晚年是否会对椎骨化后长度带的治疗结果产生负面影响? 一个前性的多中心研究
Narihito Nagoshi1,2, Satoru Egawa2,3, Kenichiro Sakai2,4
1Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku Ward.
Spine
|June 3, 2025
概括
与年轻患者相比,患有后纵带带椎骨化 (OPLL) 的老年患者在手术后表现出类似的神经改善. 然而,他们的上肢功能可能不会在术后显著改善.
科学领域:
- 神经外科 神经外科
- 老年医学 老年医学
- 整形外科手术 整形外科手术
背景情况:
- 人口老龄化需要了解与年龄相关的治疗结果,以治疗椎后纵带带 (OPLL) 的椎骨化.
- 关于退行性宫骨髓病的先前研究表明,老年患者的结果是可变的,对OPLL和患者报告的结果 (PRO) 的数据有限.
研究的目的:
- 评估手术对患有宫OPLL的老年患者的影响,重点关注患者报告的结果 (PRO).
- 为了比较老年 (≥75岁) 和非老年 (<75岁) 宫OPLL患者之间的手术结果.
主要方法:
- 一项前性多机构队列研究,涉及402名宫OPLL患者 (2014-2017年).
- 患者被分为老年人 (n=79) 和非老年人 (n=323) 组.
- 结果使用日本整形医学协会 (JOA) 评分,视觉模拟量表 (VAS) 和JOA宫骨髓病评估问卷 (JOACMEQ) 在手术前和2年后进行评估.
主要成果:
- 老年患者在基线神经功能 (JOA分数) 较差,但在手术后取得了相似的改善.
- 两组都超过了JOA得分改善的临床重要差异 (MCID) 的最低值.
- 虽然整体并发症率和VAS改善率相似,但老年患者在手术后表现出较差的上肢功能 (JOACMEQ).
结论:
- 患有宫OPLL的老年患者经历了与非老年患者相似的神经恢复,尽管基线功能较差.
- 老年人部OPLL的手术干预可能不会显著改善上肢功能.
- 需要进一步的研究来优化老年OPLL患者的手术策略,特别是关于上肢功能.
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