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老年患者的腰椎融合术,是一个好的选择吗?一家老年医院并发症及疼痛改善情况的回顾性分析

Lumbar arthrodesis in elderly patients, is it a good option? A retrospective analysis of complications and pain improvement in a geriatric hospital.

作者信息

González-Vargas Pedro Miguel, Thenier-Villa José Luis, Riveiro Antonio, Castro Julián, Varela Pilar, Lista Olalla, Raposo Martín, Pastor Ana, Pou Juan

机构信息

Complejo Hospitalario de Ourense, Ourense, Spain.

出版信息

Eur Spine J. 2025 May 29. doi: 10.1007/s00586-025-08944-4.

Abstract

INTRODUCTION

Lumbar arthrodesis is a well-established surgical procedure for degenerative spinal diseases, but its use in patients over 75 remains controversial due to potential complications. This retrospective study evaluates complication rates and postoperative pain control in elderly patients.

METHODS

A total of 150 patients over 75 years old underwent lumbar arthrodesis with laminectomy between 2015 and 2022 in a hospital in Galicia, Spain. Patients with tumors, infections, scoliosis, trauma, or prior spinal surgeries were excluded. Follow-up lasted three years and included clinical and imaging assessments.

RESULTS

  • Mean age: 78.9 years; 62% female.- Common comorbidities: hypertension (70.7%), osteoporosis (64.4%).- Postoperative complications: 5.3%, including infection, epidural hematoma, pseudoarthrosis, among others.- Significant pain improvement on the Visual Analog Scale (VAS): from 7.82 preoperatively to 2.41 postoperatively.- No statistically significant associations were found between age, number of surgical levels, or comorbidities and the presence of complications.

CONCLUSIONS

Lumbar arthrodesis with laminectomy in well-selected elderly patients over 75 may be a safe and effective option for pain relief. Advanced age alone does not imply a higher risk of complications. This study supports its use in geriatric populations under well-defined criteria.

摘要

引言

腰椎融合术是治疗退行性脊柱疾病的一种成熟手术方法,但由于存在潜在并发症,其在75岁以上患者中的应用仍存在争议。本回顾性研究评估老年患者的并发症发生率和术后疼痛控制情况。

方法

2015年至2022年期间,西班牙加利西亚一家医院共有150例75岁以上患者接受了腰椎融合术并进行了椎板切除术。排除患有肿瘤、感染、脊柱侧弯、创伤或既往有脊柱手术史的患者。随访持续三年,包括临床和影像学评估。

结果

  • 平均年龄:78.9岁;62%为女性。- 常见合并症:高血压(70.7%),骨质疏松症(64.4%)。- 术后并发症:5.3%,包括感染、硬膜外血肿、假关节形成等。- 视觉模拟量表(VAS)疼痛评分显著改善:术前为7.82,术后为2.41。- 在年龄、手术节段数量或合并症与并发症的发生之间未发现统计学上的显著关联。

结论

对于精心挑选的75岁以上老年患者,腰椎融合术联合椎板切除术可能是缓解疼痛的一种安全有效的选择。仅高龄并不意味着并发症风险更高。本研究支持在明确标准下将其应用于老年人群。

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