宫椎间盘关节整形在各种肥胖程度上是安全的
Manjot Singh1, Benjamin Chanes2, Mariah Balmaceno-Criss1
1Warren Alpert Medical School, Brown University, Providence, RI, USA.
The spine journal : official journal of the North American Spine Society
|November 29, 2024
概括
宫椎间盘关节整形术 (CDA) 对于超重和肥胖患者来说似乎是安全的,与健康个体相比,它表现出类似的医疗和手术并发症. 前椎间盘切除和融合 (ACDF) 可能会导致肥胖患者的并发症比CDA更多.
科学领域:
- 脊柱手术的结果 脊柱手术的结果
- 肥胖和手术风险 肥胖和手术风险
- 比较有效性研究比较有效性研究
背景情况:
- 宫椎间盘关节整形术 (CDA) 的适用范围正在扩大.
- 在超重和肥胖患者中,CDA的安全性和比较结果尚不清楚.
- 前椎切除和融合 (ACDF) 是一个常见的替代方案.
研究的目的:
- 评估不同的身体质量指数 (BMI) 类别的CDA结果.
- 在肥胖和超重人群中,将CDA结果与ACDF进行比较.
主要方法:
- 对12,454名CDA和45,513名ACDF患者 (2011-2020年) 的回顾性队列研究.
- 根据BMI分层的患者:健康体重 (<25kg/m2),超重 (25-30kg/m2),肥胖 (30-40kg/m2),致病性肥胖 (>40kg/m2).
- 在对年龄,性别和查尔森并发症指数 (CCI) 进行匹配后,并发症和修订进行了比较.
主要成果:
- 糖尿病和高血压等并发症随着BMI增加.
- 在90天后,BMI组的医疗并发症与BMI组相似.
- 2年后,健康体重患者的前置修订率更高;其他手术并发症类似.
- 与CDA相比,接受ACDF的肥胖患者的90天ED访问率和1年的硬件移除,伤口探索和后部融合率更高.
结论:
- 对于超重和肥胖患者来说,CDA是一种安全的选择,没有显著增加医疗或手术并发症.
- 在肥胖人口中,单级ACDF可能与单级CDA相比的并发症率更高.
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