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神经肌肉性脊柱侧凸:双医师治疗策略。

Neuromuscular Scoliosis: A Dual-Surgeon Approach.

机构信息

Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, USA.

Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, USA.

出版信息

World Neurosurg. 2022 Nov;167:e1045-e1049. doi: 10.1016/j.wneu.2022.08.128. Epub 2022 Sep 2.

Abstract

OBJECTIVE

Neuromuscular Scoliosis (NMS) causes severe deformity and operative correction for these patients carries high complication rates. We present a retrospective study comparing a series of consecutive patients who underwent posterior fusion via a single-surgeon (SS) approach with a consecutive series of patients treated via a dual-surgeon (DS) approach.

METHODS

Patients with NMS who underwent posterior fusion via a SS approach from 2019 to 2022 were analyzed and compared to a series of patients with NMS who underwent posterior fusion via a DS approach.

RESULTS

In the SS group, the average estimated blood loss (EBL) was 675 mL, average length of stay (LOS) was 6.3 days, average operative time (OT) was 6.5 hours, average packed red blood cell transfusion was 1.5 units, with a complication rate of 30%. The DS group had an average EBL of 400 mL, a LOS of 4.8 days, an OT of 4.75 hours, an average packed red blood cell transfusion of 0.8 units, with a complication rate of 20%. The DS approach was significant for a lower EBL, OT (P < 0.001), and LOS (P < 0.03).

CONCLUSIONS

This study suggests that for patients with NMS the DS approach decreases OT, EBL, complication rates, and LOS. This further supports that this approach may benefit outcomes in NMS patients.

摘要

目的

神经肌肉性脊柱侧凸(NMS)导致严重畸形,此类患者的手术矫正并发症发生率较高。我们进行了一项回顾性研究,比较了一组连续接受单外科医生(SS)入路后路融合的患者和一组连续接受双外科医生(DS)入路后路融合的患者。

方法

分析了 2019 年至 2022 年间接受 SS 入路后路融合的 NMS 患者,并与一组接受 DS 入路后路融合的 NMS 患者进行比较。

结果

在 SS 组中,平均估计失血量(EBL)为 675 毫升,平均住院时间(LOS)为 6.3 天,平均手术时间(OT)为 6.5 小时,平均输红细胞单位为 1.5 个,并发症发生率为 30%。DS 组的平均 EBL 为 400 毫升,LOS 为 4.8 天,OT 为 4.75 小时,平均输红细胞单位为 0.8 个,并发症发生率为 20%。DS 入路在 EBL、OT(P<0.001)和 LOS(P<0.03)方面有显著优势。

结论

本研究表明,对于 NMS 患者,DS 入路可减少 OT、EBL、并发症发生率和 LOS。这进一步支持该方法可能有益于 NMS 患者的结局。

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