Department of Orthopaedic Surgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC, 3050, Australia.
Epworth Hospital Richmond, 89 Bridge Road, Richmond, VIC, 3121, Australia.
Arch Orthop Trauma Surg. 2023 Sep;143(9):5707-5712. doi: 10.1007/s00402-023-04936-5. Epub 2023 Jun 5.
Spinal fractures in fused spines such as in ankylosing spondylitis or DISH are typically of type B or C fractures where operative treatment is recommended. The mortality rate in non-operatively treated patients is reported to be 51%. The purpose of this study was to investigate the mortality rate, complication rate and demographics of patients following non-operatively treatment in fused spine injuries.
Between 2019 and 2021, a retrospective study was conducted including all patients who presented to our trauma center with a spinal fracture of a fused spine. Radiology and patient charts were analyzed for fracture pattern, complications, neurological deficit, comorbidities, and mortality rate.
A total of 49 patients were found at a mean age was 79.8 ± 10.9 years and primarily males were affected in 65.3%. All fractures were of type B and the thoracic spine was involved in 85.7%. The mean follow-up was 6.3 ± 8.2 months and fusion was obtained in all patients. No neurological deficit was observed in any. A total of 13 patients died at a mean age of 86.5 ± 10.0 years after 157.1 ± 158.1 days. 6 patients (10.2%) deceased within the first 6 weeks at a mean age of 91.8 ± 3.8 years. One patient each suffered from heart failure, an acute delirium, end stage colon cancer and subdural hemorrhage.
This study shows that the mortality rate in the first 6 weeks following a fracture in a fused spine is 10.2% for patients above the age of 90 years. Therefore, non-operative treatment should be taken into consideration as the mortality rate in other studies may be overestimated.
III, retrospective study.
强直性脊柱炎或弥漫性特发性骨肥厚等融合脊柱的脊柱骨折通常为 B 型或 C 型骨折，建议采用手术治疗。未经手术治疗的患者死亡率报告为 51%。本研究旨在调查非手术治疗融合脊柱损伤患者的死亡率、并发症发生率和人口统计学特征。
在 2019 年至 2021 年期间，进行了一项回顾性研究，纳入所有因融合脊柱骨折就诊于我院创伤中心的患者。对影像学和患者病历进行分析，以评估骨折类型、并发症、神经功能缺损、合并症和死亡率。
共发现 49 例患者，平均年龄为 79.8±10.9 岁，主要为男性（65.3%）。所有骨折均为 B 型，累及胸椎 85.7%。平均随访时间为 6.3±8.2 个月，所有患者均获得融合。无一例患者出现神经功能缺损。共有 13 例患者在平均年龄为 86.5±10.0 岁时死亡，平均随访时间为 157.1±158.1 天后死亡。6 例（10.2%）患者在最初的 6 周内死亡，平均年龄为 91.8±3.8 岁。每位患者各因心力衰竭、急性意识障碍、晚期结肠癌和硬膜下血肿而死亡。
本研究表明，90 岁以上患者融合脊柱骨折后 6 周内的死亡率为 10.2%。因此，应考虑非手术治疗，因为其他研究中的死亡率可能被高估。
III，回顾性研究。
