术前宫外围注射类固醇:在ACDF,PCDF和减压中使用和术后并发症
Husni Alasadi1, Joydeep Baidya2, Yazan Alasadi3
1Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York.
Clinical spine surgery
|June 7, 2024
概括
在脊椎手术之前,术前宫外周类固醇注射 (CESI) 是常见的,但这项研究没有发现90天后并发症风险增加. 诸如年龄和诊断等因素影响了CESI的接收.
科学领域:
- 神经外科 神经外科
- 脊柱外科手术 脊柱外科手术
- 疼痛管理 疼痛管理
背景情况:
- 以前的研究表明,手术前的宫外周类固醇注射 (CESI) 可能会增加术后并发症的风险.
- 这些先前调查在审查的程序和并发症的范围上存在局限性.
研究的目的:
- 确定与接受CESI在前椎间盘切除和融合 (ACDF),后椎解压和融合 (PCDF) 或宫解压之前相关的因素.
- 评估CESI接收与90天术后并发症之间的联系.
- 确定与并发症相关的特定CESI特征.
主要方法:
- 使用IBM MarketScan数据库 (2014-2020) 进行的回顾性队列研究.
- 包括18岁以上的患者接受ACDF,PCDF或特定脊椎疾病的宫减压.
- 多变量逻辑回归分析了患者/注射特征与CESI接收/术后并发症之间的关联.
主要成果:
- 在手术前的CESI中,ACDF患者中有30.93%,PCDF患者中有22.24%,减压患者中有36.30%.
- 诸如老年,更高的并发症负担,吸烟和骨髓病的诊断等因素降低了CESI的几率.
- 女性性别和没有骨髓病的根细胞病变/脊髓病的诊断增加了CESI的几率.
- 在所有队列中,在手术前接受CESI和90天后术后并发症之间没有发现显著的关联 (P>0.05).
结论:
- 确定了CESI接收的关键决定因素.
- 术前CESI没有增加90天术后并发症的几率.
- 某些注射特征与不同的结果有关,需要进一步调查.
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