骨科与神经外科：颈椎前路融合术后的手术结果是否存在差异？
Orthopaedics and neurosurgery: Is there a difference in surgical outcomes following anterior cervical spinal fusion?
作者信息
Prabhakar Gautham, Kusnezov Nicholas, Dunn John, Cleveland Andrew, Herzog Joshua
机构信息
Department of Orthopaedic Surgery, UT Health San Antonio, San Antonio, TX, USA.
Department of Orthopaedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, El Paso, TX, USA.
出版信息
J Orthop. 2020 May 18;21:278-282. doi: 10.1016/j.jor.2020.05.015. eCollection 2020 Sep-Oct.
OBJECTIVE
The superiority of neurosurgical over orthopaedic spinal procedures is a point of contention. While there is the perception that neurosurgeons are more specifically trained to deal with spinal pathology, no study has directly compared outcomes of spinal surgeries performed by both groups.
METHODS
We sought to evaluate the differences in length of surgery, hospital stay, complications, mortality, and readmission for anterior cervical decompression and fusion (ACDF) performed by neurosurgeons versus orthopaedic surgeons.
RESULTS
17,967 ACDF procedures were analyzed. Neurosurgeons performed 74.3% of the fusions with a trend towards longer operative times and significantly more patients that were discharged to extended care facilities. There was no significant difference in the length of stay, overall complications, mortality, readmission, or reoperation when comparing the two specialties.
CONCLUSION
Despite a significantly higher volume of ACDF performed by neurosurgeons, outcomes are comparable following orthopaedic and neurosurgical procedures.
目的
神经外科脊柱手术相较于骨科脊柱手术的优越性存在争议。尽管人们认为神经外科医生在处理脊柱病变方面接受了更专业的培训，但尚无研究直接比较两组医生进行脊柱手术的结果。
方法
我们试图评估神经外科医生与骨科医生进行颈椎前路减压融合术（ACDF）时，手术时长、住院时间、并发症、死亡率及再入院情况的差异。
结果
分析了17967例ACDF手术。神经外科医生实施了74.3%的融合手术，手术时间有延长趋势，且有更多患者出院后转至长期护理机构。比较两个专业时，住院时间、总体并发症、死亡率、再入院率或再次手术率无显著差异。
结论
尽管神经外科医生实施的ACDF手术量显著更高，但骨科和神经外科手术后的结果相当。
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