Butrico Casey, Meisel Hans Jörg, Sage Katherine
From the Kuros Biosciences, Bilthoven, The Netherlands (Butrico and Sage), and the Department of Neurosurgery, Bergmannstrost Hospital, Halle, Germany (Meisel).
J Am Acad Orthop Surg. 2024 Dec 15;32(24):1115-1121. doi: 10.5435/JAAOS-D-23-01167. Epub 2024 Jul 30.
Improvements in healthcare management have led to a decrease in perioperative and postoperative complications. However, perioperative medical complications and mortality rates continue to increase in patients undergoing elective spinal surgeries. This trend is driven by the increase in the older population and the rise in the number of patients with more than two comorbidities. Managing patients with multiple comorbidities requires additional resources, augmenting the financial and societal burden. Despite the high risk of complications and mortality, patients with multiple comorbidities undergo spinal surgery for degenerative spinal conditions daily. These findings highlight the need for heightened awareness, patient education, and management of comorbidities before elective spinal surgeries. This article comprehensively reviews literature on the effects of medical comorbidities on spinal fusion surgery outcomes to increase awareness of the surgical complications associated with comorbidities. In addition, suggested preoperative and postoperative comorbidity management strategies are outlined.
医疗保健管理的改善已导致围手术期和术后并发症减少。然而，择期脊柱手术患者的围手术期医疗并发症和死亡率仍在上升。这一趋势是由老年人口增加以及患有两种以上合并症的患者数量增加所驱动的。管理患有多种合并症的患者需要额外的资源，增加了财政和社会负担。尽管存在并发症和死亡的高风险，但患有多种合并症的患者每天仍因退行性脊柱疾病接受脊柱手术。这些发现凸显了在择期脊柱手术前提高认识、开展患者教育以及管理合并症的必要性。本文全面回顾了关于医疗合并症对脊柱融合手术结果影响的文献，以提高对与合并症相关的手术并发症的认识。此外，还概述了建议的术前和术后合并症管理策略。
