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吸烟对微创脊柱融合手术的影响。

The influence of smoking in minimally invasive spinal fusion surgery.

作者信息

Senker Wolfgang, Stefanits Harald, Gmeiner Matthias, Trutschnig Wolfgang, Radl Christian, Gruber Andreas

机构信息

Department of Neurosurgery, Kepler University Hospital, Neuromed Campus, Linz, Austria.

Department of Mathematics, University of Salzburg, Salzburg, Austria.

出版信息

Open Med (Wars). 2021 Jan 27;16(1):198-206. doi: 10.1515/med-2021-0223. eCollection 2021.

Abstract

BACKGROUND

The impact of smoking on spinal surgery has been studied extensively, but few investigations have focused on minimally invasive surgery (MIS) of the spine and the difference between complication rates in smokers and non-smokers. We evaluated whether a history of at least one pack-year preoperatively could be used to predict adverse peri- and postoperative outcomes in patients undergoing minimally invasive fusion procedures of the lumbar spine. In a prospective study, we assessed the clinical effectiveness of MIS in an unselected population of 187 patients.

METHODS

We evaluated perioperative and postoperative complication rates in MIS fusion techniques of the lumbar spine in smoking and non-smoking patients. MIS fusion was performed using interbody fusion procedures and/or posterolateral fusion alone.

RESULTS

Smokers were significantly younger than non-smokers. We did not encounter infection at the site of surgery or severe wound healing disorder in smokers. We registered no difference between the smoking and non-smoking groups with regard to peri- or postoperative complication rate, blood loss, or length of stay in hospital. We found a significant influence of smoking ( = 0.049) on the overall perioperative complication rate.

CONCLUSION

MIS fusion techniques seem to be a suitable tool for treating degenerative spinal disorders in smokers.

摘要

背景

吸烟对脊柱手术的影响已得到广泛研究,但很少有研究聚焦于脊柱微创手术(MIS)以及吸烟者与非吸烟者并发症发生率的差异。我们评估了术前至少有1包年吸烟史是否可用于预测接受腰椎微创融合手术患者围手术期和术后的不良结局。在一项前瞻性研究中,我们评估了187例未经过筛选的患者群体中MIS的临床有效性。

方法

我们评估了吸烟和不吸烟患者腰椎MIS融合技术的围手术期和术后并发症发生率。MIS融合手术采用椎间融合手术和/或单纯后外侧融合。

结果

吸烟者明显比非吸烟者年轻。我们在吸烟者中未遇到手术部位感染或严重伤口愈合障碍。在围手术期或术后并发症发生率、失血量或住院时间方面,我们未发现吸烟组和非吸烟组之间存在差异。我们发现吸烟(P = 0.049)对围手术期总体并发症发生率有显著影响。

结论

MIS融合技术似乎是治疗吸烟者退行性脊柱疾病的合适工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2527/7863003/68720629264c/j_med-2021-0223-fig001.jpg

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