Halperin Scott J, Dhodapkar Meera M, Gouzoulis Michael J, Varthi Arya, Rubio Daniel R, Grauer Jonathan N
From the Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT.
J Am Acad Orthop Surg Glob Res Rev. 2025 Jul 29;9(8). doi: 10.5435/JAAOSGlobal-D-24-00304. eCollection 2025 Aug 1.
Perioperative outcomes for patients with cystic fibrosis (CF) have not been previously described following spine surgery. This study used PearlDiver to examine the 90-day postoperative outcomes and 4-year revision rates after posterior lumbar fusion (PLF) for patients with CF compared with matched controls.
This study examined a cohort of PLF patients with versus without CF. Patients were matched 1:10 for age, sex, Elixhauser Comorbidity Index, and the number of levels. Ninety-day postoperative outcomes and 4-year revision rates were compared.
One hundred twenty-seven patients with CF were matched with 1263 controls without CF. On multivariable logistic regression, those with CF had statistically significantly increased 90-day odds of the following: venous thromboembolism (odds ratio [OR], 4.2), pleural effusion (OR, 3.4), dyspnea (OR, 3.2), respiratory failure (OR, 2.8), pneumonia (OR, 2.6), acute kidney injury (OR, 2.4), hospital readmissions, (OR, 2.2), and emergency department visits (OR, 2.1). Notably, patients with CF were not at increased odds of 4-year subsequent lumbar surgery.
Patients with CF were at significantly increased odds of pulmonary and other defined adverse events. These findings are pertinent in the perioperative risk assessment, patient/family recommendations, and surgical preparations for patients with CF being considered for PLF.
脊柱手术后囊性纤维化（CF）患者的围手术期结局此前尚未有过描述。本研究使用PearlDiver软件，对比匹配的对照组，对CF患者后路腰椎融合术（PLF）后的90天术后结局和4年翻修率进行了研究。
本研究对一组接受PLF手术的CF患者与非CF患者进行了研究。患者在年龄、性别、埃利克斯豪泽合并症指数和手术节段数量方面按1:10进行匹配。比较了90天术后结局和4年翻修率。
127例CF患者与1263例非CF对照组患者相匹配。在多变量逻辑回归分析中，CF患者在90天时发生以下情况的几率在统计学上显著增加：静脉血栓栓塞（优势比[OR]，4.2）、胸腔积液（OR，3.4）、呼吸困难（OR，3.2）、呼吸衰竭（OR，2.8）、肺炎（OR，2.6）、急性肾损伤（OR，2.4）、再次入院（OR，2.2）和急诊就诊（OR，2.1）。值得注意的是，CF患者在4年后进行后续腰椎手术的几率并未增加。
CF患者发生肺部及其他特定不良事件的几率显著增加。这些发现对于考虑接受PLF手术的CF患者的围手术期风险评估、患者/家属建议以及手术准备具有重要意义。
