Department of Orthopedics of Peking Union Medical College Hospital, 1st Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China.
BMC Musculoskelet Disord. 2021 Dec 13;22(1):1039. doi: 10.1186/s12891-021-04931-0.
Retrospective case series.
This study aimed to determine the prevalence and risk factors for orthostatic hypotension (OH) in adolescents undergoing posterior spinal fusion for spinal deformity correction.
The data of 282 consecutive adolescents who underwent posterior spinal fusion for spinal deformity correction in our center over 12 months were retrieved. Patient characteristics, including whether laminectomy or osteotomy was performed during the surgery, the occurrence of postoperative nausea and vomiting (PONV), perioperative hemoglobin albumin changes, perioperative blood transfusion, length of bed rest, willingness to ambulate, length of postoperative exercises of the lower limbs, and length of hospital stay, were collected and compared statistically between patients who did and did not develop postoperative OH.
Of 282 patients, 197 (69.86%) developed OH postoperatively, and all cases completely resolved 5 days after the first out-of-bed exercises. Significant differences in the incidence of PONV, the willingness to ambulate and the length of postoperative exercises of the lower limbs were observed. The mean length of hospital stay of the patients with OH was longer than that of the patients without OH.
Our study suggests that temporary OH is a common manifestation following posterior spinal fusion for spinal deformity correction in adolescents. Postoperative OH may increase the length of hospital stay in these patients. Patients with PONV, who are not willing to ambulate and who perform postoperative lower limb exercises for a shorter time are more likely to have OH.
回顾性病例系列研究。
本研究旨在确定脊柱畸形后路脊柱融合术治疗的青少年患者中直立性低血压（OH）的发生率和危险因素。
回顾性分析了在我院接受脊柱畸形后路脊柱融合术的 282 例连续青少年患者的数据。收集患者特征，包括手术期间是否行椎板切除术或截骨术、术后恶心呕吐（PONV）的发生、围手术期血红蛋白白蛋白变化、围手术期输血、卧床休息时间、是否愿意下床活动、下肢术后运动时间和住院时间等，并对发生和未发生术后 OH 的患者进行统计学比较。
282 例患者中，197 例（69.86%）术后发生 OH，所有病例在首次离床活动后 5 天完全缓解。PONV、下床意愿和下肢术后运动时间的发生率存在显著差异。OH 患者的平均住院时间长于无 OH 患者。
本研究表明，青少年脊柱畸形后路脊柱融合术后暂时性 OH 较为常见。术后 OH 可能会增加这些患者的住院时间。PONV 患者、不愿意下床活动以及下肢术后运动时间较短的患者更容易发生 OH。
