Male patients with adult spinal deformity: sex differences in demographics, radiography, and complications
Male patients with adult spinal deformity: sex differences in demographics, radiography, and complications
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DOI：
10.1007/s43390-024-01023-6
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发表时间：
2024-12-17
期刊：
影响因子：
1.800
通讯作者：
Yukihiro Matsuyama
中科院分区：
文献类型：
--
作者：
Xuepeng Wei;Go Yoshida;Tomohiko Hasegawa;Yu Yamato;Tomohiro Banno;Hideyuki Arima;Shin Oe;Koichiro Ide;Tomohiro Yamada;Kenta Kurosu;Yukihiro Matsuyama
本研究旨在调查成人脊柱畸形（ASD）手术中人口统计学、影像学和围手术期并发症的性别相关差异，该回顾性队列、单中心研究纳入了接受胸椎至髂骨长器械融合术治疗ASD的患者，随访至少2年。分析术前合并症、围手术期并发症和术后机械并发症的发生率，在323例患者中，ASD在女性中更常见（85.8%）。女性患者的T评分低于男性患者（−1.6 ± 1.1 vs.− 0.8 ± 1.0，<i>p</i>= 0.02）。与女性患者相比，男性患者的退行性脊柱后凸发生率较低（83.4% vs. 65.2%，<i>p</i>= 0.004），但神经肌肉疾病发生率较高（7.6% vs. 21.7%，<i>p</i>= 0.003）。男性患者表现出较高的心血管疾病患病率（4.0% vs. 13.5%，<i>p</i>= 0.034）和血液透析患病率（2.5% vs. 10.8%，<i>p</i>= 0.035）。此外，男性患者的Charlson合并症指数高于女性患者（0.8 ± 1.1 vs. 1.4 ± 1.1，<i>p</i>= 0.001）。此外，男性患者的手术部位感染围手术期并发症更高（5.1% vs. 15.2%，<i>p</i>= 0.018）。然而，近端交界失败（43.3% vs. 39.1%，<i>p</i>= 0.595）和棒断裂（27.8% vs. 26.1%，<i>p</i>= 0.81）的发生率没有差异。ASD男性患者表现出神经肌肉疾病、术前合并症和手术部位感染的频繁病理，需要仔细的术前检查和术中护理。
This study aimed to investigate sex-related differences in demographics, radiography, and perioperative complications in adult spinal deformity (ASD) surgeries.This retrospective cohort, single-center study enrolled patients who underwent long-instrumented fusion from the thoracic spine to the ilium for ASD, with a minimum follow-up of 2 years. The incidence of preoperative comorbidities, perioperative complications, and postoperative mechanical complications was analyzed.Of the 323 patients, ASD was more common in females (85.8%). The T-score in female patients was lower than that in male patients (−1.6 ± 1.1 vs.− 0.8 ± 1.0, <i>p</i> = 0.02). Male patients demonstrated lower rates of degenerative kyphoscoliosis (83.4% vs. 65.2%, <i>p</i> = 0.004) but higher rates of neuromuscular disease (7.6% vs. 21.7%, <i>p</i> = 0.003) than female patients. Male patients exhibited higher prevalence of cardiovascular disease (4.0% vs. 13.5%, <i>p</i> = 0.034) and hemodialysis (2.5% vs. 10.8%, <i>p</i> = 0.035). Additionally, male patients had a higher Charlson Comorbidity Index than female patients (0.8 ± 1.1 vs. 1.4 ± 1.1, <i>p</i> = 0.001). Moreover, male patients showed higher perioperative complications in surgical site infection (5.1% vs. 15.2%, <i>p</i> = 0.018). However, the incidence of proximal junctional failure (43.3% vs. 39.1%, <i>p</i> = 0.595) and rod fracture (27.8% vs. 26.1%, <i>p</i> = 0.81) was not different.Male patients with ASD demonstrated frequent pathology of neuromuscular disease, preoperative comorbidities, and surgical site infection, necessitating careful preoperative checkups and intraoperative care.