊柱手术的质量与安全改进

Quality and Safety Improvement in Spine Surgery.

作者信息

Jiang Fan, Wilson Jamie R F, Badhiwala Jetan H, Santaguida Carlo, Weber Michael H, Wilson Jefferson R, Fehlings Michael G

机构信息

Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.

University of Toronto, Toronto, Ontario, Canada.

出版信息

Global Spine J. 2020 Jan;10(1 Suppl):17S-28S. doi: 10.1177/2192568219839699. Epub 2020 Jan 6.

DOI:10.1177/2192568219839699
PMID:31934516
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6947676/
Abstract

STUDY DESIGN

Review article.

OBJECTIVES

A narrative review of the literature on the current advances and limitations in quality and safety improvement initiatives in spine surgery.

METHODS

A comprehensive literature search was performed using Ovid MEDLINE focusing on 3 preidentified concepts: (1) quality and safety improvement, (2) reporting of outcomes and adverse events, and (3) prediction model and practice guidelines. The search was conducted under appropriate subject headings and using relevant text words. Articles were screened, and manuscripts relevant to this discussion were included in the narrative review.

RESULTS

Quality and safety improvement remains a major research focus attracting investigators from the global spine community. Multiple databases and registries have been developed for the purpose of generating data and monitoring the progress of quality and safety improvement initiatives. The development of various prediction models and clinical practice guidelines has helped shape the care of spine patients in the modern era. With the reported success of exemplary programs initiated by the Northwestern and Seattle Spine Team, other quality and safety improvement initiatives are anticipated to follow. However, despite these advancements, the reporting metrics for outcomes and adverse events remain heterogeneous in the literature.

CONCLUSION

Constant surveillance and continuous improvement of the quality and safety of spine treatments is imperative in modern health care. Although great advancement has been made, issues with reporting outcomes and adverse events persist, and improvement in this regard is certainly needed.

摘要

研究设计

综述文章。

目的

对脊柱外科质量与安全改进举措的当前进展及局限性相关文献进行叙述性综述。

方法

使用Ovid MEDLINE进行全面的文献检索,重点关注3个预先确定的概念:(1)质量与安全改进;(2)结果及不良事件报告;(3)预测模型与实践指南。检索在适当的主题词下进行,并使用相关文本词。对文章进行筛选,与本讨论相关的手稿纳入叙述性综述。

结果

质量与安全改进仍然是吸引全球脊柱领域研究人员的主要研究重点。为了生成数据和监测质量与安全改进举措的进展,已经建立了多个数据库和登记处。各种预测模型和临床实践指南的发展有助于塑造现代脊柱患者的护理模式。随着西北脊柱团队和西雅图脊柱团队发起的示范项目取得成功,预计其他质量与安全改进举措也将随之而来。然而,尽管有这些进展,但结果和不良事件的报告指标在文献中仍然存在差异。

结论

在现代医疗保健中,持续监测和不断改进脊柱治疗的质量与安全至关重要。尽管已经取得了巨大进展,但结果和不良事件报告方面的问题仍然存在,这方面肯定需要改进。