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手术前外围注射类固醇是否会增加宫椎间盘置换后手术后并发症的风险?

Zuhaad Hameed¹, Ved A Vengsarkar^1,2, Clare K Green¹

¹Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, 22908.

|April 24, 2025

概括

在宫椎间盘置换 (CDR) 之前进行术前的外周类固醇注射 (ESI) 会增加术后并发症,再入院和重新手术的风险. 接受ESI治疗的患者出现了更高的尿路感染率,复发性根性病变和修复手术.

科学领域:

神经外科神经外科
整形外科手术整形外科手术
麻醉学麻醉学

背景情况:

手术前的外周类固醇注射 (ESI) 是常见的宫脊椎问题.
以前的研究将ESI与前椎间盘切除和融合后的并发症联系在一起.
宫椎间盘置换 (CDR) 后ESI对结果的影响尚不清楚.

研究的目的:

调查手术前ESI和CDR后的术后并发症之间的关联.
评估ESI在CDR后对再接收和重新运营率的影响.

主要方法:

对PearlDiver数据库 (2010-2022) 的回顾性分析.
在手术前90天内,接受CDR的患者通过ESI使用进行了分层.
倾向性得分匹配被用来控制基线差异;结果包括90天的并发症,再入院和2年的重新手术.

主要成果:

在ESI组中,术后尿路感染 (3.2%对1.6%) 和复发性根性病变 (63.1%对16.1%) 的发生率显著更高.
在ESI组中,在2年内进行更改手术 (7.8%对2.4%) 和30天的急诊室访问 (6.2%对4.8%) 的比率更高.
在接受手术前ESI的患者中,再入院率在30天 (2.8%对1.1%) 和90天 (9.7%对2.0%) 显著增加.

结论:

在CDR90天内使用的术前ESI与术后并发症的增加有关.
在CDR之前使用ESI与更高的再接收和重新运行率有关.
这些发现表明需要重新考虑在CDR之前常规使用手术前的ESI.

关键词:

宫椎间盘置换术宫椎间盘置换术脊髓周围注射类固醇注射医疗保健利用率医疗保健利用率患者的治疗结果.术后并发症术后并发症根基病变是一种根基病变.重新运行率的使用率这是一项回顾性队列研究 (retrospective cohort study).脊柱外科手术脊柱外科手术尿道并发症尿道并发症

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