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脊柱转移的最小侵入性稳定与开放性手术:使用倾向性得分匹配和权重灵敏度分析的回顾性研究.

Kamil Krystkiewicz1, Aleksander Kowal1, Agata Krajniak1

  • 1Department of Neurosurgery and Neurooncology, Copernicus Memorial Hospital, 93-513 Lodz, Poland.

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概括

至少侵入性脊柱稳定 (MISS) 显示较低的伤口并发症比开放后部稳定 (OPEN) 脊柱转移. 虽然在统计学上不显著,但MISS也趋向于更短的住院时间.

关键词:
转移性脊椎病的发生.微创脊柱手术是最少的入侵性脊柱手术.手术并发症 手术并发症手术部位感染 手术部位感染

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科学领域:

  • 神经外科 神经外科
  • 整形外科手术 整形外科手术
  • 在瘤学瘤学.

背景情况:

  • 最少侵入性脊柱稳定 (MISS) 越来越多地被用于转移性脊柱手术.
  • 在MISS和开放后部稳定 (OPEN) 之间进行比较的证据是有限的,特别是关于外科手术后期的结果.
  • 伤害相关的发病率是脊柱稳定程序中的一个关键问题.

研究的目的:

  • 在脊髓转移的患者中,比较MISS和OPEN后部稳定之间的术后结果.
  • 具体评估和比较两个手术方法之间的与伤口相关的发病率.
  • 评估二次结果,包括估计的血液损失和停留时间.

主要方法:

  • 追溯单中心队列研究71名脊髓转移患者进行后部稳定.
  • 患者被分为MISS (n=45) 和OPEN (n=26) 组.
  • 主要终点是伤口愈合障碍;非参数精确测试,调整分析和倾向得分匹配 (IPTW) 用于比较.

主要成果:

  • 伤口愈合障碍在MISS组 (6.7%) 与OPEN组 (30.8%) 相比显著较低 (p=0.014).
  • 手术部位感染 (SSI) 率在MISS (2.2%) 与OPEN (19.2%) (p=0.022) 中也较低.
  • 估计的血液损失在各组之间是相似的;在MISS中停留时间往往较短,但缺乏统计学意义.

结论:

  • 与转移性脊柱手术中微创脊柱稳定相比,开放的后部稳定与较高的未调整的伤口相关发病率有关.
  • 在这两种手术方法之间,血液损失没有显著差异.
  • 虽然MISS显示出短期住院的趋势,但对于最终的结论,还需要进一步的不足的研究.