Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Department of Anaesthesiology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
BMC Musculoskelet Disord. 2021 May 4;22(1):413. doi: 10.1186/s12891-021-04225-5.
There has been a growing interest in using all pedicle screw construct in posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) surgery in recent years. However, studies focusing on perioperative outcome and complications utilizing only pedicle screw system in AIS population are lacking. This study aims to evaluate perioperative outcomes and to determine the prevalence of major and minor complications following single-staged PSF for AIS.
In this retrospective study of prospectively collected data, 1057 AIS patients operated between 2012 and 2019 were included. Main outcome measures were operative time, intraoperative blood loss, allogeneic blood transfusion rate, length of hospital stay after surgery, complication rate, and mean drop of haemoglobin (Hb) level. We documented the number of fusion levels, screw density, and postoperative radiographic parameters.
There were 917 females and 140 males. Majority were Lenke 1 curve type (46.9%). Mean age was 15.6 ± 3.7 years, with mean BMI of 18.6 ± 3.2 kg/m. Mean operative time was 146.8 ± 49.4 min. Average intraoperative blood loss was 952.9 ± 530.4 ml with allogeneic blood transfusion rate of 5%. Mean screw density was 1.27 ± 0.21 screws per fusion level. Average hospital stay after surgery was 3.5 ± 0.9 days. Twenty-four complications were documented: twelve superficial infections (1.14%), five transient neurological deficits (0.47%), two deep infections (0.19%), two superior mesenteric artery syndrome, and one case each (0.09%) for massive intraoperative blood loss, intraoperative seizure, and lung atelectasis.
AIS patients treated with single-staged PSF using pedicle screw construct had a 0.95% rate of major complications and 1.32% rate of minor complications. Rate of neurologic complication was 0.47% while non-neurologic postoperative complications was 1.80% with infection being the leading complication at 1.32%.
近年来，人们对在后路脊柱融合术（PSF）中使用全椎弓根螺钉固定治疗青少年特发性脊柱侧凸（AIS）越来越感兴趣。然而，缺乏专门针对 AIS 人群使用椎弓根螺钉系统的围手术期结果和并发症的研究。本研究旨在评估单阶段 PSF 治疗 AIS 的围手术期结果，并确定主要和次要并发症的发生率。
本研究为前瞻性收集数据的回顾性研究，纳入了 2012 年至 2019 年间接受手术的 1057 例 AIS 患者。主要观察指标为手术时间、术中失血量、异体输血率、术后住院时间、并发症发生率和平均血红蛋白（Hb）水平下降量。我们记录了融合节段数、螺钉密度和术后影像学参数。
患者中 917 例为女性，140 例为男性；大多数为 Lenke 1 型曲线（46.9%）。平均年龄为 15.6±3.7 岁，平均 BMI 为 18.6±3.2kg/m2。平均手术时间为 146.8±49.4 分钟，平均术中失血量为 952.9±530.4ml，异体输血率为 5%。平均螺钉密度为 1.27±0.21 枚/融合节段。术后平均住院时间为 3.5±0.9 天。共记录了 24 例并发症：12 例浅表感染（1.14%），5 例短暂性神经功能障碍（0.47%），2 例深部感染（0.19%），2 例肠系膜上动脉综合征，1 例大出血（0.09%）、术中癫痫发作（0.09%）和肺不张（0.09%）各 1 例。
采用全椎弓根螺钉固定的单阶段 PSF 治疗 AIS 的主要并发症发生率为 0.95%，次要并发症发生率为 1.32%。神经并发症发生率为 0.47%，术后非神经并发症发生率为 1.80%，感染是 1.32%的主要并发症。
