Cetik Riza M, Dimar John R, Brown Morgan E, Daniels Christy L, Carreon Leah
Orthopedics, Norton Leatherman Spine Center, Norton Healthcare, Louisville, USA.
Research, Norton Leatherman Spine Center, Norton Healthcare, Louisville, USA.
Cureus. 2024 Jul 15;16(7):e64587. doi: 10.7759/cureus.64587. eCollection 2024 Jul.
Anterior approaches to the lumbar spine have been used extensively for various indications but they are also associated with unique complications and have been linked with higher incisional morbidity.This study aimsto evaluate incisional morbidity related to anterior lumbar surgeries and to assess how incisional outcomes correlate with patient and surgery-related factors.
Patients ≥18 years old and with planned anterior lumbar fusions from L1 to S1 were prospectively enrolled. Follow-up ended at two years, and patients who did not complete the follow-up were excluded. Incision was assessed for general appearance, width, color, cross-hatching, hypertrophy, and pain by using a validated scoring system and a visual analog scale (VAS). Patient and surgery-related factors were analyzed for possible correlations with complications or wound-related parameters.
A total of 205 patients with a mean age of 54.4 ± 11.5 were included. Significant improvements were seen in color, hypertrophy, pain, and appearance of the incision. At two years, the mean patient-based VAS for appearance was 8.6 while surgeon-based VAS was 8.8. The total rate of complications was 9%, with no incisional hernia or bulging. No significant relation was found between incision-related parameters and the demographic and surgical variables.
This study reports acceptable cosmetic results and no chronic pain after anterior lumbar surgery, which is contrary to previous reports. Together with a low total rate of complications, anterior approaches are safe when carefully executed, and have low morbidity.
腰椎前路手术已广泛应用于各种适应证，但也伴有独特的并发症，且与较高的切口发病率相关。本研究旨在评估与腰椎前路手术相关的切口发病率，并评估切口结果与患者及手术相关因素之间的相关性。
前瞻性纳入年龄≥18岁且计划进行L1至S1腰椎前路融合术的患者。随访期为两年，未完成随访的患者被排除。通过使用经过验证的评分系统和视觉模拟量表（VAS）对切口的总体外观、宽度、颜色、交叉纹理、肥厚情况及疼痛进行评估。分析患者及手术相关因素与并发症或伤口相关参数之间可能存在的相关性。
共纳入205例患者，平均年龄为54.4±11.5岁。切口的颜色、肥厚情况、疼痛及外观有显著改善。两年时，基于患者的外观VAS平均为8.6，基于外科医生的VAS为8.8。并发症总发生率为9%，无切口疝或切口膨出。未发现切口相关参数与人口统计学及手术变量之间存在显著关系。
本研究报告了腰椎前路手术后可接受的美容效果且无慢性疼痛，这与既往报道相反。连同较低的并发症总发生率，精心实施时前路手术是安全的，发病率低。
