针对成人脊柱形进行正手术的老年患者中,急性和延迟的近端结节衰竭之间的不同特征:风险因素,衰竭模式和临床后果的比较分析
Se-Jun Park1, Jin-Sung Park1, Dong-Ho Kang1
1Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
概括
急性和延迟近端结节衰竭 (PJF) 有不同的风险因素和临床结果. 了解这些差异对于开发有针对性的手术策略至关重要,以改善脊柱形纠正后的患者结果.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 整形外科 整形外科 整形外科
- 生物医学工程 生物医学工程
背景情况:
- 靠近结节衰竭 (PJF) 是脊髓融合手术后的一个已知的并发症.
- 对于急性 (在6个月内) 与延迟 (6个月后) PJF的临床意义和独特的风险因素尚不清楚.
研究的目的:
- 为了确定急性和延迟PJF的单独风险因素.
- 为了比较急性和延迟PJF的发病率,失效模式和临床后果.
主要方法:
- 对363名患者 (≥60岁) 进行了回顾性比较研究,这些患者接受了脊椎形正,并进行了≥5级融合.
- 分析临床和放射性参数,以确定急性与延迟PJF的风险因素.
- 失败模式 (软组织,脊椎骨折,固定,骨髓病变) 和临床结果 (PJA,修订率,PROM) 的比较.
主要成果:
- 156名患者经历了PJF (87例急性,69例延迟).
- 急性PJF风险因素:年龄较大,骨质疏松症,高ASA得分,过度纠正. 延迟PJF的危险因素:高BMI,顶部仪器脊椎 ≤T10.
- 急性PJF的脊椎骨折和固定失败率较高;延迟的PJF有更多的软组织失败和骨髓病变. 急性PJF具有更具侵略性的临床过程.
结论:
- 急性和延迟PJF具有不同的风险因素和失败模式.
- 过度校正是急性PJF的危险因素,但不是延迟PJF.
- 需要量身定制的手术策略来解决急性和延迟PJF,以尽量减少并发症.
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