Baroncini Alice, Migliorini Filippo, Langella Francesco, Barletta Paolo, Trobisch Per, Cecchinato Riccardo, Damilano Marco, Quarto Emanuele, Lamartina Claudio, Berjano Pedro
IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi, 4, 20161 Milan, Italy.
Department of Orthopaedic Surgery, RWTH Uniklinik Aachen, 52074 Aachen, Germany.
J Clin Med. 2021 Dec 28;11(1):144. doi: 10.3390/jcm11010144.
Identifying perioperative factors that may influence the outcomes of long spine fusion for the treatment of adult deformity is key for tailored surgical planning and targeted informed consent. The aim of this study was to analyze the association between demographic or perioperative factors and clinical outcomes 2 years after long spine fusion for the treatment of adult deformity.
This study is a multivariate analysis of retrospectively collected data. All patients who underwent long fusion of the lumbar spine for adult spinal deformity (January 2016-June 2019) were included. The outcomes of interest were the Oswestry disability index (ODI), visual analogic scale (VAS) preoperatively and at 1 and 2 years' follow up, age, body mass index, American Society of Anaesthesiologists (ASA) score, upper and lowest instrumented vertebrae (UIV and LIV, respectively), length of surgery, estimated blood loss, and length of hospital stay.
Data from 192 patients were available. The ODI at 2 years correlated weakly to moderately with age ( 0.4), BMI ( 0.2), ASA ( 0.3), and LIV ( 0.2), and strongly with preoperative ODI ( 0.6). The leg VAS at 2 years moderately correlated with age ( 0.3) and BMI ( 0.3).
ODI and VAS at 2 years' follow-up had no to little association to preoperative age, health status, LIV, or other peroperative data, but showed a strong correlation with preoperative ODI and pain level.
确定可能影响成人脊柱畸形长节段脊柱融合术治疗效果的围手术期因素，是进行个性化手术规划和针对性知情同意的关键。本研究的目的是分析成人脊柱畸形长节段脊柱融合术后2年的人口统计学或围手术期因素与临床疗效之间的关联。
本研究是对回顾性收集的数据进行多变量分析。纳入了所有因成人脊柱畸形接受腰椎长节段融合术的患者（2016年1月至2019年6月）。感兴趣的结果指标包括术前、术后1年和2年的Oswestry功能障碍指数（ODI）、视觉模拟评分法（VAS）、年龄、体重指数、美国麻醉医师协会（ASA）评分、上终椎和下终椎（分别为UIV和LIV）、手术时长、估计失血量和住院时长。
有192例患者的数据可供分析。术后2年的ODI与年龄（r = 0.4）、体重指数（r = 0.2）、ASA评分（r = 0.3）和下终椎（r = 0.2）呈弱至中度相关，与术前ODI呈强相关（r = 0.6）。术后2年的腿部VAS与年龄（r = 0.3）和体重指数（r = 0.3）呈中度相关。
术后2年的ODI和VAS与术前年龄、健康状况、下终椎或其他手术数据无至几乎无关联，但与术前ODI和疼痛水平密切相关。
