Marie-Hardy Laura, Khalifé Marc, Pietton Raphaël, Rollet Marie-Eva, Boissière L, Cohen-Bittan J, Pascal-Moussellard H
Pitié-Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 20, rue Leblanc, Paris, France; Université de Paris, Paris, France.
Gerontol Geriatr Med. 2024 Jan 16;10:23337214231225841. doi: 10.1177/23337214231225841. eCollection 2024 Jan-Dec.
Patients and surgeons may be reluctant on spinal surgery over 80 years old, fearing medical complications despite the possible improvement on quality of life. However, fewer reservations for lower limb prosthetic surgery (LLPS) seem to be arisen in this population. Is spinal surgery after 80 years-old responsible of more complications than lower limb surgery? The consecutive files of 164 patients over 80 years that had spinal surgery or LLPS were analyzed. The data collected pre-operatively were demographic, clinical and post-operatively the number and types of medical complications and length of stay. The mean number of medical complications was 1.11 ± 0.6 [0-6] for spinal surgery and 1.09 ± 1.0 [0-3] for LLPS, ( = 0,87). The length of stay in orthopedic unit was comparable between the two groups: 10.7 ± 4.9 days [2-36] for SS and 10.7 ± 3.0 days [5-11] for LLPS ( = 0,96). The global rate of peri-operative complications and the length of hospital stay were similar between spinal surgery and lower limb prosthetic surgery. These results may be explained by the rising cooperation between geriatric specialist and surgeons and the development of mini-invasive surgical technics, diminishing the early post-operative complication rates.
患者和外科医生可能不愿为80岁以上的患者进行脊柱手术,尽管脊柱手术可能改善生活质量,但他们担心会出现医疗并发症。然而,这一人群对下肢假肢手术(LLPS)的顾虑似乎较少。80岁以上患者进行脊柱手术比下肢手术更容易引发更多并发症吗?我们分析了164例80岁以上接受脊柱手术或LLPS的患者的连续病历。术前收集的数据包括人口统计学、临床数据,术后收集的是医疗并发症的数量和类型以及住院时间。脊柱手术的平均医疗并发症数量为1.11±0.6[0 - 6],LLPS为1.09±1.0[0 - 3],(P = 0.87)。两组在骨科病房的住院时间相当:脊柱手术为10.7±4.9天[2 - 36],LLPS为10.7±3.0天[5 - 11],(P = 0.96)。脊柱手术和下肢假肢手术的围手术期并发症总发生率和住院时间相似。这些结果可能是由于老年专科医生和外科医生之间的合作增加以及微创外科技术的发展,降低了术后早期并发症的发生率。