Ito Sadayuki, Imagama Shiro, Nakashima Hiroaki, Machino Masaaki, Sakai Toshinori, Aizawa Toshimi, Arima Hideyuki, Hamanaka Hideaki, Ishimoto Yuyu, Kato Satoshi, Kawaguchi Yoshiharu, Konishi Hiroaki, Miyakoshi Naohisa, Murakami Hideki, Nagamoto Yukitaka, Nakanishi Kazuo, Nishida Kotaro, Ohba Tetsuro, Okuda Shinya, Otani Koji, Suda Kota, Suzuki Nobuyuki, Takasawa Eiji, Terai Hidetomi, Tezuka Fumitake, Yamato Yu, Yukawa Yasutsugu, Kanemura Tokumi, Takaso Masashi, Takahashi Hiroshi
Nagoya University Graduate School of Medicine, Nagoya, Japan.
Meijo Hospital, Nagoya, Japan.
Eur Spine J. 2025 Jun 11. doi: 10.1007/s00586-025-08981-z.
To provide an updated analysis of perioperative complications, patient demographics, and surgical techniques in spinal surgeries across Japan and examine their impact on risk management.
Data were collected prospectively from 739 of 1,106 registered facilities across Japan using the JSSR database. All spinal surgeries conducted in November 2021 were included, capturing complications within 1 month post-surgery. Data analyzed included patient demographics, disease classification, surgical techniques, site, approach, and complications. Descriptive statistics determined complication rates and trends.
The survey included 11,559 surgeries (average patient age: 67.0 years). Degenerative diseases comprised 71.0% of cases. Posterior surgical approaches were predominant (87.9%), and minimally invasive techniques were widely adopted. The overall complication rate was 8.8%, with dural tears (2.4%) being the most common. Minimally invasive techniques improved outcomes but posed technical challenges, highlighting the need for advanced training and equipment.
Japan's aging surgical population and the adoption of minimally invasive techniques are evident. While complication rates remain stable, specific complications such as dural tears require targeted management. These findings underscore tailored surgical strategies for older patients and innovation in techniques, providing critical evidence for improving outcomes and informing healthcare policy in Japan.
对日本各地脊柱手术的围手术期并发症、患者人口统计学特征和手术技术进行最新分析，并研究它们对风险管理的影响。
使用日本脊柱手术登记数据库（JSSR），前瞻性收集了日本1106家注册机构中739家的数据。纳入了2021年11月进行的所有脊柱手术，记录术后1个月内的并发症情况。分析的数据包括患者人口统计学特征、疾病分类、手术技术、手术部位、手术入路和并发症。描述性统计确定了并发症发生率和趋势。
该调查涵盖了11559例手术（患者平均年龄：67.0岁）。退行性疾病占病例的71.0%。后路手术入路占主导地位（87.9%），微创技术被广泛采用。总体并发症发生率为8.8%，硬膜撕裂（2.4%）最为常见。微创技术改善了手术效果，但带来了技术挑战，凸显了先进培训和设备的必要性。
日本手术患者老龄化以及微创技术的采用情况明显。虽然并发症发生率保持稳定，但硬膜撕裂等特定并发症需要针对性管理。这些发现强调了针对老年患者的个性化手术策略和技术创新，为改善手术效果和为日本医疗政策提供关键依据。
