关节骨关节炎与经过跨腰椎体融合后的更高的修订率有关
Michael J Farias1, Manjot Singh1, Ashley Knebel1
1Brown University, Providence, USA.
概括
患有关节骨关节炎的患者接受了跨腰部体融合 (TLIF) 经历了更高的修订率和更糟糕的腿部疼痛结果. 综合性部和脊柱评估对于优化手术结果至关重要.
科学领域:
- 整形外科 整形外科 整形外科
- 神经外科 神经外科
- 退行性脊柱疾病 退行性脊柱疾病
背景情况:
- 同时的关节骨关节炎 (OA) 和腰椎病理增加了患者的残疾.
- 关节骨关节炎对转腰部体融合 (TLIF) 后的结果的影响还不清楚.
研究的目的:
- 评估先前存在的关节骨关节炎对TLIF后的结果的影响.
- 为了比较手术并发症和患者报告的结局措施 (PROMs) 在接受TLIF的关节OA和没有关节OA的患者之间.
主要方法:
- 在一个学术机构接受TLIF的患者的回顾性审查.
- 排除以前进行过全关节整形手术的患者.
- 在关节骨质炎和非关节骨质炎组之间对基线人口统计,一年后术并发症和PROMs进行比较.
- 多变量回归分析调整年龄,性别和查尔森并发症指数 (CCI).
主要成果:
- 患有关节骨关节炎的患者的修订融合率显着更高 (19.7%对6.0%,p=0.002),修订的几率是4.18倍.
- 关节骨关节炎患者报告说,手术后一年的VAS腿部得分较差 (5.04比3.95,p=0.005),腿部疼痛改善较小 (-1.61比-2.81,p=0.008).
- 在两组之间的其他PROM中没有发现显著差异.
结论:
- 关节骨关节炎与TLIF后的修订率增加和较差的腿部疼痛结果有关.
- 对部和脊椎疾病的综合护理对于手术决策和患者咨询至关重要.
- 多学科评估可能会改善关节和腰部病理综合症患者的术后结果.
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