成年人脊柱形纠正手术的最高可实现结果:脆弱性严重程度是否具有天花板效应?
Peter G Passias1, Oluwatobi O Onafowokan1, Peter Tretiakov1
1Departments of Orthopaedic and Neurosurgery, Division of Spinal Surgery/NYU Langone Medical Center, New York Spine Institute, New York, NY.
Spine
|April 10, 2024
概括
虚弱会对ASD手术后的最大改善产生负面影响. 严重虚弱的患者显示初始收益,但总体结果的改善较小,这表明了天花板效应.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 老年人手术是一门老年手术.
- 患者的治疗结果.
背景情况:
- 脆弱性是影响成年脊柱形手术 (ASD) 结果的重要因素.
- 它可能会限制在纠正程序后获得最大改善的潜力.
研究的目的:
- 评估脆弱性如何影响ASD纠正手术后可获得的最佳结果.
- 了解虚弱状态和手术结果之间的关系.
主要方法:
- 一个回顾性单中心研究分析了393名ASD患者的脆弱度和2年的结果.
- 患者被分类为不脆弱 (NF),脆弱 (F) 或严重脆弱 (SF) 使用修改的脆弱指数.
- 后勤回归和卡普兰-梅尔曲线评估了脆弱性对奥斯韦斯特里残疾指数 (ODI) 评分和并发症的影响.
主要成果:
- 严重虚弱 (SF) 患者手术后病情恶化率最高 (16.7%).
- 虽然所有组都出现了改善,但SF患者最初的改善更大,但达到了天花板效应,与NF和F组相比,最大改善较小.
- 一个趋势表明,随着脆弱性增加,重大并发症或重新手术的时间更短.
结论:
- 增加的脆弱性会对ASD手术后的最大改善产生负面影响.
- 严重脆弱的患者经历了天花板效应,限制了他们的整体功能收益.
- 脆弱性可能会影响长期维持外科改善.
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