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微创腰椎手术后的术后疲劳影响。

Impact of postoperative fatigue following minimally-invasive lumbar spine surgery.

机构信息

Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.

Department of Anesthesiology, Mayo Clinic, Jacksonville, FL, USA.

出版信息

J Clin Neurosci. 2023 Jun;112:64-67. doi: 10.1016/j.jocn.2023.04.013. Epub 2023 Apr 25.

Abstract

BACKGROUND

Postoperative fatigue is a distressing symptom and can have a major impact on the patient's quality of life after surgery. We investigate the extent of postoperative fatigue following minimally invasive spine surgery under general anesthesia (GA), and its impact on patients' quality of life (QOL) and activities of daily living (ADLs).

METHODS

We surveyed patients that underwent minimally-invasive lumbar spine surgery under GA within the previous year. A five-point Likert scale ("very much", "quite a bit", "somewhat", "a little bit", "not at all") was used to assess the extent of fatigue during the first postoperative month, its impact on QOL, and ADLs.

RESULTS

The survey was completed by 100 patients, 61% were male, mean age 64.6 ± 12.5 years, 31% underwent MIS-TLIF, 69% lumbar laminectomy. During the first postoperative month 45% of patients referred significant fatigue ("very much" or "quite a bit"); for 31% of patients fatigue significantly impacted their QOL; significantly limited their ADLs in 43% of patients. MIS-TLIF was associated with higher rate of postoperative fatigue compared to laminectomy (61.3% versus 37.7%, p = 0.02). Patients 65 years old or older had higher rates of fatigue compared to younger patients (55.6% versus 32.6%, p = 0.02). We did not observe a significant difference in postoperative fatigue between male and female patients.

CONCLUSIONS

Our study revealed a substantial incidence of postoperative fatigue in patients that underwent minimally-invasive lumbar spine surgery under GA, with a significant impact on QOL and ADLs. There is a need to research new strategies to reduce fatigue after spine surgery.

摘要

背景

术后疲劳是一种令人痛苦的症状,会对患者术后的生活质量产生重大影响。我们调查了全身麻醉(GA)下微创脊柱手术后的术后疲劳程度,及其对患者生活质量(QOL)和日常生活活动(ADLs)的影响。

方法

我们调查了过去一年内接受 GA 下微创腰椎手术的患者。采用 5 分李克特量表(“非常多”、“相当多”、“有些”、“有点”、“一点也不”)评估术后第一个月的疲劳程度、对 QOL 的影响以及 ADLs。

结果

共有 100 名患者完成了调查,其中 61%为男性,平均年龄 64.6±12.5 岁,31%接受了 MIS-TLIF,69%行腰椎椎板切除术。术后第一个月,45%的患者出现明显疲劳(“非常多”或“相当多”);31%的患者疲劳明显影响了他们的 QOL;43%的患者 ADLs 明显受限。与椎板切除术相比,MIS-TLIF 术后疲劳发生率更高(61.3%比 37.7%,p=0.02)。65 岁或以上的患者比年轻患者疲劳发生率更高(55.6%比 32.6%,p=0.02)。我们没有观察到男女患者术后疲劳的显著差异。

结论

我们的研究表明,全身麻醉下微创腰椎手术患者术后疲劳发生率较高,对 QOL 和 ADLs 有显著影响。需要研究新的策略来减少脊柱手术后的疲劳。

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