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成功的门诊颈椎手术疗效:波兰前100例患者的安全性、有效性及早期经验

Performance of successful ambulatory cervical spine surgery: safety, efficacy, and early experiences of first 100 cases in Poland.

作者信息

Latka Kajetan, Kolodziej Waldemar, Pawus Dawid, Bielecki Mateusz, Latka Dariusz

机构信息

Department of Neurosurgery, University of Opole, Opole, Poland.

Center for Minimally Invasive Spine and Peripheral Nerve Surgery, Opole, Poland.

出版信息

Br J Neurosurg. 2024 Jul 15:1-6. doi: 10.1080/02688697.2024.2378825.

Abstract

BACKGROUND

Ambulatory anterior cervical discectomy and fusion (ACDF) is a promising method, but not common in Poland.

OBJECTIVE

That is why the purpose of this study was to demonstrate the experience of performing ACDF in patients with degenerative spinal diseases.

METHODS

This study at the Spine Centre involved a single-center, multi-surgeon evaluation of 100 patients undergoing ACDF.

RESULTS

Outcomes assessed included pain severity, measured by the visual analogue scale, which improved from 4.28 ± 0.76 preoperatively to 1.11 ± 0.59 one month postoperatively. The Core Outcome Measures Index-neck (COMI-neck) scale also showed significant improvement: before surgery, 30% of patients scored their condition severity between 4-6, and 70% scored 7-10; 6 months postoperatively, the scores were 0-3 for 55% of patients, 4-6 for 45%, and 7-10 for none. Only 2% of patients experienced moderate, temporary complications, with no serious complications or postoperative hematomas observed.

CONCLUSION

The study supports the feasibility, safety, and efficacy of performing ACDF in an ambulatory setting, suggesting that with appropriate patient selection and surgical protocols, ambulatory ACDF can be more broadly implemented.

摘要

背景

非住院前路颈椎间盘切除融合术(ACDF)是一种很有前景的方法,但在波兰并不常见。

目的

这就是本研究的目的是展示在退行性脊柱疾病患者中进行ACDF的经验。

方法

本脊柱中心的研究涉及对100例行ACDF手术患者的单中心、多外科医生评估。

结果

评估的结果包括疼痛严重程度,通过视觉模拟量表测量,术前为4.28±0.76,术后1个月改善至1.11±0.59。核心结局指标指数-颈部(COMI-颈部)量表也显示出显著改善:术前,30%的患者病情严重程度评分为4-6分,70%评分为7-10分;术后6个月,55%的患者评分为0-3分,45%评分为4-6分,7-10分的患者无。仅2%的患者出现中度、暂时性并发症,未观察到严重并发症或术后血肿。

结论

该研究支持在非住院环境下进行ACDF的可行性、安全性和有效性,表明通过适当的患者选择和手术方案,非住院ACDF可更广泛地实施。

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