Hospital General Obispo Polanco (Orthopaedic Surgery and Traumatology Service), Teruel, Spain.
Hospital Universitario Miguel Servet, (Orthopaedic Surgery and Traumatology Service, Spine surgery), Zaragoza, Spain.
Int Orthop. 2024 Feb;48(2):555-561. doi: 10.1007/s00264-023-06047-7. Epub 2023 Nov 29.
Main question The aim of this study is to describe and analyze the frequency of acute perioperative (intraoperatively and 30 days after) complications of open/MISS thoracolumbar spine surgery. Secondary questions A) Describe the treatment of choice for every kind of complication mentioned. B) Perform a bibliographic search and compare the complications described and their frequency with those studied in the manuscript.
A retrospective cohort of 816 patients undergoing spinal surgery over a two year period was analyzed. Acute complications of 59 patients are described whether those with a greater number of levels required longer periods of hospitalization.
The frequency of acute complications was 7.2%. The most common was infection (2.7%), followed by dural tear (1.7%), and screw malpositioning (1%), which is consistent with the current literature. No statistically significant results were observed when comparing the mean length of hospital stay among patients operated on a greater number of levels compared to the rest (P: 0.344; 95% CI: -3.88-10.93).
The subsidiary patient of spinal surgery is getting older and has more comorbidities, and therefore, has a higher risk of complications. Although there are models predicting the risk of complications, they are not used in routine clinical practice. It would be necessary to unify the main criteria and establish guidelines for risk detection and therapeutic algorithms based on new high-quality studies.
主要问题
本研究旨在描述和分析开胸/微创胸腰椎手术围手术期(术中及术后 30 天内)急性并发症的发生频率。
次要问题
A)描述每种提到的并发症的首选治疗方法。
B)进行文献检索,并将描述的并发症及其频率与本文研究的并发症进行比较。
对两年间接受脊柱手术的 816 例患者进行回顾性队列分析。描述了 59 例患者的急性并发症,无论这些患者需要进行更多的手术水平,是否会导致更长的住院时间。
急性并发症的发生率为 7.2%。最常见的是感染(2.7%),其次是硬脊膜撕裂(1.7%)和螺钉位置不当(1%),这与当前文献一致。与其他患者相比,接受更多手术水平的患者的平均住院时间没有统计学意义(P:0.344;95%CI:-3.88-10.93)。
脊柱手术的患者年龄更大,合并症更多,因此并发症风险更高。尽管有预测并发症风险的模型,但它们并未在常规临床实践中使用。有必要统一主要标准,并根据新的高质量研究建立风险检测和治疗算法指南。