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单节段腰椎结核后路斜外侧椎间融合术的学习曲线和并发症分析:一项回顾性单中心连续研究。

Learning curve and complication analysis of oblique lateral interbody fusion in cases with single-segment lumbar tuberculosis: a retrospective single-center consecutive study.

机构信息

Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, No. 1 YouYi Road, Yuan Jia Gang, Yu Zhong District, Chongqing, 400016, Chongqing, China.

Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016, China.

出版信息

BMC Musculoskelet Disord. 2024 Oct 30;25(1):871. doi: 10.1186/s12891-024-07968-z.

DOI:10.1186/s12891-024-07968-z
PMID:39478513
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11523855/
Abstract

OBJECTIVE

Oblique lateral interbody fusion (OLIF) is becoming widely used in patients with single-segment spinal tuberculosis (STB). The learning curve and complications associated with OLIF for the treatment of STB are still unknown. This study aims to figure out the learning curve and associated complications experience of OLIF for the treatment of STB.

METHODS

Between September 2018 and August 2023, 61 STB patients underwent OLIF plus percutaneous pedicle screw fixation (PPSF) were consecutively included in this research. Cumulative sum analysis (CUSUM) was applied to establish the learning curve of OLIF and determine the cut-off case number. All cases were divided into learning and experienced groups based on the cut-off case number. Clinical characteristics and relating surgical complications were compared and analyzed between the two groups.

RESULTS

The best-fitting curve was quadratic. The fitting equation was CUSUM (min) = 95.83 + 34.16x - 0.611 x  (x means operation case). The cut-off operation case number was 27 cases. The presence of significant differences particularly in the duration of operation, operative blood loss, overall incidence, and severity of postoperative complications was noteworthy between the two groups.

CONCLUSION

A total of 27 cases is the minimum number to master OLIF combined with PPSF for the treatment of patients with single-segment STB. When surgeons master this operation, the operative time, operative blood loss, overall incidence, and severity of postoperative complications will improve.

摘要

目的

斜外侧椎间融合术(OLIF)在单节段脊柱结核(STB)患者中得到广泛应用。OLIF 治疗 STB 的学习曲线和相关并发症尚不清楚。本研究旨在探讨 OLIF 治疗 STB 的学习曲线和相关并发症的经验。

方法

2018 年 9 月至 2023 年 8 月,连续纳入 61 例 STB 患者行 OLIF 联合经皮椎弓根螺钉固定术(PPSF)。采用累积和分析(CUSUM)确定 OLIF 的学习曲线和截止病例数。根据截止病例数将所有病例分为学习组和经验组。比较和分析两组的临床特征和相关手术并发症。

结果

最佳拟合曲线为二次曲线。拟合方程为 CUSUM(min)= 95.83 + 34.16x - 0.611x(x 表示手术病例数)。截止手术病例数为 27 例。两组在手术时间、手术出血量、总体发生率和术后并发症严重程度方面存在显著差异。

结论

对于单节段 STB 患者,掌握 27 例 OLIF 联合 PPSF 的手术是掌握该技术的最低病例数。当外科医生掌握该手术时,手术时间、手术出血量、总体发生率和术后并发症严重程度将得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c52/11523855/159e604a1725/12891_2024_7968_Figc_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c52/11523855/e67f60371d7a/12891_2024_7968_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c52/11523855/c29faaed86d1/12891_2024_7968_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c52/11523855/0c6e8aea4472/12891_2024_7968_Figa_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c52/11523855/f5585dfcb4c1/12891_2024_7968_Figb_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c52/11523855/159e604a1725/12891_2024_7968_Figc_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c52/11523855/e67f60371d7a/12891_2024_7968_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c52/11523855/c29faaed86d1/12891_2024_7968_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c52/11523855/0c6e8aea4472/12891_2024_7968_Figa_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c52/11523855/f5585dfcb4c1/12891_2024_7968_Figb_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c52/11523855/159e604a1725/12891_2024_7968_Figc_HTML.jpg

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本文引用的文献

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Learning Curve and Complications of Unilateral Biportal Endoscopy: Cumulative Sum and Risk-Adjusted Cumulative Sum Analysis.单侧双孔道内镜检查的学习曲线及并发症:累积和与风险调整累积和分析
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One-stage freehand minimally invasive pedicle screw fixation combined with mini-access surgery through OLIF approach for the treatment of lumbar tuberculosis.经椎间孔入路单阶段徒手微创置钉结合小切口手术治疗腰椎结核。
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Oblique lateral interbody fusion combined percutaneous pedicle screw fixation in the surgical treatment of single-segment lumbar tuberculosis: A single-center retrospective comparative study.后路斜外侧椎间融合联合经皮椎弓根螺钉固定术治疗单节段腰椎结核: 单中心回顾性对比研究。
Int J Surg. 2020 Nov;83:39-46. doi: 10.1016/j.ijsu.2020.09.012. Epub 2020 Sep 11.
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Comparison of anterior transthoracic debridement and fusion with posterior transpedicular debridement and fusion in the treatment of mid-thoracic spinal tuberculosis in adults.前路经胸病灶清除植骨融合术与后路经椎弓根病灶清除植骨融合术治疗成人胸中段脊柱结核的比较。
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