Department of Neurosurgery, Spine Center, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Spine (Phila Pa 1976). 2022 Mar 1;47(5):396-404. doi: 10.1097/BRS.0000000000004260.
Retrospective cohort study.
The aim of this study was to analyze postoperative complications and recovery patterns in different modified 11-item frailty index (mFI-11) groups after lateral lumbar interbody fusion (LLIF) surgery.
The relationship between the mFI-11 score and LLIF surgery has not been previously reported.
A single-center, consecutive series of patients who underwent LLIF with at least two years of follow-up were retrospectively reviewed. Complications after LLIF surgery were recorded. Clinical outcomes, including the visual analog scale (VAS) for back/leg pain and the Oswestry Disability Index (ODI), were evaluated preoperatively and at 1 and 2 years postoperatively. The proportions of patients who achieved substantial clinical benefit (SCB) for the VAS-B, VAS-L, and ODI were also analyzed.
One hundred fifty-two patients included in the present study were grouped according to their mFI-11 score: 0 (n = 39), 0.09 (n = 69), 0.18 (n = 31), and ≥0.27 (n = 13). An mFI-11 score ≥0.27 was a significant predictor of urinary complications (adjusted odds ratio: 3.829, P = 0.013). At 2 years postoperatively, patients in all frailty categories experienced improvements in the VAS for back pain, VAS for leg pain, and ODI, without significant differences between the four groups (p = 0.182, 0.121, and 0.804, respectively). There were also no significant differences in the proportions of patients achieving SCB for back/leg pain and the ODI between the four groups (P = 0.843, 0.957, and 0.915, respectively).
An mFI-11 score was found to be independently associated with urologic complications in patients who underwent LLIF. Patients in all frailty categories experienced significant improvements in back pain, leg pain, and the ODI at 1 year and 2 years postoperatively. LLIF surgery may be useful for patients with high frailty index.Level of Evidence: 4.
回顾性队列研究。
本研究旨在分析不同改良 11 项虚弱指数（mFI-11）组在侧路腰椎椎间融合术（LLIF）后的术后并发症和恢复模式。
mFI-11 评分与 LLIF 手术之间的关系尚未有报道。
对单中心、连续接受 LLIF 治疗且随访时间至少 2 年的患者进行回顾性分析。记录 LLIF 术后的并发症。在术前及术后 1 年和 2 年评估临床结果，包括视觉模拟量表（VAS）背部/腿部疼痛和 Oswestry 功能障碍指数（ODI）。还分析了 VAS-B、VAS-L 和 ODI 达到显著临床获益（SCB）的患者比例。
本研究共纳入 152 例患者，根据 mFI-11 评分分组：0 分（n=39）、0.09 分（n=69）、0.18 分（n=31）和≥0.27 分（n=13）。mFI-11 评分≥0.27 是尿并发症的显著预测因素（调整后的优势比：3.829，P=0.013）。术后 2 年，所有虚弱组别的患者 VAS 背部疼痛、VAS 腿部疼痛和 ODI 均有改善，四组间无显著差异（分别为 P=0.182、0.121 和 0.804）。四组患者在 VAS 背部/腿部疼痛和 ODI 达到 SCB 的比例也无显著差异（分别为 P=0.843、0.957 和 0.915）。
mFI-11 评分与接受 LLIF 的患者的泌尿系统并发症独立相关。所有虚弱程度组的患者在术后 1 年和 2 年均有显著的背部疼痛、腿部疼痛和 ODI 改善。LLIF 手术可能对高虚弱指数的患者有益。
4 级
